Egg Retrieval Anesthesia: A Fertility Clinic Surgeon Answers FAQs
September 22nd, 2023 | 14 min. read
As you prepare for your IVF egg retrieval, you may be wondering: What kind of sedation or anesthesia will be used for my egg retrieval? What measures are in place to ensure I remain comfortable? Get answers to all these questions and more, straight from an experienced surgeon at a fertility clinic.
In this article:
- Your Safety & Comfort Are Our Priority
- What to Expect at Your Egg Retrieval
- Our Surgical Team & Safety Measures
- Egg Retrieval Anesthesia FAQs
- What anesthesia is used for egg retrieval?
- How are pain medications like fentanyl secured at Illume?
- Who administers anesthesia during egg retrieval?
- Is there any chance I'll wake up during my retrieval?
- Patient/Physician Communication
- A Note From Our Patient Advocate
- Your Voice Matters
Your Safety & Comfort Are Our Priority
As the Surgical Director at Illume Fertility, my priority is making sure that each patient has a safe, comfortable, and successful surgical procedure. We pride ourselves on maintaining an exceptionally high standard of care, strict safety protocols, and excellent communication between every team member involved in the process.
With conversations increasing around egg retrievals, anesthesia, and pain management, we want to offer a transparent look at Illume's approach to addressing patient concerns, as well as our medication protocols, security measures, and other important aspects of your IVF journey.
In this in-depth guide to egg retrieval sedation and anesthesia, we will walk through each step of the process to help you feel more prepared and confident about the entire experience.
What is an egg retrieval? This minor surgical procedure is one of the biggest milestones in an IVF cycle - performed to carefully collect eggs from the ovaries.
What to Expect at Your Egg Retrieval
When you come in for your egg retrieval at Illume Fertility, you will be arriving at one of the best IVF surgical suites in the U.S. Our beautiful, state-of-the-art facility is welcoming, fully-equipped, and modern.
Before Your Procedure
After you get settled, your assigned surgeon (one of our eight board-certified reproductive endocrinologists) will introduce themselves to you. They will review your medical history and your stimulation sheet to try to predict how many eggs they think they will be able to retrieve.
They will also explain what you can expect in the operating room and go over exactly who will be in the room with you during your egg retrieval. You will also meet your nurse anesthetist, three surgical suite nurses, and our operating room coordinator.
Each member of the team is there to make you feel comfortable and safe. If you're feeling nervous, don't be afraid to communicate that (or tell your nurse in advance of your retrieval day so we can give you extra attention). You've got this!
After Your Procedure
Soon after you wake up, your surgeon will be able to tell you how many eggs were successfully retrieved during the procedure. You will then be monitored by one of Illume's highly-skilled nurses as you rest in our recovery area.
Most patients are able to go home around 1.5 hours after their egg retrieval is completed.
Will I be in pain after my egg retrieval?
The vast majority of patients will experience some cramping and spotting that night, but should only require Motrin for any discomfort. It is very rare to need anything stronger than Motrin for pain control.
The Day After Egg Retrieval
Your Care Team will call you to let you know how many of your eggs successfully fertilized in the IVF lab overnight, as well as check in to see how you are feeling after your retrieval.
Three days later, your physician will call you to check in again and review Day 3 embryo development, followed by a call on Day 7 to review the number of embryos we were able to biopsy and freeze if you've opted for preimplantation genetic testing (PGT).
Our Surgical Team & Safety Measures
At Illume Fertility, we have developed a standard procedure that we follow before beginning any procedure in our onsite surgical suite, which includes egg retrievals, hysteroscopies, and D&Cs. This is a reliable way of making sure each member of the Care Team (as well as you, the patient) are ready for a successful procedure.
We begin with an introduction of all of the providers in the room. For example, the surgeon performing the procedure will introduce themselves, followed by a clear identification of our medical assistants, and lastly, our anesthesiology provider.
After Care Team introductions, the patient's identity will be verified. The team will make sure there are no additional concerns to discuss, address any need for antibiotics, and ask the patient about any potential allergies. Everyone must be in agreement and ready to begin before anesthesia is administered.
Will my primary physician perform my egg retrieval? The answer to this question depends on the week's procedure schedule, since each of our eight physicians rotate through the operating room. Your nurse will usually be able to confirm who your surgeon will be prior to egg retrieval day. Rest assured that all of our physicians are equally skilled surgeons who will take excellent care of you!
Egg Retrieval Anesthesia FAQs
Is your head swirling with questions? We get it!
This is an intricate, personal experience that requires a high level of trust and vulnerability. To help you feel more confident about your upcoming egg retrieval, let's tackle some of the most common questions we get from our IVF patients.
