The day before an egg retrieval procedure is the final step in an In Vitro Fertilization (IVF) cycle, bridging ovarian stimulation and the collection of mature eggs. This 24-hour period requires precise adherence to specific medical and logistical instructions. Following these protocols ensures both the safety of the patient under sedation and the biological success of the procedure, directly influencing the outcome of the treatment.
Essential Medication Protocols
The most important instruction on the day before retrieval centers on the “trigger shot,” the final hormone injection administered to induce the eggs’ final maturation. This injection, typically containing human chorionic gonadotropin (hCG) or a GnRH agonist like leuprolide (Lupron), must be administered at an exact, predetermined time. The timing is non-negotiable because the retrieval procedure is scheduled precisely 34 to 36 hours after the injection to collect the eggs just before they would naturally ovulate.
Injecting the trigger shot too early means the eggs may not be fully mature, while injecting it too late risks premature ovulation. Clinics often instruct patients to set multiple alarms or have a partner double-check the time to prevent error. In some protocols, particularly those using a Lupron trigger or a dual trigger, a second injection may be required 12 hours after the first, further emphasizing meticulous timing.
Patients are also instructed to stop taking specific non-fertility medications to minimize the risk of bleeding during the procedure. Blood-thinning medications, including non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, and certain supplements such as fish oil, are commonly discontinued one to two days before the retrieval. Most standard fertility medications used for ovarian stimulation are stopped the evening before the trigger shot. Only non-fertility medications for chronic issues, such as thyroid conditions, are often permitted with a small sip of water, but only after specific approval from the medical team.
Strict Fasting and Consumption Rules
The most critical safety instruction involves mandatory restrictions on food and drink due to the need for safe sedation or anesthesia. The procedure is typically performed under conscious sedation or general anesthesia, which requires an empty stomach to prevent aspiration. Aspiration occurs when stomach contents are regurgitated and inhaled into the lungs while the patient is unconscious, potentially leading to severe lung damage.
To mitigate this risk, a strict cut-off time for solid food is enforced, generally set at least 8 hours before the scheduled procedure, often meaning no food after midnight. This restriction includes chewing gum, hard candies, and any non-clear liquids. Clear liquids, which are fluids you can see through, are usually permitted until closer to the procedure, often up to 2 to 4 hours before the retrieval.
Acceptable clear liquids include plain water, clear apple juice, and black coffee or tea without milk, cream, or sugar substitutes. Alcohol consumption is absolutely prohibited the day before retrieval, as it interferes with sedatives. Smoking, vaping, and the use of other recreational substances must also be completely avoided.
Physical and Logistical Preparations
Non-medical preparations focus on optimizing comfort, reducing the risk of infection, and ensuring a smooth logistical process on the day of the retrieval. Patients should shower the evening before or the morning of the procedure to minimize bacteria, but are instructed to avoid applying any lotions, perfumes, or powders. Strong scents can interfere with the sterile environment of the operating room and the laboratory where the eggs will be handled.
It is necessary to wear loose-fitting, comfortable clothing, as patients will likely experience some bloating or discomfort following the retrieval. All jewelry, including wedding rings, earrings, and body piercings, must be removed before arriving at the clinic to prevent interference with medical equipment. Nail polish, particularly on the fingers, should be removed because it interferes with the pulse oximeter, a device used to monitor oxygen levels during sedation.
Finally, arranging mandatory transportation and planning for post-procedure rest are crucial logistical steps. Because the patient will receive sedation, they are legally prohibited from driving, operating machinery, or making major decisions for the remainder of the day. A responsible adult must be arranged to drive the patient home and ideally remain with them for the first 24 hours. The day before the procedure should be dedicated to rest and minimal physical activity.