During an In-Vitro Fertilization (IVF) cycle, a woman’s eggs are removed and fertilized outside of her body. A few days later, the best one or two are then introduced to her uterus, where they will hopefully implant into her uterine lining and grow into a healthy baby. The process of removing the eggs is called “oocyte retrieval”, or sometimes “egg collection”.
After the suppression / down-regulation phase and during the stimulation phase of a long protocol IVF cycle (or, during the stimulation phase of a short IVF protocol), an IVF doctor will monitor closely with ultrasound how the uterine lining and follicles are developing. Once the uterine lining is ready (usually about 7 mm thick), and once a majority of the follicles are ready (usually measuring about 18 mm), the doctor will order a “trigger shot”. This is an injection of Human Chorionic Gonadotropin (HCG), which helps finalize the growth and maturation of the eggs. The timing of this trigger shot is important – the IVF doctor will retrieve the eggs from the follicles just before ovulation would occur (about 24-36 hours after the trigger shot). Reproductive endocrinologists like to retrieve as many eggs as they can, since the more eggs are collected the more likely some viable embryos will be created.
Ooocye Retrieval – Egg Collection Day
Although this procedure is perhaps one of the more “invasive” parts of an IVF cycle, a local anesthetic and possibly an intravenous sedative will help ease any discomfort. Guided by a small ultrasound, a needle is passed through the vaginal wall and into each developed follicle. The fluid inside each follicle is aspirated out, then given to an embryologist who separates the mature eggs from the fluid. Once all of the follicles on one ovary are aspirated, the needle is withdrawn and the procedure is repeated on the opposite side. The woman is allowed to recover for a while in the IVF clinic before being sent home to rest.
Shortly after the eggs are isolated, they are combined with a man’s sperm. Embryologists watch for fertilization, cell division, and the general quality (based largely on appearance) of each egg. After a few days, one or two of the fertilized eggs (now considered to be embryos) are selected to be transferred into the woman’s uterus. Any remaining embryos may be frozen, and can be used for future transfers a week, a month, or even several years later.
Ooctye Retrieval and Acupuncture
Even if a woman has been receiving acupuncture in the weeks or months before egg collection, in most cases Chinese medicine is not used on the actual day of egg retrieval. Since the oocyte retrieval process causes some bleeding from the aspirated follicles, the goal after the procedure is to minimize any trauma and blood loss. Increased blood flow to the ovaries and uterus is not necessary (or desired) at this particular time.
There are some rare cases, however, where a woman is not able to take the anesthetic which is usually used during the ooctye retrieval. For these cases, and also to explore any relationship between the method of pain management used during egg collection and pregnancy rates, studies have been completed to examine whether acupuncture can be used during an ooctye retrieval when no anesthetic is used. The results of these studies (two of which you can find by clicking here or here) suggest acupuncture may be helpful as a method of controlling pain during oocyte retrieval if anesthetic is not used.
