During this webinar, Dr Cristina Gavilán, Fertility Specialist at Instituto Bernabéu Palma de Mallorca, explained the egg retrieval process and shared practical insights for patients. Dr Gavilán discussed: Step-by-step procedure of egg retrieval, the main risks and how they can be minimised, what patients can expect during recovery and average recovery times, tips on how to prepare physically and emotionally and more.
Egg retrieval is a central step in IVF treatment and often one of the most anticipated and anxiety-provoking moments for patients. In this educational session, Dr Cristina Gavilán explained the procedure in detail, from ovarian stimulation to recovery, highlighting what patients can realistically expect and why understanding each step matters.
Dr Gavilán began by explaining how egg retrieval fits into the natural ovarian cycle. In a normal menstrual cycle, several follicles begin to develop in the ovaries, but only one typically reaches ovulation. The remaining follicles regress naturally.
IVF stimulation changes this natural selection process. Through daily medication, doctors encourage all follicles that are already present and ready in that specific cycle to continue growing. The goal is not to create new follicles, but to support those that would otherwise stop developing.
During stimulation, regular ultrasound scans are used to monitor follicular growth. On ultrasound, follicles appear as black, fluid-filled structures. Inside each follicle there may be an egg, although eggs themselves are microscopic and cannot be seen on imaging.
As follicles grow, patients attend several monitoring appointments. Dr Gavilán explained that this allows clinicians to track both the size and number of follicles and adjust medication if necessary.
Approximately 36 hours before egg retrieval, a final injection, often referred to as the trigger shot, is administered. Depending on the patient’s characteristics and protocol, this may be hCG-based or use a GnRH agonist. The purpose of this injection is to induce final maturation of the eggs, preparing them for fertilisation.
Timing is critical. Egg retrieval is scheduled very precisely after the trigger injection to maximise the chances of collecting mature eggs.
Egg retrieval, also called ovarian puncture, is performed under ultrasound guidance using a transvaginal approach. Dr Gavilán described this as a very precise technique, as the ovaries are usually positioned close to the vaginal wall after stimulation.
On the day of the procedure, patients arrive at the clinic after fasting for approximately six to eight hours. An intravenous line is placed to allow sedation and monitoring. The procedure is typically performed under light sedation rather than full general anaesthesia, which allows for a quick recovery.
Sedation means the patient does not feel pain during the procedure, but waking up is fast and smooth, Dr Gavilán explained.
Using the same type of ultrasound probe used during monitoring scans, the doctor guides a very fine needle through the vaginal wall and into each follicle. The fluid inside each follicle is gently aspirated and immediately passed to the embryology laboratory.
While the procedure itself takes place in the operating room, embryologists work in parallel in the laboratory. Each tube of follicular fluid is examined under a microscope to identify whether an egg is present.
Dr Gavilán emphasised an important point for patients: not every follicle necessarily contains an egg, and not every egg retrieved will be mature.
It is very important to understand that follicles are not eggs, eggs are not embryos, and embryos are not babies, she explained. We need numbers because fertility treatment is a process of selection.
This realistic perspective helps patients understand why retrieving a higher number of eggs improves the chances of eventually achieving a healthy pregnancy.
The egg retrieval procedure itself is relatively short. Dr Gavilán explained that it usually lasts between 10 and 15 minutes. The doctor accesses each follicle one by one, first in one ovary and then in the other, aspirating all visible follicles.
Throughout the procedure, ultrasound guidance ensures that surrounding organs, such as the bowel or blood vessels, are avoided as much as possible.
After the procedure, patients are moved to a recovery area where they are monitored until they are fully awake. Vital signs are checked, pain levels are assessed, and fluids are gradually introduced.
If needed, pain relief medication is provided. Patients are encouraged to eat lightly and are discharged only once they feel well, can urinate normally, and show no signs of complications.
Dr Gavilán highlighted that, beyond checklists and monitoring, how the patient feels is crucial. Visual assessment and communication play an important role in deciding when a patient is ready to go home.
Once home, patients are advised to rest for the remainder of the day. A light diet is recommended, and pain relief such as paracetamol or ibuprofen can be taken if necessary. Aspirin is not recommended after egg retrieval.
Most patients can return to normal daily activities within a couple of days. Dr Gavilán advised contacting the clinic if symptoms such as severe pain, fever, or heavy bleeding occur.
Egg retrieval is generally considered a safe procedure, but Dr Gavilán clearly outlined potential risks so patients can recognise warning signs.
Minor bleeding can occur during or after the procedure. Because several organs are located close to the ovaries, there is a small risk of injury, although ultrasound guidance significantly reduces this possibility.
In very rare cases, significant bleeding may require additional intervention. Patients are therefore monitored carefully before discharge.