What anesthesia is used for egg retrieval?
At Illume Fertility, we utilize two medications called fentanyl and propofol to ensure patients remain comfortable and sedated during egg retrieval. Here's how these medications work:
Fentanyl
Our anesthesia team will first administer fentanyl, which will decrease any discomfort that may occur when the propofol is started, and will keep you pain-free throughout the entire procedure.
Propofol
The anesthetist will then administer propofol, a medication that induces relaxation and sedation. It works very quickly - within minutes. Propofol causes deep sleep while still allowing the patient to breathe easily on their own (meaning no intubation is required).
Working together, fentanyl and propofol offer excellent sedation and pain relief during your egg retrieval. After the procedure has been completed, you will wake up quickly and spend time being monitored by our nurses in the recovery area of our onsite surgical suite.
In Illume's 20 years, all of our patients have had a completely pain-free experience with this combination of medications - many even refer to it as "the best nap ever!"
How are pain medications like fentanyl secured at Illume?
We pride ourselves on our strict medication management policy. All medications (such as fentanyl or propofol) are kept in a locked location. Our operating room nurses and anesthetists make sure these medicines are secured at all times.
Our nurse manager and anesthetist make sure that all medicines are handled according to state regulations and tracked in a log book which is available to the state of Connecticut during regular inspections.
Each morning, our nurse manager opens the medication lock box, allowing the anesthetist to access the needed medications. All medications are accounted for every day and cannot be tampered with.
Who administers anesthesia during egg retrieval?
Here at Illume Fertility, anesthesia is administered by our nurse anesthetists. These highly-skilled professionals undergo extensive training for 7-10 years and a comprehensive vetting process before being cleared to work with patients.
Our nurse anesthetist team have incredible biographies and training. They provide excellent anesthesia care, making sure that each patient is comfortable and experiencing zero discomfort throughout the procedure.
Is there any chance I'll wake up during my retrieval?
No, you will not be awake at all during your egg retrieval, and your team will be monitoring you closely the entire time to ensure your body isn't showing any signs of discomfort. If at any point your anesthetist notices any subtle movement or other signals, they will administer additional anesthesia to keep you comfortable.
Fun fact: Egg retrievals only take about 10 minutes to complete!
What if something goes wrong during my retrieval?
During any surgical procedure, the anesthetist, surgeon, and medical assistants ensure that everything is going smoothly and the patient's needs are always attended to. We understand the trust placed in our team and take that responsibility seriously.
Due to the routine nature of the egg retrieval procedure, it is extremely rare that any problems will arise. However, our team is prepared to safely manage any situation if needed.
If there are ever any concerns in the operating room, they are immediately brought to the attention of the surgical director and operating room nurse manager.
Patient/Physician Communication
While we've never had an occurence of a patient waking up or experiencing pain during egg retrieval, we always work to prioritize good communication and maintain a high level of trust.
Whenever a patient voices concerns or states that they are in pain, those concerns are immediately addressed. We have an open system of internal communication at Illume which encourages each member of your team to know how to advocate for you.
Any issues are then brought to the physician in charge so we can help determine what needs to be done. Our patients' physical and emotional comfort is of the utmost importance to us, as we know this is both a stressful and hopeful time.
In addition to our clinical safeguards and collaborative care model, we are one of the only fertility clinics in the country that offers an in-house Patient Advocate. Lisa Rosenthal has been a core member of our practice for over 17 years, working closely with patients to ensure they feel heard, respected, and taken care of.
Keep reading for some excellent self-advocacy tips from Lisa, her take on why some patients dismiss their own feelings during treatment, who to turn to when your team isn't the right fit, and more.
A Note From Our Patient Advocate
Fertility treatment is a complex medical journey, but it isn’t just that - it’s also an emotional one that holds all your hopes and dreams of having a baby. That's why we strive to maintain excellent communication (both between our teams and with our patients), offer a variety of support, and remain transparent about the entire process.
Here are a few ways we work to achieve those goals:
Collaborative Care
We prioritize this by assigning a comprehensive Care Team to each and every patient. The core members of this team include your patient navigator, finance advocate, fertility nurse, and board-certified reproductive endocrinologist, but we also have additional supports in place to ensure you feel heard and cared for throughout your time with us.
Regular Check-Ins
Our Patient Experience Team includes warm, caring professionals like Tina Steadman, who has been with Illume for over 16 years. Tina calls patients to offer personal check-ins at several key points in the journey, including before and after egg retrievals, embryo transfers, and surgical procedures.
Her job is to ensure that each patient feels prepared and confident going into each big milestone - as well as comfortable and cared for afterwards.
