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In Vitro Fertilization (cont.)

Egg Retrieval and Fertilization

The egg retrieval procedure is performed 34 to 36 hours after the hCG injection was given. In this procedure, the surgeon inserts a needle through the vagina into the woman's ovary to remove the fluid from the follicles, which contains the mature eggs. General anesthesia is not required for this part of the procedure, but the woman may be given some sedating medication.

The procedure takes about 20 to 30 minutes and is performed on an outpatient basis. The woman is generally advised to rest on the day of the procedure. Some light spotting and/or mild cramping may occur after the retrieval procedure.

The fluid removed from the follicles is examined in the laboratory to make sure eggs are present.

At the same time, the man provides a semen sample. He is asked not to have sexual intercourse for a few days before the eggs are retrieved from the woman, and before he produces a semen sample (usually by masturbation). The sperm are separated from the semen in a laboratory procedure.

The active sperm are combined in the laboratory dish with the eggs. This is the actual process of in vitro fertilization. In some cases, a sperm cell will be manually inserted into the egg in a process known as intracystoplasmic sperm injection (ICSI). This step is done for a variety of reasons including poor sperm quality or other suspicions that fertilization may be difficult. Some clinics may perform ICSI on part of the follicles in each case.

About 18 hours after this fertilization procedure, it is possible to determine if the egg or eggs have been fertilized and have begun to grow as embryos. They are incubated and observed over the next 2 to 3 days or longer.

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