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Biggest Side Effects of IVF Egg Retrieval Blog Feature

By: Kirsten Hennigan on January 14th, 2020

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Biggest Side Effects of IVF Egg Retrieval

Congrats! You’ve made it to your egg retrieval! This is a huge deal and you should be so proud of all you have accomplished to this point. Between the scheduling, the precise measuring, and all of the injections, you’ve made it to your big day!

First, let’s describe what you can expect on your egg retrieval day. While this is a big day for your IVF journey, it’s still anxiety-inducing for many. Did I do everything correctly? Will I have a good amount of eggs? Will this hurt? The doubt and self-questioning can be endless. I’ll be explaining how we do things here at RMA of Connecticut. Your personal experience might vary slightly based on your practice’s protocol. Generally, though, the process should be very similar.

Okay, are you ready to live a virtual egg retrieval? Here we go!

What to Expect at Your IVF Egg Retrieval

You will be asked to check in to our Norwalk office approximately one hour before your scheduled procedure time. Once you’ve been greeted by our front desk staff, you will be taken back to our operating room, shown your private prep and recovery area (including bed, chair, and locker), and given a gown and cozy socks to change into. You will meet with our OR nurses who will go over paperwork and start your IV. You’ll also meet the anesthesiologist and the fertility doctor who will be performing your procedure that day. 

Please note, our doctors rotate through the operating room covering all seven days of the week. Therefore, you may or may not see your primary doctor on egg retrieval day. If your egg retrieval doesn’t happen with your primary doctor, don’t worry! He or she will be monitoring your progress remotely and getting updates throughout the day.

The egg retrieval is a relatively simple and safe procedure that averages 15 minutes from start to finish. Our anesthesiologist will administer medications through your IV so that you are comfortably asleep the whole time. Once asleep, the fertility doctor will place an ultrasound probe vaginally and look at your follicles on the monitor. This step is identical to what you experienced during those early morning monitoring appointments. 

Once your follicles are in clear view, the doctor will advance a thin needle through your vaginal wall and into the egg follicle. You can think of the egg follicle as a small water balloon filled with fluid and a single egg. The doctor will use a machine to apply gentle suction and drain the fluid from the follicle. This fluid is collected in a test tube, then handed to the embryologist who evaluates it under a microscope and counts any eggs that are collected.

This process of piercing the follicles with needles, draining fluid, and counting eggs, continues until all visible follicles are drained and the procedure is complete. You are then carefully transported back to your area where you will be monitored while you wake up. Most women feel woozy (slightly disoriented) from the anesthesia, and some will experience a sense of fullness or mild menstrual cramp-like discomfort. Very rarely do we need to administer anything more than Tylenol after the procedure. You will be monitored for approximately an hour, then sent home to rest for the remainder of the day. Nearly all of our patients are back to normal activities the next day. (We will call you to make sure.)

Normal Egg Retrieval Side Effects

So, let’s talk about the biggest side effects of this procedure. As mentioned above, women are typically ready to resume their normal activities by the next day. Here is a list of the common, more mild symptoms you may experience after egg retrieval:

  •       Bloating
  •       Spotting
  •       Feeling of fullness
  •       Constipation
  •       Cramping

Ovarian Hyperstimulation Syndrome: What is it and How do I Know if I Have it?

Often patients have questions about a very rare condition developed during the egg retrieval phase of IVF called Ovarian Hyperstimulation Syndrome, or “OHSS” for short. This is a medical complication that affects approximately 3% (or less) of women undergoing IVF each year. It occurs when the ovaries have an abnormally robust response to the fertility medications that we prescribe. A large number of egg follicles grow, the ovaries continue to swell, and eventually leak fluid into the pelvis. The good news is that with early diagnosis, and careful monitoring, this condition will resolve on its own within 7-10 days. Very rarely will a patient need to be admitted to the hospital for round the clock monitoring (in fact, I’ve only seen this twice in my 19 years as a nurse).

OHSS SYMPTOMS:

  •       Abdominal pain
  •       Nausea/Vomiting
  •       Abdominal tenderness
  •       Difficulty breathing
  •       Tight/enlarged abdomen
  •       Rapid weight gain
  •       Decreased urination

Are you an RMA patient and experiencing these symptoms?