Patients are able to ask Tina questions, like "Who will be performing my embryo transfer?" or "What should I expect after my egg retrieval?" and walk through all the logistics of their upcoming procedure - step by step. She answers each query with care and provides patients with reassurance, while giving them room to take a deep breath. Thanks to Tina, we frequently hear how at ease and prepared our patients feel on the day of their procedure.
Dedicated Patient Advocate
As Illume's designated Patient Advocate, I am also a part of each patient's team.
Available by phone (203-354-1157) or email at any point during your journey (yes, even nights and weekends), I am here to listen when you are feeling lost, disempowered, or frustrated. When given express permission, I am also able to act as a liaison between you and your Care Team, sharing feedback and concerns so we can get any challenges resolved together.
Remember: If at any time you feel unable to communicate with your team directly, please reach out to me for support! I'm always here to help.
Common Fertility Patient Concerns
What makes it so hard to tell our healthcare providers that we’re experiencing pain or have hard questions to ask, especially as it pertains to fertility treatment? Well, many things - including wanting to get through treatment without more delays, feeling unsure about who to talk to about your concerns, and feeling anxious about how you'll be perceived by your team.
Here are a few worries that real fertility patients have shared:
- "I just want to get through treatment with as little conflict as possible."
- "When I ask too many questions, I hear annoyance or I get short answers that don’t really answer my questions anyway."
- "My team is professional and clinically perfect, but just aren’t as compassionate as I would like...how am I supposed to change that to get what I need?"
Am I being too difficult?
This is such a frustrating process - add in a chaotic mix of hormones, unexpected test results, procedures, injections, and roadblocks...it's only natural that all of this would lead to disappointment, sadness, or even anger. It's okay to feel all of those emotions!
The only real way to be a "difficult" patient is by not expressing those feelings to your team in a timely, respectful manner. Don't forget that your team wants you to feel confident and comfortable throughout treatment. We are here to help, so be sure to tell us what you need.
How to Get What You Need
With all of this in mind, here are some questions to consider: Have you let your team get to know you? Have you told them what you need to feel comfortable? Have you been vocal about any discomfort or frustration?
Remember: Communication works both ways. Please don’t suffer in silence, and speak up whenever something doesn't feel right. Staying silent isn't a healthy solution, and can lead to further resentment and/or anxiety.
As the patient, you are the most important person in the equation.
Your Care Team works for you, and you should feel comfortable raising concerns to them at any point during your journey. If you feel that you are being dismissed or not getting the attention you need, don't be afraid to say it.
When that doesn't feel doable, try writing down a list of the things you’re upset or worried about. Make use of any support resources your fertility practice offers (like support groups, patient advocacy, and counseling). Reach out, advocate for yourself, and be proactive.
Why do we diminish our pain?
We live in a society that encourages us to downplay our feelings and "suck it up" - and that can be especially true for women, people of color, and LGBTQ+ folks.
There is also a complicated dynamic at play when it comes to medical spaces. Patients may feel that their healthcare provider is the complete authority, and feel uncomfortable questioning their actions.
However, you are the only one who can accurately report how you feel, what your symptoms are, what you need, and how you’re doing. You are the only one living in your body. You are the only one who can accurately assess your pain or discomfort.
With that said, here are three key things to remember:
- Don't second guess yourself
- Trust what your body is telling you
- Believe that you are worthy of attention
Working with Your Care Team
More communication is always better than less, so push past the fear that you might be bothering your team. They cannot help you unless they know how you're feeling. If you ever feel that you aren't receiving the level of care you deserve, speak up.
We've created some excellent guides for patients on how to self-advocate, which may be helpful to you as you navigate your fertility journey:
- A Fertility Clinic Team Reveals Their Best Tips for Patients
- How to Be an Empowered & Effective Fertility Patient
- 20 Experts Share Ways to Advocate for Yourself On a Fertility Journey
Your Voice Matters
We hope that this guide to egg retrieval anesthesia and Lisa's tips on how to advocate for yourself are helpful tools to reference throughout fertility treatment. Your experience is important to us, and we will do everything in our power to make it as smooth as possible.
Whether you are preparing for a big milestone like an egg retrieval or getting ready for a routine appointment, always honor your own intuition, and speak up whenever something doesn't feel quite right. Do this knowing that your Care Team is here for you, and wants you to feel empowered and comfortable throughout this process.
We wish you all the best on your fertility journey!
Dr. Spencer Richlin is the Surgical Director at Illume Fertility, having joined the team in 2004. He is board certified in both Reproductive Endocrinology and Obstetrics and Gynecology. In addition to helping patients achieve their fertility and family-building goals, Dr. Richlin is a passionate advocate for increasing access to fertility care and raising awareness for men's health issues.