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Biggest Side Effects of IVF Egg Retrieval, OHSS Symptoms & More

Learn what egg retrieval side effects to expect, what OHSS is, and what symptoms to look out for as you tackle this big milestone on your IVF journey.

March 17th, 2023 | 8 min. read

By Kirsten Hennigan, NP

You’ve finally made it to your egg retrieval! As you prepare for this big milestone, let's walk through the biggest side effects of IVF egg retrieval - what to expect, what symptoms to look out for, how to spot OHSS, and what comes next on your fertility journey.

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First, let’s explore what you can expect on your egg retrieval day.

While this is an exciting milestone on your IVF journey, it’s still anxiety-inducing for many. Did I do everything right? Will I have a good amount of eggs? Will my retrieval hurt? The concerns can feel endless. To help you feel more confident, let's walk through an egg retrieval and talk about what to expect in terms of side effects. 

What to Expect at Your IVF Egg Retrieval

Disclaimer: I’ll be explaining how we do things here at Illume Fertility. Your personal experience might vary slightly based on your fertility clinic's protocol, but regardless of clinic, the process should be very similar.

You will be asked to check in to our Norwalk office approximately one hour before your scheduled procedure time.

Once you’ve been greeted by our front desk team, you will be taken back to our operating room, shown your private prep and recovery area (including a bed, chair, and locker), and given a gown and cozy socks to change into (we all know fun socks are one of the only perks of this whole process).

You will then meet with our OR nurses who will go over your paperwork and start your IV. You’ll also meet the anesthesiologist and the reproductive endocrinologist who will be performing your procedure that day. 

💡 Who will perform my egg retrieval? Our doctors rotate through the operating room, covering all seven days of the week, so you may or may not see your primary doctor on egg retrieval day. If your egg retrieval doesn’t happen with your primary doctor, know that you are still in great hands and that your doctor will be monitoring your progress remotely and getting updates throughout the day.

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What happens during egg retrieval? 

The egg retrieval is an extremely safe and relatively simple procedure that averages only 15 minutes from start to finish. Our anesthesiologist will administer medications through your IV so that you are comfortably asleep the whole time.

Once asleep, the fertility doctor will place an ultrasound probe vaginally and look at your follicles on the monitor. This step is identical to what you've experienced during all those early morning monitoring appointments. 

As soon as your follicles are in clear view, the doctor will advance a thin needle through your vaginal wall and into the egg follicle. You can think of the egg follicle as a small water balloon filled with fluid and a single egg.

The doctor will use a machine to apply gentle suction and drain the fluid from the follicle. This fluid is collected in a test tube, then handed to the embryologist who evaluates it under a microscope and counts any eggs that are collected.

This process of piercing the follicles with needles, draining fluid, and counting eggs, continues until all visible follicles are drained and the procedure is complete.

What happens after egg retrieval?

After your egg retrieval, you are carefully transported back to the recovery area where you will be monitored as you wake up. Most patients feel woozy (slightly disoriented) from the anesthesia, and some will experience a sense of fullness or mild menstrual cramp-like discomfort.

Very rarely do we need to administer anything more than Tylenol after the procedure.

You will be monitored for approximately an hour, then sent home to rest for the remainder of the day. Nearly all of our patients are back to normal activities the next day. (We will always call you to make sure you're feeling well after your procedure.)

Normal Egg Retrieval Side Effects

Let’s talk about the biggest side effects of an egg retrieval procedure. As mentioned above, patients are typically ready to resume normal activities by the next day.

Here are some common, mild symptoms you may experience after an egg retrieval:

  • Bloating
  • Spotting
  • Feeling of fullness
  • Constipation
  • Cramping   

What is OHSS? 

Patients often have questions about a rare condition that can develop during the egg retrieval phase of IVF called Ovarian Hyperstimulation Syndrome, or “OHSS” for short.

OHSS is a medical complication that affects approximately 3% (or less) of patients undergoing in vitro fertilization (IVF) each year.

It occurs when the ovaries have an abnormally robust response to the fertility medications that we prescribe. A large number of egg follicles grow, the ovaries continue to swell, and eventually leak fluid into the pelvis.

The good news is that with early diagnosis and careful monitoring, this condition will resolve on its own within 7-10 days.

