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  » Infertility  »  Potential risks to the child from intracytoplasmic sperm injection - ICSI

In order to get sufficient eggs for the in vitro fertilization process, the woman is stimulated with injected medications to develop multiple egg development. The injections are usually done by the woman, or by her husband.

The eggs develop in structures in the ovaries called follicles. Each follicle contains one egg and can be seen on ultrasound.

Ultrasound of multiple follicles (3 black circles) in a stimulated ovary

When the woman's follicles are mature, the egg aspiration procedure is performed to remove the eggs.

A needle is passed through the top of the vagina under ultrasound guidance to get to the ovary and follicles. See the image below.

We give powerful narcotics to the woman so that she will not have significant pain during the procedure.

The actual aspiration procedure takes about 2-8 minutes at our facility. The average procedure duration is 5 minutes (our figures).

The egg aspiration procedure in progress - an egg is being aspirated from a follicle
The needle is the bright white structure (right side) above the 3rd white dot from bottom
Ovary outlined in blue, top of vagina in red

The follicles are fluid-filled structures in the ovary that are surrounded by cells from the ovary called granulosa cells. The egg is microscopic and can not be seen on ultrasound. Eggs are surrounded by a mass of ovarian cells called cumulus cells.

The oocyte-cumulus complex is removed from the follicle when we aspirate the fluid through the needle. The fluid and the oocyte-cumulus complex as well as some granulosa cells are collected in tubes and passed to the IVF lab staff. The contents of the tubes are poured into flat dishes so that we can search for the eggs under a microscope.   The oocyte-cumulus complexes are what we can then identify.

When all of the follicles have been aspirated, the woman is monitored closely for about 2 hours - after which she can be discharged home.

Sperm is mixed with the eggs about 4 hours after the egg aspiration, and the following morning we check the eggs for evidence of fertilization.

The embryos are cultured in the IVF lab incubators for 1-5 more days in the lab before they are put into the woman's uterus with an embryo transfer procedure.

Eleven days after the embryo transfer, we take blood from the woman to find out if she is pregnant.