How Much Surgery Will I Need for IVF and How Bad Is It?


Surgical instruments lying on a table

IVF treatment is a medical procedure so it’s only natural to wonder how much surgery will be needed and how bad it will be. Since I have done many IVF cycles, I can tell you.

How much surgery will you need for IVF? In most cases, only one minor and relatively simple surgical procedure is required to retrieve your eggs. If other problems exist, or if the IVF treatment cycle is repeatedly failing, other surgical examinations or procedures may be necessary.

Let’s further reassure you by looking at the egg retrieval process in a bit more detail and at other non-surgical medical procedures that IVF requires. We’ll also look at other surgeries that may be needed if other problems exist or to optimize IVF.

IVF’s One Minor Surgical Procedure – Egg Retrieval

The egg retrieval process is where a needle is inserted through the back wall of the vagina into your ovaries. The eggs are then sucked into the needle.

As you can see this is not a complex procedure at all but you should be aware of the following important points:

  • In most cases, the egg retrieval process is carried out under general anesthetic, so you will not feel any pain or discomfort during the procedure.
  • The actual procedure usually takes under 30 minutes depending on how many eggs are available for aspirating – the fancy word for eggs being sucked into the needle that I picked up after many rounds of IVF. If a lot of eggs are removed, the procedure could take up to 45 minutes.
  • Once the retrieval is finished, you’ll be kept in the clinic for up to a few hours to make sure that the anesthetic wears off, that nothing untoward is going on as a result of the procedure and that you are generally feeling ok. We’re not looking at days in the hospital or even an overnight stay.
  • Although it’s only minor surgery, most clinics require someone to accompany you and escort you home after the procedure. Even if this is not required by your clinic, I would suggest that you find someone to accompany you. While I have seen many women come for their egg retrieval alone, it’s nice to have someone accompany you if only for moral support.
  • After the procedure, you may be told to watch out for symptoms of OHSS – Ovarian Hyperstimulation Syndrome. This is when the ovaries swell with fluid which in severe cases requires immediate hospitalization and in moderate cases prevents the continuation of treatment for that cycle. Don’t be too concerned though. This only occurs in approximately 10% of patients and as I have had it, the statistical probability of you having it is therefore lowered.
  • You may have mild cramping, discomfort or tenderness for up to 2 days afterwards. This is perfectly normal and will eventually subside by itself. Until it does, you can alleviate the discomfort by resting, drinking plenty of fluids and avoiding strenuous activity.

At the end of the day, the egg retrieval process is not that bad – for a medical procedure. It’s not as simple as a blood test or injection, but it’s not heart surgery either. Obviously, we would prefer not to have to undergo even this minor surgery, but then again, I’m sure we would all prefer not to have to do IVF in the first place.

The IVF Procedure That Looks Like Surgery but Isn’t

The embryo transfer procedure can look and feel like surgery, but it isn’t.

It looks and feels like surgery because you’ll be wearing a hospital gown, have an I’ve-been-admitted-to-hospital wristband, be in a room with one doctor, two technicians, and a whole host of impressive looking medical equipment, and be lying on a bed with your legs held open with stirrups and your vagina held opened by a speculum.

So you can be excused for thinking surgery is about to happen.

Instead, all that will happen is that your embryo(s) will be transferred into your uterus. They will be placed into a catheter which is then inserted into your uterus and the embryo(s) will be deposited there.

At most you may experience some discomfort having a speculum inserted into your vagina and possibly some very mild cramping but that is quite rare. All in all, it’s not a painful procedure and there are no painful aftereffects. You will be awake and alert the entire time.

Also, your partner will be there with you and if you’re anything like myself and my husband you’ll be paying far more attention to the doctor bringing in a long tube that contains your invisible-to-the-naked-eye embryo(s) and then the screen as the ultrasound shows the catheter move into the uterus and deposit your hopefully, future children.

You don’t get that in the normal baby making process.

A man holding his partner's hand while she's being treated in an operating room

How Many Non-Surgical Procedures Do I Need for IVF

Although IVF requires only one surgical procedure, it does require several other non-surgical, medical procedures:

  • The Routine Blood Tests. Since you’ll be taking hormones to stimulate the ovaries into producing more eggs than usual, you’re going to need regular blood tests to monitor their levels and ensure they’re not too low to be insufficient to work or too high causing overstimulation. These are more of a pain in the neck than anything else as you can end up going to the clinic several times a week and waiting hours to be seen.
  • The Injections. During the earlier stages of the process, you will need to have hormone and hormone affecting injections to stimulate the ovaries. Later in the process, you may also need injections to help support a possible successful pregnancy.

