A vaginal ultrasound will monitor follicle development. This is considered non-invasive and not associated with
any known risk.
Transvaginal egg retrieval is an outpatient procedure using IV anesthesia. There is a very small risk of injury
to surrounding organs or tissues. If this occurs, the repair will be made at the time of injury and is usually a
small bleeder in the vaginal wall from the aspirating needle.
Transferring the embryos into the uterus may cause slight discomfort, cramping, spotting, or infection. There
is a slight possibility of ectopic pregnancy (less than 5%) with any attempt at pregnancy. This would require
treatment by MTX (methotrexate) or surgery to remove the ectopic pregnancy.
The transfer of multiple embryos may result in multiple gestations. The risks of
prematurity and other
complications have been explained.
Patients are advised that any of the following may occur to prevent pregnancy:
The time of ovulation may be misjudged (is rare to non-existent with the use of hCG trigger), may be
unpredictable (again rare with the use of hCG trigger), may occur prior to retrieval (only if retrieving on a
natural cycle), or may not occur in the monitored cycle (only if there is no follicular response) precluding any
attempt to obtain an egg(s).
Pelvic adhesions may prevent access to the ovary(s) but fortunately is very uncommon.
Medical emergencies may make an operating room and/or anesthesia unavailable (would have to be a natural
disaster, but Arizona Center for Fertility Studies has a back-up power supply to adequately run the entire
Assisted Reproductive Technology (ART) and cryo labs).
Withdrawing an egg may be unsuccessful (generally because there was no egg in the follicle).
The egg(s) may be of poor quality. This may or may not be visible or known to the embryologist or physician at
the time of recovery.
The partner may be unable to obtain a semen specimen (if this is anticipated, then Arizona Center for Fertility
Studies will get a sperm sample in advance and freeze it, or in extreme cases, schedule back-up MESA/TESA.
The sperm sample may be of poor quality (this is generally eliminated by doing ICSI).
Fertilization may not occur; performing ICSI (intracytoplasmic sperm injection) does not guarantee
fertilization (generally an egg quality issue).
Cleavage or cell division of the fertilized egg(s) may not occur (again, generally an egg quality issue).
The embryo(s) may not develop normally and would not be transferred.
Implantation may not occur.
A laboratory accident may result in loss or damage to the egg, sperm, or embryo (very rare).
Transfer of the embryo(s) may not be successful (by doing a mock transfer first, this should never happen).
VIDEO OF TRANSVAGINAL ASPIRATION (TVA) OF FOLLICLES FOR OOCYTE (EGG) RECOVERY.
A picture of our embryologist receiving follicular fluid through a window attached to the adjacent operating
room. The follicular fluid is at all times kept in a heat block on a warming tray at 37 degrees celsius until it
is checked for the egg. As the eggs are identified, they are "cleaned" of surrounding tissue and blood
placed in a holding dish on the warming stage of the microscope until all the eggs are collected, then placed in
the incubator to await later ICSI.
A picture of the holding dish on the microscope warming plate after all the oocytes (eggs) have been recovered
and identified from the follicular fluid. Each egg is surrounded by specialized cells called cumulus cells,
making the usually microscopic egg visible to the naked egg.
Jennifer and Scott
"I recall the first phone conversation I had with Gina. She spent over an hour explaining every detail of
transfer process to me. Every time I called the office, no matter who answered, they have always been polite and
helpful. Scott and I were stunned at how much time Dr. Nemiro spent consulting with us. He is so friendly and
approachable. After everyone adjusted schedules and plans for surgery, I witnessed Dr. Nemiro's passion and
for what he does. Your entire staff is compassionate and has a unique understanding of patients. Scott and I are
thankful for each and every one of you. You've made this such a positive, memorable experience. We will
return visit in the future with the newest member of the family. Until then, thanks so much, and we'll keep
80% of our patients conceive with IVF/PGT and frozen embryo transfer!