Egg retrieval day — called "OPU day" (Oocyte Pick-Up) at most Indian clinics — is the most physically significant day of your IVF cycle. You've spent 10-14 days injecting hormones. Your ovaries are enlarged. The whole cycle has been building to this.

And then it happens in 20 minutes, and you go home the same day.

This guide walks you through the entire day — from the night before through recovery — so nothing catches you off guard. The more you know what's coming, the less anxiety you'll carry into that procedure room.

Key Takeaways

  • Egg retrieval is a 20-30 minute procedure performed under sedation — you will be asleep or deeply sedated and feel nothing during it.
  • You must fast from midnight the night before (no food or water).
  • The procedure uses a thin needle guided by transvaginal ultrasound through the vaginal wall into each follicle to aspirate the egg.
  • You'll be in the clinic 3-5 hours total, including prep, procedure, and recovery.
  • Common post-retrieval symptoms: bloating, cramping, spotting, fatigue — these are normal. Severe pain, fever, or inability to urinate requires immediate medical attention (OHSS signs).
  • You will not know the egg count until the embryologist reports after the procedure.

The Night Before

After the Trigger Shot

The trigger shot was given 34-36 hours before your retrieval. In the hours after the trigger, your ovaries are completing final follicle maturation. You may feel increased bloating and pelvic fullness — this is normal.

Instructions for the night before:

  • Nil by mouth (NBM) from midnight: No food, no water, no medications (confirm with your clinic which medications to continue — usually progesterone if you've already started it, and any blood thinners are typically paused as advised)
  • Remove nail polish from at least one fingernail (for pulse oximeter reading during sedation)
  • No perfume or strong-scented products — some labs request this
  • Sanitary pad in your bag — there will be some spotting after
  • Loose, comfortable clothes — your abdomen will be bloated
  • Arrange for someone to accompany you — you will be sedated and cannot drive or travel alone
  • Sleep as well as you can — anxiety is normal, but sleep helps

The Day of Egg Retrieval: Hour by Hour

6:00–7:00 AM: Arrival

Most egg retrievals in India are scheduled for early morning. You'll arrive at your prescribed time — typically 1-2 hours before the procedure.

At arrival:

  • Registration and ID verification
  • Nursing assessment: blood pressure, pulse, temperature
  • IV line placement (usually in the hand or forearm) — this is how sedation will be administered
  • Confirmation of trigger shot timing (you'll be asked when you gave it)
  • You'll change into a hospital gown
  • Partner gives their semen sample — this happens on the morning of retrieval, not before. The clinic will direct your partner to a collection room. Sample must be given before your procedure begins so the embryology lab can prepare.

7:30–8:00 AM: Pre-Procedure Preparation

  • Nurse confirms identity, procedure, and your empty stomach
  • Anesthesiologist or sedation team will assess you and confirm the plan
  • The embryologist may briefly come out to explain the embryology process
  • You'll wait — this waiting period is emotionally hard for many patients. Try to stay calm; the procedure itself is quick.

8:00–8:30 AM: The Procedure

Who is in the room:

  • Your fertility specialist / reproductive endocrinologist
  • Embryologist (usually connected via intercom from the adjacent embryology lab)
  • Anesthesiologist or sedation nurse
  • Procedure nurse

The sedation:

Most Indian clinics use intravenous sedation — typically propofol with or without a short-acting opioid (fentanyl or tramadol). You will be deeply sedated — effectively asleep — for the duration. You will feel nothing.

Some clinics offer general anesthesia. A small number of clinics still do retrieval under local anesthesia + strong analgesia for patients who prefer to avoid sedation risks — but this is uncommon in most Indian cities.

You will not be conscious during the procedure.

The procedure itself:

  1. 1You lie in a lithotomy position (feet in stirrups)
  2. 2The sedation takes effect — within seconds, you're asleep
  3. 3A transvaginal ultrasound probe is inserted — the same type used during your monitoring scans, but with a needle guide attached
  4. 4The needle is advanced through the vaginal wall into each follicle under ultrasound visualization
  5. 5The follicle fluid is aspirated (suctioned) and passed through tubing into a collection tube
  6. 6The embryologist in the adjacent lab immediately examines the fluid under a microscope to identify the egg(s)
  7. 7They announce "egg found" or "no egg in this follicle" for each aspiration
  8. 8The doctor proceeds to the next follicle on the same ovary, then moves to the other side
  9. 9The procedure typically takes 15-25 minutes depending on the number of follicles

How many eggs will be retrieved?

Not every follicle contains a mature egg. In general:

  • 60-80% of follicles yield an egg
  • Of those eggs, 70-85% are mature (MII) and suitable for fertilization

Follicles Seen: 5-8 · Expected Eggs Retrieved: 3-6 eggs

Follicles Seen: 10-15 · Expected Eggs Retrieved: 7-11 eggs

Follicles Seen: 15-20 · Expected Eggs Retrieved: 10-15 eggs

Follicles Seen: > 20 · Expected Eggs Retrieved: Variable — OHSS risk zone

The embryologist will give you the egg count immediately after (or sometimes after you've come out of sedation).

