Egg donation is a voluntary process that allows individuals or couples to attempt pregnancy using a donor’s eggs. This act involves a series of medical steps culminating in the collection of mature eggs from the donor’s ovaries. The retrieval process is a highly coordinated medical procedure, requiring careful preparation, precise timing, and a brief surgical step. It is managed by fertility specialists in a controlled clinical environment to maximize the chances of a successful outcome for the recipients.
Ovarian Stimulation and Monitoring
The preparatory phase focuses on controlled ovarian stimulation, which is necessary because the body naturally matures only one egg per menstrual cycle. The goal is to encourage a cohort of ovarian follicles to grow and mature simultaneously, yielding multiple eggs for donation. This is achieved through a daily regimen of injectable medications that typically lasts between 10 and 14 days, tailored to the donor’s individual response.
The primary medications used are gonadotropins, which contain Follicle Stimulating Hormone (FSH) or a combination of FSH and Luteinizing Hormone (LH) analogs. These medications, such as Gonal-F, Follistim, and Menopur, directly stimulate the ovaries to increase follicle development. A second type of medication, a GnRH antagonist (like Ganirelix or Cetrotide), is introduced later to prevent the body from ovulating prematurely. This ensures the retrieval can be performed at the optimal moment.
Throughout the stimulation period, the donor attends frequent monitoring appointments at the fertility clinic, often every one to three days. These appointments involve blood tests to measure hormone levels, such as estrogen, and transvaginal ultrasounds to track the growth of the ovarian follicles. The ultrasounds allow the medical team to count the developing follicles and measure their diameter, confirming they are reaching maturity. This surveillance ensures the donor is responding well to the medication.
Once monitoring indicates a sufficient number of follicles have reached a mature size, the final step is administered: the “trigger shot.” This injection contains Human Chorionic Gonadotropin (HCG) or a GnRH agonist, which mimics the natural LH surge and initiates the final maturation process. The timing of this injection is extremely precise, as the retrieval procedure must occur approximately 34 to 36 hours later, just before the eggs would naturally be released.
The Retrieval Procedure
The egg retrieval procedure, also called transvaginal ovarian aspiration, is a short, minimally invasive surgical procedure performed in an outpatient surgical center or fertility clinic. The donor is given intravenous sedation, often referred to as monitored anesthesia care, which ensures she rests comfortably and experiences no discomfort. Fasting for several hours before the procedure is required, as is standard practice for any procedure involving sedation.
The physician uses a transvaginal ultrasound probe, inserted into the vagina, to visualize the ovaries and mature follicles. A thin, hollow needle is then guided through a channel on the probe, passing through the vaginal wall and into the center of each follicle. This precise guidance ensures the needle accurately targets the fluid-filled sacs that contain the eggs. No external incisions or stitches are required for this method.
Once the needle is positioned within a follicle, suction is applied to aspirate the follicular fluid, which carries the egg, into a test tube. This process is repeated for every mature follicle on both ovaries, and the entire aspiration generally takes about 20 to 30 minutes. The extracted fluid is immediately handed to an embryologist in an adjacent laboratory, who examines the contents under a microscope to identify and count the retrieved eggs.
Immediate Post-Procedure Care and Recovery
Following the retrieval procedure, the donor is moved to a recovery area for immediate post-procedure monitoring. This initial recovery period typically lasts between one and two hours while the effects of the intravenous sedation wear off. Nurses monitor the donor’s blood pressure, heart rate, and overall condition until she is alert and stable enough for discharge. Due to the lingering effects of the sedation, the donor must have a companion drive her home and stay with her for the next 24 hours.
Common side effects in the hours and days following retrieval are generally mild. Donors often report abdominal cramping, comparable to a moderate menstrual period, and a feeling of bloating due to the enlarged ovaries. Light vaginal spotting is also normal, resulting from the needle passing through the vaginal wall. Over-the-counter pain medication, such as acetaminophen, is usually sufficient to manage this discomfort, though non-steroidal anti-inflammatory drugs (NSAIDs) are avoided as they can interfere with blood clotting.
Donors are advised to rest for the remainder of the retrieval day and to avoid strenuous activity, heavy lifting, or vigorous exercise for the next few days. The ovaries remain slightly enlarged, making it important to avoid actions that could cause discomfort or a rare complication like ovarian torsion. Most donors are able to resume their normal daily activities, including work, within 24 to 48 hours of the procedure.
It is important for the donor to monitor her body for any signs that require immediate medical attention. While mild symptoms are normal, the following symptoms warrant an urgent call to the clinic:
- Severe, worsening abdominal pain.
- A fever above 100.4 degrees Fahrenheit.
- Heavy vaginal bleeding.
- Signs of Ovarian Hyperstimulation Syndrome (OHSS), such as rapid weight gain or severe nausea and vomiting.
The medical team provides clear instructions and remains available for consultation during recovery.