Due to improvements in ultrasound imaging, surgery is no longer necessary for most In Vitro Fertilization patients. A technique for recovery of eggs from the ovary is described below. It uses a sonographically-guided needle to replace the surgical procedure which previously was used to recover oocytes (eggs). This procedure, called Transvaginal Oocyte Retrieval, requires neither hospitalization nor general anesthesia.

In order to prepare a proper environment in the woman and to increase the chances of recovering several healthy and mature eggs, the woman will undergo about two weeks of intensive preparation. This will include hormonal therapy with "fertility drugs." Blood tests and ultrasound scans of the ovaries are used to determine the optimal time to retrieve the eggs from the ovary. This optimal time is just before ovulation when the oocytes are almost ready for fertilization.

At the proper time, an outpatient procedure under local anesthesia will allow the female's eggs to be visualized by ultrasound and retrieved from the ovary by placing a needle through the vaginal wall. The mild discomfort that the patient feels has been described as similar to a Pap smear or endometrial biopsy. After a short rest, the patient will be able to go home and resume normal activities.

The fluid from the follicles is examined under the microscope by the embryologist, who locates the eggs and keeps them in the laboratory under physiologic conditions. The embryologist will place the sperm with the eggs when they are ready for fertilization. Usually, the eggs will develop into cleaving pre-embryos, whose cells divide 2 or 3 times to become preimplantation embryos (pre-embryos). They are maintained in laboratory dishes, in a nutrient mixture which acts as a substitute for the environment that would otherwise have been provided by the fallopian tubes.

Using a special catheter, the couple's pre-embryos will be passed through the vagina and into the uterus at the time the pre-embryos would normally have reached the uterus (2+ days after retrieval).

After the pre-embryo placement in the uterus, the patient will lie quietly in a bed for about an hour, and then will return home.