It's very rare that a patient will need to be admitted to the hospital for round-the-clock monitoring (in fact, I’ve only seen this twice in my 20+ years as a nurse). So, while severe cases of OHSS are not common, it's good to be aware of what symptoms to look out for.

What are the symptoms of OHSS?

These are the most common signs of OHSS. If you experience any of the following, reach out to your nurse or doctor to come up with a plan to manage your symptoms. 

  • Abdominal pain
  • Nausea/Vomiting
  • Abdominal tenderness
  • Difficulty breathing
  • Tight/enlarged abdomen
  • Rapid weight gain
  • Decreased urination

Why does OHSS occur?

During an IVF cycle, we are asking the ovaries to do something that they don’t typically do: produce a lot of egg follicles, all at once. The best way to explain this is with a quick analogy…

The First Level: A Normal Menstrual Cycle

Imagine there is a job opening at a company with ONE office available for ONE new employee to sit in. This is what we expect of your ovary during any given month; one egg follicle growing to full maturity in one ovary.

The Second Level: A Typical IVF Cycle

What if, however, after interviewing 45 candidates, human resources decides to hire 12 employees instead of just the one! Now there are 12 new employees that we need to find space for in one office. Luckily, it is a spacious corner office with enough room for a large conference table and chairs.

Although cozy (and maybe with a small amount of discomfort), we are able to fit all 12 employees in to the one office, and all works out well.

The Third Level: Ovarian Hyperstimulation Syndrome

Imagine that now, instead of 12 employees being hired and squeezing into one office...all 45 candidates are hired! We can squeeze all 45 in the door, but they are scrunched in tight, it's uncomfortable, and they are literally pouring out into the hallway.

This is what happens during OHSS.

The good news? While approximately 15% of IVF patients experience mild hyperstimulation symptoms, such as bloating and menstrual-like cramping, most will never suffer from moderate or severe OHSS.


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When To Call Your Doctor About OHSS Symptoms

Please know that as our patient you are ALWAYS welcome to reach out to us with questions or concerns. However, don’t be surprised if after your egg retrieval you don’t feel totally back to normal until your first period, which generally occurs 10 days after retrieval. 

So, when should you be concerned or reach out to your Care Team? If you experience any of the following symptoms, please call your doctor, nurse or patient navigator right away to discuss next steps:

  • Vomiting
  • Shortness of breath
  • More than 1lb weight gain in 24 hours
  • Decreased urine output

These are all signs that your ovaries are swelling and putting pressure on your diaphragm. After speaking with a nurse, we will generally bring you in to perform an ultrasound and blood work and figure out a treatment plan so you can get back to feeling like yourself!

How to Prevent OHSS

Luckily, it is rare for an OHSS case to catch us off guard. Based on your physical characteristics and hormonal bloodwork, we will usually know if you are at risk for OHSS before you even get started.

If we suspect you are at risk, we will use special medications and change your protocol to greatly reduce your risk. We will also advise that you freeze your embryos and wait for your ovaries to recover before you attempt an embryo transfer.

If you have been identified as high risk for OHSS, we will advise you to eliminate exercise and avoid sexual intercourse. We will ask that you regularly update us and notify us immediately if your symptoms change.

In order to decrease the amount of fluid that is collecting in your belly, we will ask you to avoid drinking large quantities of water/clear fluids, and instead stick with thick liquids (think: milkshakes and V8 juice) that you can’t see through.

Your Fertility Team Has Your Back

While it's extremely rare, OHSS can happen. However, it won’t catch us off guard, and we have lots of helpful ways to get you through it safely and swiftly.

Whatever your side effects, we will help you manage them until they subside, so you can focus on the next big milestone of IVF treatment: your embryo transfer.

Be proud of yourself! You’ve made it through some of the hardest parts of the process.

From the never-ending blood draws to the self-injections, you are doing your best, and your entire fertility team is so proud of you. Congratulations, and good luck on your embryo transfer if that's what's next for you! We will all be thinking about you and your growing family.

Kirsten Hennigan, NP

Kirsten is a Nurse Practitioner who joined the Illume Fertility team in 2014 after working in women's health in the USA, United Kingdom and other countries. She feels privileged to be able to help fertility patients go from feeling broken and overwhelmed to feeling empowered with options about their future.

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