Egg Collection (OPU)

Egg collection (OPU) is a short procedure in IVF treatment in which the mature eggs you have developed with medicines are collected from the ovaries. It is performed through the vagina under ultrasound guidance, with no incision in the abdomen; it is carried out under sedation or anaesthesia. The information below draws a general framework; it does not replace a diagnosis or treatment recommendation specific to you.

What is egg collection (OPU)?

OPU is the removal of the eggs inside the follicles developing in your ovaries. An aspiration needle passed through the vaginal wall is guided to the follicles while being watched on ultrasound; the follicular fluid is drawn up together with the eggs and sent to the laboratory. The eggs are examined there.

When is egg collection performed?

When your eggs have reached sufficient size, a trigger injection is given so that they complete their maturation. The procedure is done at a time planned after this trigger, before ovulation happens by itself. Your doctor determines the day and time according to the ultrasound and blood test results.

In which treatments is egg collection performed?

In IVF treatment, where eggs are fertilised outside the body, egg collection is needed both in the conventional method and in microinjection. OPU is not performed in applications such as ovulation induction and insemination, where fertilisation inside the body is the aim. IVF treatment is carried out within Ota Jinemed and Liv Hospital Ulus, with the laboratory and embryology teams of these hospitals.

What is done before the procedure?

Your doctor gives the instructions about the day of the procedure beforehand: which medicines you will use, from when you will stop eating and drinking, and how you will get to the procedure are included in these instructions. You need to tell your doctor about the medicines you use, your allergies and your previous experience of anaesthesia. The timings and details vary with the centre and the anaesthetic practice.

How is the procedure performed?

The ultrasound probe is placed in your vagina and the path of the needle is watched on the screen. The follicles in both of your ovaries are emptied in turn. The fluid taken is searched for eggs; an egg may not come out of every follicle. The number of eggs collected depends on the response you gave to the stimulation.

Sedation or anaesthesia is given to reduce the pain you will feel. Your doctor decides which method will be used according to your situation and the centre's practice. The level of pain varies from person to person; it is not possible to say beforehand that you will feel no pain at all.

After the procedure you rest for a time and are kept under observation. Your doctor will tell you the time of discharge and the instructions for the first days.

Which symptoms are expected after the procedure?

After the procedure it is normal to have light vaginal spotting, mild cramp-like pain, a feeling of fullness in the abdomen and short-lived drowsiness due to the effect of the sedation. Because your ovaries have grown with the stimulation, you may also have a feeling of heaviness in your abdomen. You decide when you will return to daily life, exercise and sexual intercourse according to your doctor's instructions.

What are the risks and complications of egg collection?

During the procedure, light vaginal bleeding may be seen where the needle passes. More rarely, bleeding into the abdomen or infection in the pelvis can develop. Dizziness, fainting or abdominal pain that gets progressively worse may be signs of bleeding inside the abdomen.

Injury to neighbouring organs such as the bowel, bladder or ureter, and problems related to the anaesthetic, have been reported, although rarely. Performing it under ultrasound guidance helps to keep this risk low. You can ask your doctor before the procedure how these risks are reduced and whether there is anything additional in your own case.

In ovaries that respond excessively to stimulation, ovarian hyperstimulation syndrome (OHSS) can develop in the days after the trigger injection and egg collection, and, if a pregnancy forms, at a later stage too. Rapid weight gain, swelling of the abdomen, being unable to take in fluid because of nausea and vomiting, a decrease in the amount of urine and shortness of breath are among its symptoms. In overstimulation, clots can also be seen in the leg veins. Your doctor chooses the methods aimed at reducing the risk.

A stimulated, enlarged ovary can twist around its own axis (ovarian torsion). This is seen rarely and can appear in the days after the procedure or later. It shows itself with sudden, severe abdominal pain, mostly on one side, and nausea.

What happens to the collected eggs?

The eggs are fertilised in the laboratory by being placed alongside sperm or by microinjection. Not every egg is expected to fertilise or to become an embryo. Embryo transfer is a separate stage.