8:30–9:30 AM: Recovery

You wake up in a recovery room, usually within 10-20 minutes of the procedure ending. Most patients feel:

  • Groggy, slightly disoriented — normal from sedation
  • Cramping or pelvic aching — similar to period cramps, often moderate
  • Bloating and pressure — your ovaries are enlarged and tender
  • Nausea — possible from sedation, usually brief
  • Some emotional relief — it's done

A nurse monitors your vital signs. You'll be given pain relief if needed (typically oral paracetamol or ibuprofen, occasionally a stronger analgesic for the first few hours).

Your partner or support person will be brought to sit with you. The doctor will come to update you on the egg count if the embryologist hasn't already.

10:00–11:00 AM: Egg Count and Instructions

Before you leave, you'll be told:

  • Total eggs retrieved
  • Number that appear mature (this may be confirmed by the embryologist after a few hours)
  • What happens next: fertilization (ICSI or conventional IVF) will happen today
  • When to expect the fertilization report: Usually the next morning (Day 1 check)
  • Medications to start: progesterone supplementation typically begins on the evening of retrieval or the morning after
  • Discharge instructions

You must have someone take you home. You cannot drive for 24 hours after sedation.

After You Get Home: Days 1-5

Day of Retrieval (Rest Day)

Rest completely. Bloating and cramping are normal. Spotting from the vaginal puncture sites is expected — light spotting for 1-3 days.

Eat lightly: Avoid heavy meals. Some patients have nausea and appetite suppression. Keep hydrated — this is especially important for OHSS risk patients.

Signs to watch for (call your clinic immediately if you have these):

  • Severe abdominal pain or distension
  • Inability to urinate for 8+ hours
  • Rapid weight gain (>2 kg in 24 hours)
  • Difficulty breathing
  • Nausea/vomiting so severe you can't keep liquids down
  • Fever > 38°C

These signs may indicate OHSS (Ovarian Hyperstimulation Syndrome), which is more likely in patients with many eggs retrieved and PCOS.

Day 1: Fertilization Report

The next morning, your clinic will call with the fertilization report:

  • How many eggs were fertilized (showed 2 pronuclei = 2PN — this is normal fertilization)
  • This is your embryo count at Day 1

Expect: 60-80% of mature eggs to fertilize normally. If you had 8 mature eggs, expect 5-7 fertilized embryos.

Day 3: Cleavage Stage Report

The embryologist may call with a Day 3 update — how many embryos have reached 6-8 cells. Some clinics do Day 3 transfers; most continue to Day 5.

Day 5-6: Blastocyst Report

The blastocyst report tells you:

  • How many embryos survived to blastocyst
  • Their grades (e.g., 4AA, 3BB — see the embryo grading article)
  • Which will be transferred fresh (if doing fresh transfer) or frozen

Typically: 40-60% of Day 3 embryos reach blastocyst stage. Some cycles lose all embryos between Day 3 and Day 5 — this is emotionally devastating but reflects the natural inefficiency of human embryo development, not necessarily a problem with the IVF cycle itself.

When Is Egg Retrieval Cancelled?

Rarely, an egg retrieval scheduled cycle is cancelled before OPU. This can happen when:

Premature LH surge: If the body's own LH surges before the trigger shot (spontaneous ovulation begins), the retrieval may need to happen urgently or may be cancelled if ovulation has already occurred.

Poor response: If stimulation produces very few follicles (< 2-3 mature follicles), some clinics recommend cancelling and starting again with a different protocol.

Empty follicle syndrome (EFS): A rare but devastating event where follicles appear on ultrasound but yield no eggs at retrieval. This occurs in 0.5-3% of cycles and can be partial (some follicles empty) or complete. The cause is often a trigger shot problem (wrong dose, improper storage, or metabolic issue). It is more common with certain hCG preparations.

If you have very few eggs despite many follicles, your doctor may suspect EFS and sometimes gives a "rescue trigger" (a second trigger dose) if time permits.

Questions to Ask Before Egg Retrieval

Questions to Ask Your Doctor 1. What type of sedation will I receive? Who administers it? 2. Based on my follicle count, how many eggs do you expect to retrieve? 3. What is my OHSS risk? What monitoring happens after retrieval? 4. When should my partner give the semen sample? 5. Will we do ICSI or conventional IVF, and why? 6. When will I hear about fertilization? 7. What medications start after retrieval, and when? 8. What symptoms should prompt me to call versus come in?

Emotional Reality of Egg Retrieval Day

Egg retrieval day is significant beyond the physical. Many patients feel intense relief when it's over — the injections phase is done, you made it to this step. The egg count can bring either relief or grief, and sometimes both at once.

If the egg count is lower than hoped, allow yourself to feel that. The eggs that fertilize may surprise you. One good embryo is all it takes. Two retrieved eggs have resulted in healthy pregnancies. The embryology lab works with what exists.

If the egg count is higher than expected — say, 15-20 eggs — that comes with a different concern: OHSS risk. Your clinic will monitor you closely. Take rest seriously.

Medical Disclaimer This article is for informational and educational purposes only. Egg retrieval procedures, sedation choices, and post-retrieval care vary between clinics. This article describes common practice in India as of 2026. Always follow your own fertility clinic's specific instructions, which take precedence over any general guidance. This is not medical advice.

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