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Keep in mind that during an IVF cycle, we are asking the ovaries to do something that they don’t typically do. The best way for me to explain this is with an elevated analogy…

THE FIRST LEVEL: A NORMAL MENSTRUAL CYCLE

Imagine there is a job opening at a company with ONE office available for ONE new employee to sit in. This is what we expect of your ovary during any given month; one egg follicle grows to full maturity in one ovary.

THE SECOND LEVEL: A TYPICAL IVF CYCLE

What if, however, after interviewing 45 candidates, human resources decides to hire 12 employees instead of just the one! Now there are 12 new employees that we need to find space for in one office. Luckily, it is a spacious corner office with enough room for a large conference table and chairs. Although cozy (and maybe a small amount of discomfort), we are able to fit all 12 employees in to the one office, and all works out well.

THE THIRD LEVEL: OVARIAN HYPERSTIMULATION SYNDROME

Imagine NOW, that instead of 12 employees being hired and squeezing into one office, that all 45 are hired! We can squeeze all 45 in the door, but they are scrunched tight, uncomfortable, literally pouring out into the hallway. This is what happens during OHSS.

While approximately 15% of IVF patients experience mild hyperstimulation symptoms, such as bloating and menstrual like cramping, most will never suffer from moderate or severe OHSS.

When To Call Your Doctor About OHSS Symptoms

Please know that as our patient you are ALWAYS welcome to reach out to us with questions or concerns. However, don’t be surprised if after your egg retrieval you don’t feel totally back to normal until your first period, which generally occurs 10 days after retrieval. 

Concerning symptoms and ones where we would definitely want to hear from you are listed above under the OHSS symptoms. Specifically, though, keep an eye out for vomiting, shortness of breath, >1lb weight gain in 24 hours, and decreased urine output. These are all signs that your ovaries are swelling and putting pressure on your diaphragm. After speaking with a nurse, we will generally bring you in to perform an ultrasound and bloodwork.

Luckily, it is rare for an OHSS case to catch us off guard. Based on your physical characteristics and hormonal bloodwork, we will know if you are at risk for OHSS before you even get started. If we suspect you are at risk, we will use special medications and change your protocol to greatly reduce your risk. We will also advise that you freeze your embryos and wait for your ovaries to recover before you attempt pregnancy.

If you have been identified at high risk for OHSS, we will advise you to eliminate exercise and avoid sexual intercourse. We will ask that you regularly update us and notify us immediately if your symptoms change. In order to decrease the amount of fluid that is collecting in your belly, we will ask you to avoid drinking large quantities of water/clear fluids, and rather stick with thick liquids (like milkshakes and V8 juice) that you can’t see through.

Your Fertility Team Has Your Back

In sum, while extremely rare, OHSS can happen. However, it won’t catch us off guard, and we have lots of helpful ways to get you through it safely and swiftly. Whatever your side effects, we will offer you the best tools so they subside, and you can focus on the next phase of IVF: The Transfer.

You’ve made it through some of the hardest parts of the process. From never-ending blood draws to self-injections, you are doing your best, and your fertility team is so proud of you. Congratulations, and good luck on your transfer! We will all be thinking about you and your growing family.


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About Kirsten Hennigan

Kirsten has been a nurse for 18 years. She earned her Bachelor of Science in Nutrition from Cornell University in 1999 and went on to earn both her Bachelor and Master of Science in Nursing from the University of Pennsylvania in 2002. Her entire nursing career has been in women’s health, first as a nurse practitioner in general gynecology in Philadelphia. She moved to London in 2006 and worked as a fertility nurse on Harley Street. After a move to Tokyo and a short stint as a nurse practitioner in Manhattan, she landed at RMA of Connecticut in 2014. Kirsten’s favorite part of working at RMA is helping patients gain trust in us and watching their transition from feeling broken to feeling empowered with options. She feels very privileged to play a part in that transition. The most shocking fact about Kirsten is that she doesn’t watch television. She hears all about different shows during morning monitoring but has never seen a single episode!