    Most injections are self-administered. This can be quite frightening at first, but it’s something you’ll get used to. Trust me, I did. Eventually your main problem with injections will be finding a place that you haven’t already used and being so bruised you look like a pin cushion.
  • The Medications. This is not really a medical procedure but it’s something you’re constantly doing for the whole treatment cycle, so it might as well be! Again, during the earlier stages of the process you’ll be taking medications to stimulate the ovaries and later on, they help support a possible successful pregnancy.

    Obviously taking medications is not so terrible, but it does have its problems. You have to be on top of all the medications you’re taking because there will be quite a few. You may even feel as if your life revolves around taking your next dose. Some pills are taken vaginally and require you to lie down afterwards so you’ll have to carve out 20 minutes extra in the morning and 20 minutes extra in the evening.

    And of course, while not as bad a surgery, being tanked up on hormones, has effects of its own. Fatigue, sore or tender breasts, spikes of nausea, consistent low-level nausea, inability to bend over without experiencing extreme discomfort because your ovaries feel swollen and being more hormonally emotional than a year of periods combined is not pleasant but it’s something that can be coped with.

    At least that’s what my husband told me. But only once.
  • The Embryo Transfer. As explained above.

Surgeries That May Be Needed to Optimize IVF

If you have complicated or serious problems with your uterus, or you have undergone many treatment cycles without success then you may need other surgeries to give your IVF treatment a higher chance of success. The following is not a comprehensive list and you may need only one.

  • Diagnostic Hysteroscopy. This is where a camera is inserted into the uterus via the vagina so that it can be examined for any issues. Water may be pumped in too. It does not require anesthetic, it only takes about ten minutes and you’ll be able to leave immediately afterwards. Although you may experience mild cramp from the water pressure it’s otherwise not a painful procedure at all.
  • Surgical Hysteroscopy. This is surgery done via the hysteroscopy (vagina), for example the correction of a uterine septum, or the removal of scar tissue, polyps or fibroids. This usually requires general anesthetic, takes about 30 minutes and you’ll need to remain in the hospital or clinic for a few hours. Apart from some mild bleeding after the surgery and some discomfort for a couple of days, there are no other side effects.

    Initially the doctors said everything looked fine with my uterus. But after repeated implantation failures, the doctors wondered whether the small imperfections in my uterus could be the cause. Also, my child had been born via C-Section which left some minor scarring. Fortunately, one surgical hysteroscopy smoothed out the scar and removed a partial, uterine septum.

  • Laparoscopy. This is where a small incision is made in the abdomen to diagnose and / or treat ovarian cysts, abnormal fallopian tubes, fibroids, endometriosis and scar tissue. This usually requires general anesthetic, takes about an hour and you may require an overnight stay in the hospital. Recovery takes about two weeks.
  • Laparotomy. This is where an incision in made into the abdominal cavity to examine abdominal organs, reconnect surgically sealed fallopian tubes, or deal with complex cases of endometriosis or fibroids. This is obviously done under general anesthetic and a hospital stay of 1 – 2 nights is typical. It takes about six weeks to recover from a laparotomy.

How Much Surgery Will My Partner Need for IVF?

All the major process of IVF take place inside the woman, but if there’s a problem obtaining sperm from your partner, he may have to undergo surgery too. Again, the following is not a comprehensive list and only one may be required:

  • Sperm Retrieval. This is either done by inserting a needle into the epididymis or cutting through to it and extracting the sperm. It’s done under local anesthetic and takes about half an hour. A full recovery takes 5 – 10 days.
  • Varicocelectomy. This is where any varicose veins in the scrotum are surgically removed. This is done under general anesthetic and takes about 1 – 2 hours. It takes 3 – 4 weeks for a full recovery.
  • Vasectomy Reversal. If your partner has had a vasectomy, he will need it reversed to enable him to provide the sperm. This procedure requires a small incision in the testicle to reconnect the tube that carries the sperm from the testicle into the semen. This is done under general anesthetic and takes 2 – 4 hours. It takes 4 weeks for a full recovery.

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