Eggs are removed through a minimally invasive procedure called transvaginal ultrasound-guided aspiration, where a thin needle passes through the vaginal wall and into each ovarian follicle to suction out the eggs. The retrieval itself takes about 20 to 30 minutes, but the full process leading up to it spans roughly two weeks of hormone injections and clinic visits. Here’s what each stage actually looks like.
Hormone Stimulation: The Two Weeks Before
Your ovaries normally release one egg per month. To make donation worthwhile, fertility doctors use hormone injections to push your ovaries into producing multiple eggs in a single cycle. You’ll inject yourself daily with hormones that stimulate your ovaries, typically for about 10 to 11 days. The injections go into your abdomen or thigh using small needles, similar to what people with diabetes use.
During this window, you’ll visit the clinic several times for morning monitoring appointments, usually between two and six visits total. Each appointment involves two things: a blood draw to check your estrogen levels and a transvaginal ultrasound to measure how your follicles (the fluid-filled sacs that contain eggs) are growing. The doctor uses these results to adjust your medication dose and determine when your eggs are ready.
The Trigger Shot
Once your follicles reach the right size, you’ll take a single injection called a trigger shot. This is a precisely timed dose of a hormone that signals your eggs to complete their final stage of maturation. Timing matters: the retrieval is scheduled 36 to 46 hours after the trigger shot, because that’s the window when the eggs are mature but haven’t yet been released from the follicles. You’ll be given an exact time to administer the injection, sometimes in the middle of the night, and missing that window can compromise the entire cycle.
What Happens During the Retrieval
On retrieval day, you arrive at the clinic and change into a gown. An anesthesiologist places an IV line and administers sedation. Most clinics use what’s called total intravenous anesthesia, a light general anesthesia that makes you fully unconscious during the procedure but wears off quickly. You won’t feel anything, and you likely won’t remember much of the immediate aftermath either, since the medications create significant short-term amnesia.
Once you’re sedated, the doctor inserts an ultrasound probe into your vagina, which shows the ovaries and follicles on a screen in real time. A thin needle is attached alongside the probe. The doctor guides this needle through the vaginal wall and into each follicle, one at a time. A gentle suction device connected to the needle draws the fluid out of each follicle, and each egg comes out with it. The fluid passes through tubing into a test tube, which an embryologist immediately examines under a microscope to confirm whether an egg was collected.
The doctor repeats this for every accessible follicle on both ovaries. The average yield is about 10 to 11 eggs per donation cycle, with roughly 90% of those being mature enough to use. Some donors produce more, some fewer. The entire procedure takes 20 to 30 minutes.
Recovery in the First Few Days
You’ll wake up in the operating room and move yourself to a recovery bed, though you may not remember doing so. After about 30 to 60 minutes of observation, someone will need to drive you home since you’ve been under anesthesia.
Most donors take it easy the day of retrieval and feel well enough to return to work or school the next day. Common symptoms in the days following include bloating, mild cramping, and constipation (a side effect of both the hormones and the anesthesia). Drinking at least 12 cups of water daily, plus electrolyte-rich fluids like coconut water, helps reduce swelling. Fiber-rich foods and stool softeners can ease the constipation.
Exercise and sex are typically off-limits until after your next period, which usually arrives one to two weeks after retrieval. Your ovaries are still enlarged at this point, and vigorous activity could cause them to twist, a painful complication called ovarian torsion. A follow-up appointment lets the doctor confirm everything is healing normally.
Risks During and After the Procedure
The needle aspiration itself carries a low risk of surgical complications. Severe internal bleeding occurs in roughly 0.09% of retrievals, or about 1 in 1,100 procedures, based on a pooled analysis of over 31,000 cases. When it does happen, symptoms typically appear within 24 hours. Because the needle passes through tissue near the bladder, bowel, and blood vessels, damage to these structures is possible but rare.
The more common risk comes from the hormone stimulation itself: ovarian hyperstimulation syndrome, or OHSS. In a study of 289 egg donors across 801 donation cycles, about 35% experienced only mild symptoms that fall within the normal range of what stimulation drugs do to your body. Moderate OHSS, involving more significant bloating and discomfort, was reported in 26% of cycles. Severe OHSS occurred in 9% of cycles, and critical cases requiring hospitalization happened in about 0.5%.
Mild to moderate OHSS feels like intense bloating, abdominal pressure, and nausea. It typically resolves on its own within a week or two. Severe cases can involve rapid weight gain, difficulty breathing, and vomiting, and may require medical intervention to drain accumulated fluid from the abdomen.
Effects on Future Fertility
One of the most common concerns donors have is whether giving away eggs now will reduce their ability to get pregnant later. The existing research is limited but somewhat reassuring. In follow-up surveys of former donors, the rates of infertility reported (ranging from 5% to 9.6% depending on the study) are similar to infertility rates in the general population. Some former donors reported new fertility or menstrual issues after donating, but researchers have not been able to determine whether those problems were caused by the donation or would have happened regardless.
The honest answer is that no long-term prospective studies have tracked egg donors over many years to definitively measure cancer risks, fertility outcomes, or other health effects. The studies that do exist rely on retrospective surveys with relatively short follow-up periods, averaging around four to five years. The absence of evidence of harm is not the same as evidence of safety, and this gap in the research is something to weigh when making your decision.