Many fertility clinics advise women to stay away from sex after egg retrieval due to fears that orgasms could impact embryo implantation. However, this is largely unfounded.
The ovaries are enlarged after the hormone treatment and it is important to avoid activities such as bouncing or jumping. These could cause the ovaries to get twisted around, a medical emergency called ovarian torsion.
The Ovaries Are Stimulated
During a normal menstrual cycle, the ovaries produce and release one mature egg into the fallopian tube where it awaits fertilization with sperm. In an IVF treatment, a woman is given hormones to stimulate the ovaries so they develop multiple eggs instead of just one. Those eggs are then retrieved during the same menstrual cycle.
Before starting ovarian stimulation, a woman undergoes extensive fertility testing that includes blood work and an ultrasound of the ovaries. This lets doctors know how many follicles are present and whether they’re mature enough for the procedure. The doctor will then design a medication protocol to encourage the follicles to develop. Typically, a patient will start taking gonadotropins such as Follistim or Gonal-F and Menopur to stimulate the ovaries, ovulation suppression drugs like Ganirelix or Cetrotide, and HCG to trigger the oocytes to mature for egg retrieval.
The patient is under sedation during the egg retrieval surgery. A speculum is placed so the doctor can clean the vagina with warm saline, then she will insert a needle into each of the ovary and follicle sacs (one at a time) to aspirate the egg and fluid from each follicle. This is called egg aspiration and takes about 10 minutes.
During the ovarian stimulation process, the patient may experience cramping and bloating. This is because the ovaries are overstimulated, which can cause the follicles to enlarge.
The Semen Samples Are Needed
The sperm sample is collected either via masturbation or with the help of a specialized condom designed to collect semen during sexual intercourse (this will be discussed in more detail by your doctor). Whether or not the sample is collected during intercourse, the patient should be careful not to use any regular condoms as they can contain chemicals that may damage the sperm.
The semen sample is tested to assess its quality. It is analyzed for volume, count and concentration and also for motility and morphology. A low motility or morphology is a sign of possible problems with the seminal fluid that could affect the health and quality of the sperm.
If the semen is found to be healthy, it can then be used to fertilize the eggs. This can be done using conventional insemination or intracytoplasmic sperm injection (ICSI).
To ensure accurate testing results, the sperm should be collected in a sterile plastic receptacle at the clinic and should be delivered to the laboratory for analysis within an hour of being produced. Any delay in the delivery and exposure to different temperatures may cause the sperm to die. This is especially important for a test conducted at home, as most tests only analyze for sperm count and not motility or morphology. This can be purchased at most pharmacies.
The Embryos Are Fertilized
After your hormone treatment has triggered the follicles to grow, the doctor will inject human chorionic gonadotropin (hCG). This triggers the ovaries to ovulate, and each egg goes on a journey through the fallopian tube toward the uterus where it will be fertilized with sperm. The doctor will time egg retrieval to catch the eggs just before they would begin this journey, at a point when they are still within their follicles.
During the procedure, you will be under sedation, but you won’t feel any pain. The doctor will use ultrasound to locate your ovaries, then insert a needle attached to a catheter through the vaginal wall into each follicle. The needle punctures the follicle, and the follicular fluid inside is drawn out by light suction into test tubes. The follicles and their eggs are then transferred to an in-vitro fertilization lab.
Many fertility clinics recommend a two-week period of “pelvic rest” after an embryo transfer to prevent infection, uterine contractions and other complications from occurring. The reason behind this recommendation is that it was thought that the introduction of infection and the uterine contractions caused by orgasm could harm an embryo or cause it to simply fall out. However, there is now no scientific evidence that this is true. There is no evidence that having sex after embryo transfer affects the outcome of in vitro fertilization (IVF). If you’re considering IVF for pregnancy, ask your doctor about sex after egg retrieval.
The Embryos Are Transferred
After your hormones are balanced again and the follicles have reached their full size, the doctor will perform a procedure called a follicular puncture. This is done under light anesthesia, and involves inserting a small needle into each mature follicle. This will cause the follicle to release an egg.
The retrieved eggs will then be placed in a dish with sperm. The sperm can either come from your partner or from a donor. A special technique known as intracytoplasmic sperm injection (ICSI) will then be used to fertilize each mature egg. This procedure is very effective, and about 70% of the eggs will successfully be fertilized.
After the fertilized embryos are created, your doctor will then transfer them into your uterus. This is a relatively short procedure that only takes up to 30 minutes. You may feel bloating and some spotting or cramping after the transfer, but it is not usually painful.
Before the procedure begins, you will be given a sedative. A doctor will then insert a speculum into your vagina with ultrasound for accuracy, and pass a catheter through your cervix and into the uterus. A syringe with one or more embryos suspended in a small amount of fluid will then be attached to the end of the catheter, and the doctor will then “transfer” them into your uterus.