Definition and Overview

Also known as transvaginal ovum retrieval, the extraction of egg cells is part of in vitro fertilisation (IVF), a popular type of artificial reproductive technology (ART). The procedure involves extracting egg cells from the ovaries so they can be fertilised outside of the body. It can harvest eight to 15 egg cells and in most cases, some of the collected eggs are stored for future use.

Who Should Undergo and Expected Results

Females who cannot conceive through sexual intercourse or natural means can opt for an egg cell extraction to facilitate in vitro fertilisation. The procedure can also be performed for patients who want to donate their egg cells to another person who cannot conceive or is infertile. In recent years, more and more are undergoing this procedure to preserve their healthy ova for fertilisation and conception at a later date.

Patients diagnosed with cancer can also opt for this procedure as cancer treatment can affect their fertility.

How is the Procedure Performed?

The process might sound simple and straightforward, but egg cell extraction is actually a complex procedure that requires careful planning, operation and monitoring.

Before the procedure

Following a consultation with an obstetrician and gynaecologist (OBGYN), a patient is required to make necessary preparations for the procedure. This may include following a recommended diet and making lifestyle changes to ensure the optimum health of egg cells. Oral or intravenous fertility medication can also be prescribed to ensure that the highest possible amount of healthy egg cells can be harvested during the extraction procedure.

During the procedure

The egg extraction will be performed in a fertility clinic or a hospital with the required facilities. The patient will be provided with a hospital gown, cap and foot covers to prevent contamination of the facility.

An embryologist, or the qualified medical professional that handles the embryos, egg cells and sperm for a subsequent IVF procedure, will come in to record the patient’s information to ensure that there will be no mix up once the egg cells are extracted and stored. General anaesthesia or sedatives will be administered followed by an IV drip for medication or provision of fluids in the event of an emergency.

A speculum will then be inserted into the patient’s vagina. The doctor will thoroughly wash the patient’s genital area to ensure that the harvested egg cells will be free from bacteria and other contaminants.

The patient will be hooked up to a machine for a vaginal ultrasound probe, which will guide the doctor throughout the extraction process. This probe, which has a needle and a hollow tube attached to one end, will be pushed into the vaginal wall to reach the ovaries. This part of the procedure should be performed with great caution to ensure that other tissues will not be damaged. Using the probe, the doctor will find the follicles of the ovaries. The needle attached to the probe will punch a hole in the follicles to release the egg cells.

After the egg cells are released from the follicles, they will be collected by the hollow tube, which is attached to a test tube for ova collection. Each ripe follicle in the patient’s ovaries will undergo the same procedure.

The embryologist will require the fluid collected along with the patient’s egg cells, which will help in determining the amount of eggs collected, as well as the quality of the ova and whether they will be ideal for IVF use.

The whole procedure takes around forty minutes to an hour.

After the procedure

The patient will be moved into a recovery room. She might experience soreness and inflammation of the stomach and the genitals, which would normally pass a day after the procedure. She can return to work and normal activities a day or two after the procedure. The doctor will then prescribe antibiotics to prevent infections.

Possible Risks and Complications

Like with any other type of surgical procedure, egg cell extraction has several risks and complications, including the following:

  • Ovarian hyperstimulation syndrome, which can be caused by the injection of hCG. Hormone injections stimulate the development of egg cells in the ovaries and the release of these cells during the period of ovulation. Patients with polycystic ovarian syndrome are more vulnerable to this complication. In mild cases, the patient may experience distension of the abdomen, abdominal pain, diarrhoea and nausea. However, in severe cases, this can lead to the enlargement of the ovaries, respiratory distress, a decrease in urine production, renal failure, or even death.
  • Injuries to the organs in or near the pelvic area due to the transvaginal insertion of the needle used to extract the egg cells
  • Haemorrhage
  • Infection
  • Complications caused by general anaesthesia or intravenous sedation, which includes obstruction of the airways, pulmonary aspiration of the stomach contents, low blood pressure and apnoea.
    References:

  • American Society for Reproductive Medicine

  • Society for Assisted Reproductive Technology
  • American College of Obstetricians and Gynaecologists
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