Finally, the day will come when Dr. Springer will determine that the eggs are “ready”, that is, the majority of eggs are ripe for harvesting. Although there are always exceptions, his general guidelines for determining the appropriate time for retrieval are: there are at least 2 follicles 18mm or greater in size, half or more of all the follicles are at least 15mm and Estradiol levels are between 1500 and 5000. These values refer to measurements and blood levels taken on the last day of stimulation – not on the day of retrieval. As a matter of fact, we usually don’t take nay blood on the day of retrieval.

Despite the fact that the eggs are “ready” they are not yet truly mature. In order for each follicle of 15mm or more to produce a mature egg, a final injection must be taken. This final shot is called HCG. For the first 36 to 40 hours after the HCG shot is taken, the larger eggs will go through their final maturation process. It is essential that eggs be allowed this final maturation process. It is essential that eggs be allowed this final maturation; otherwise, they would be incapable of being fertilized. On the other hand, it is vital that not more than 40 hours pass after the HCG shot. Sometime after 40 hours, if not retrieved, the eggs will “ovulate”, that is they will be expelled out of the ovary and lost in the abdominal cavity and there will be nothing to retrieve. Thus, it is vital that the HCG shot be taken exactly as instructed. Dr. Springer will time the HCG shot and retrieval precisely 36 hours apart. A couple of hours either way will do no harm, but more than that could seriously jeopardize the chance for success.

Retrieval will be scheduled 36 hours following. An Egg Retrieval is a minor surgical procedure performed by inserting a needle through the upper vaginal wall directly into the ovary. Dr. Springer performs this procedure under direct ultrasound guidance, so that he visualizes the location of the follicle and actually sees the needle enter the follicle and aspirate the fluid and egg. After aspiration of each follicle, Dr. Springer passes the fluid filled test tube to our embryologist in the IVF laboratory. The procedure takes anywhere from 20 to 45 minutes depending on the number of follicles.

Our patients arrive at our IVF Center approximately one hour before the scheduled time of retrieval. Anesthesia services are provided by Ideal Anesthesia, and they administer a mild but very effective intravenous anesthetic prior to retrieval. The procedure is painless and most patients are awake within minutes after Dr. Springer has finished. Recovery in our center is usually about a half hour, after which our patients are sent home. Other than feeling a little sleepy form the anesthesia, most of our patients do very well and need no pain medication.

Although most follicles contain an egg, it is not unusual for one of several follicles to be “empty”. The eggs contained in the smaller follicles (14mm or less on the day of HCG) are often immature and difficult to fertilize. After our embryologist has received the contents of all the follicles from Dr. Springer, she examines them microscopically and identifies and then isolates all of the eggs. It is at this time, shortly rafter the conclusion of the egg retrieval, that we ask the male partner to produce a semen sample.