One of the more serious risks associated with ovarian stimulation, rather than the retrieval itself, is ovarian hyperstimulation syndrome. This condition occurs when the ovaries respond excessively to stimulation medication.
After egg retrieval, fluid may shift into other parts of the body, requiring close monitoring. Most cases are mild and managed on an outpatient basis, but hospitalisation may occasionally be necessary.
Dr Gavilán stressed that with modern stimulation protocols and careful monitoring, severe OHSS has become much less common than in the past.
Beyond the physical procedure, Dr Gavilán addressed the emotional side of egg retrieval and fertility treatment. Anxiety before the procedure, fear of results, and emotional exhaustion are common experiences.
Our priority is not only medical safety, but also emotional support, she explained. Patients must feel confident to speak openly if they feel anxious or unwell at any point.
Open communication with the medical team before and after egg retrieval helps ensure both physical recovery and emotional well-being.
Egg retrieval is a carefully controlled, well-established procedure that plays a vital role in IVF treatment. Understanding how it works, what the risks are, and what recovery looks like can help patients approach this step with greater confidence and realistic expectations.
As Dr Gavilán concluded, fertility treatment is a shared journey between patient and medical team, with trust, communication, and support at its core.
The procedure itself is not painful because it is performed under sedation. Patients do not feel pain during the egg retrieval. Some women worry about hearing or feeling things during the procedure, but with current sedation methods, this does not happen.
Before the procedure, after ovarian stimulation, the ovaries are enlarged, so it is normal to feel discomfort similar to ovulation pain or menstrual pain. During the procedure, patients usually feel very comfortable. Afterwards, many women feel relieved because the pressure in the ovaries decreases, although mild menstrual-like discomfort can occur. Recovery is usually fast.
Yes, bloating is common and depends largely on the size of the ovaries. With ovarian stimulation, if many eggs are produced, patients usually experience more symptoms, including bloating and slower recovery. On the other hand, women with very low ovarian reserve often go through stimulation and retrieval with fewer symptoms, less bloating, and quicker recovery, but they also retrieve fewer eggs.
There is always a balance between having more eggs and having more symptoms.
No specific diet is required. Patients should continue their usual diet. It is recommended to avoid very heavy meals before the procedure. As the ovaries grow, the body naturally prefers lighter meals. A normal, balanced diet is sufficient.
Recovery time is very individual. Some patients feel well enough to travel the same day, including flying home, especially international patients. Others may still feel discomfort a week later.
On average, most patients return to normal within two to five days. Intercourse and heavy exercise are not recommended for 5 days. Swimming or baths should be avoided for 2 to 3 days. In most cases, normal daily activities can be resumed within a few days.
Follicular flushing is a technique used when an egg is not retrieved from a follicle initially. The follicular fluid is aspirated, then flushed back into the follicle and aspirated again. This can help release an egg that may be attached to the follicle wall.
Studies show mixed results. Some indicate that flushing increases egg numbers, others show no benefit, and some suggest higher complication rates. For this reason, flushing is not routinely used. It may be considered in women with low ovarian reserve who have only two or three follicles. It is not recommended for ovaries with many follicles because it prolongs the procedure and may increase the risk of complications. The decision is always personalised.
Egg retrieval is a very safe procedure, and complications are rare. The most common risk is bleeding because a needle is inserted into the body. Minor bleeding usually stops on its own because the needle is very thin.
Bleeding can occur externally or around the ovary. In approximately 95% of cases of internal bleeding, observation is sufficient. In about 5% of those cases, another procedure may be needed to stop the bleeding.
The risk of significant bleeding is estimated at about one in 10,000 egg retrievals. Certain patients may have a higher risk due to medical conditions or increased blood vessels around the ovaries. All patients receive full information and provide informed consent before the procedure.
If egg retrieval is performed properly and all accessible eggs are collected, natural pregnancy immediately afterward is unlikely. However, sometimes a follicle may remain if accessing it would carry a high risk of bleeding. In theory, pregnancy could occur, but it is extremely rare.
For safety and recovery reasons, patients are advised not to have intercourse for several days after egg retrieval.
No, egg retrieval does not damage the ovaries when performed without complications. During natural ovulation, the ovary ruptures to release the egg. In egg retrieval, very fine needles are used to aspirate follicular fluid without removing ovarian tissue.
The ovaries have a strong ability to heal. Even when they appear very large after stimulation, they usually return to normal size within a week. No scarring is typically seen, even during later surgeries. Ovarian damage is more associated with the surgical removal of ovarian cysts, not egg retrieval.
The most important advice is for patients to communicate openly with their doctor. Patients know their bodies best. Any symptom, concern, or feeling that does not seem normal should be shared.
Emotional wellbeing is also very important. Anxiety, expectations, and disappointment about egg numbers can strongly affect recovery and overall experience. Taking care of both physical and emotional health is essential throughout egg retrieval and the entire IVF process.
