The Fertility Guide: The ART Procedures

There are two approaches used for egg retrieval: the vaginal approach using ultrasound guidance and the laparoscopic approach. The vaginal approach is used for IVF procedures and for the first part of the ZIFT procedure, while a GIFT procedure is done laparoscopically.

Vaginal egg retrieval is accomplished with the use of a long needle that can be precisely guided via vaginal ultrasound into each follicle within the ovary. The ovaries typically sit right at the top of the vagina, and the needle is simply placed through the wall of the vagina and into the ovaries; it doesn't go through the uterus or through the fallopian tubes. Each individual follicle is visualized, and the needle inserted into the follicle. A small amount of suction is then applied to the needle, and the contents of each follicle aspirated into a test tube. The test tube is then transferred to the laboratory where technicians examine the contents of the tube microscopically, isolate any eggs contained therein, evaluate them, and place them in an incubator.

General anesthesia is not required. Vaginal egg retrieval can be performed under sedation in an operating room setting, or in an office-type setting with simple use of oral pain medications. The latter approach is becoming increasingly more common because of the associated cost savings. A typical retrieval takes no more than 10 to 15 minutes. Some women may experience mild cramping after a vaginal egg retrieval, but most resume normal activity the same day of the procedure. While there are risks to any type of operative procedure, the risks associated with vaginal egg retrieval, including bleeding, infection, and damage to organs are absolutely minimal.

The whole goal of IVF is to achieve fertilization and early embryo development in the laboratory. Every step of this process must, therefore, mimic as closely as possible the environment that would normally exist in the fallopian tube. Embryo culturing (achieving the fertilization of eggs and early development of embryos) requires meticulous preparation of carefully designed media (the fluid in which the embryos will be maintained in the laboratory), the use of controlled environments within incubators, and painstaking attention to detail.