Everything You Need to Know About Anesthesia and Sedation During Egg Freezing

Egg retrievals, which take about 30 minutes, are considered a minimally invasive procedure. Women undergoing egg freezing often ask me if they are “put to sleep” (under anesthesia) during that time… and the answer is, usually yes. Not only is it important for you to remain still during the procedure, but anesthesia can help you relax and block pain. In this guide, we’ll review some of the most common questions we get about anesthesia and egg retrievals:

• What happens during an egg retrieval? 
• What is anesthesia and is it safe?
• What type of anesthesia is used for an egg retrieval?
• Is propofol used for egg retrievals?
• How is sedation administered during an egg retrieval?
• How long are you under anesthesia for egg retrieval? 
• What happens during anesthesia in an egg retrieval?
• How do you prepare for anesthesia during egg freezing?
• Why do you need anesthesia during egg freezing?
• Can you do an egg retrieval without anesthesia or sedation?
• What can you do if you’re afraid of anesthesia?

First, let’s review what happens during an egg retrieval

The egg retrieval is the final culmination of the egg freezing process. During an egg retrieval, the eggs are removed from the ovaries and frozen for your future use. 

Here is a general overview of what happens during an egg retrieval procedure:

1. You are usually given medication to help relax and reduce anxiety.
2. You are usually given a local anesthetic to numb the area where the eggs will be retrieved.
3. A thin needle is inserted through the vagina and into the ovary, guided by ultrasound imaging.
4. Fluid is gently suctioned through the needle to remove the eggs from the follicles.
5. The retrieved eggs are examined under a microscope to determine their number and quality.
6. The eggs are then frozen and sent to long-term storage.

The entire egg retrieval procedure typically takes about 30 minutes, and you can go home the same day knowing how many eggs were retrieved.

What is anesthesia and is it safe?

Anesthesia is a medical treatment that blocks the sensation of pain and other sensations during surgery or other medical procedures. It is administered by anesthesiologists, doctors who are specially trained to manage pain and other aspects of care during and after surgery.

Anesthesia is generally safe, but like any medical procedure, it does carry some risks. The type and severity of the risks depend on the individual patient and the type of anesthesia being used. Some common risks associated with anesthesia include allergic reactions, breathing problems, and blood pressure changes. However, these risks are rare and the benefits of anesthesia typically outweigh the potential risks.

It's important to discuss any concerns you have with your anesthesiologist and other members of your healthcare team before your surgery or procedure. They can help you understand the potential risks and benefits of different types of anesthesia and help you make an informed decision about your care.

There are several types of anesthesia:

• General anesthesia is used to render a patient unconscious and provide full body muscle relaxation. 
• Regional anesthesia numbs a larger area of the body, typically involving a nerve block.
• Local anesthesia numbs a small area of the body, such as a single tooth.
• Monitored anesthesia care (MAC) is a form of sedation used to keep a patient relaxed and comfortable during a procedure. 
• Sedation is used to help people relax and feel comfortable during a medical procedure. It can range from minimal sedation (also known as "conscious sedation") to deep sedation, in which the person is not conscious but can be aroused.
• Twilight sedation or twilight anesthesia is another term you may hear for sedation, when a patient is sedated but remains conscious in a “twilight state”.

The type of anesthesia that is best for you will depend on your medical history and your preferences. Your healthcare team will help you decide which type of anesthesia is best for you.

What type of anesthesia is used for an egg retrieval?

For egg retrieval procedures, a common type of anesthesia used is sedation, a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic). Conscious sedation lets you recover quickly and return to your everyday activities soon after your procedure.

According to board-certified anesthesiologists Dr. Steven Alfond of Extend Fertility, “There’s light sedation, like taking a dose of Valium; during light sedation, patients are awake, and they’ll probably remember what’s going on. Light sedation might be used for simpler procedures. The fertility procedures require something a little deeper; we call it deep sedation. Most patients require just one medication—propofol—and, depending on pain, a pain medication.”

Sedation for egg retrievals is generally a combination of propofol, fentanyl, and midazolam, and designed to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable. In some cases, such as when a larger procedure is required, general anesthesia may be used. This type of anesthesia is designed to put the patient into a deeper sleep, allowing them to remain unaware of the procedure.

Propofol for egg retrievals

Propofol is a sedative-hypnotic medication that is used to produce sleepiness or drowsiness and to relieve anxiety before and during the egg retrieval. It is often used for intravenous (IV) conscious sedation, which means that you remain awake but relaxed and comfortable during the procedure. Propofol is a popular choice for conscious sedation because it takes effect quickly and wears off rapidly, so you typically feel alert soon after the procedure. 

How is sedation administered during an egg retrieval?

Propofol is administered through an IV line, and the amount of medication can be adjusted to achieve the desired level of sedation. Because it is not general anesthesia, you can breathe on your own and don’t need breathing tubes (phew!).

How long are you under anesthesia for egg retrieval? 

Here’s the good news – the egg retrieval is a relatively quick procedure that typically takes 30 minutes. The length of time you are “under” or “asleep” depends on the type of anesthesia being used and your response to the medication.

If general anesthesia is used, you will be unconscious for the duration of the procedure and will not be aware of the time passing. If conscious sedation is used, you will be awake but relaxed and comfortable, and may not remember much of the procedure.

Regardless of the type of anesthesia used, the anesthesiologist will carefully monitor your vital signs and adjust the medication as needed to ensure your safety and comfort during the procedure. After the procedure, you will need to rest in a recovery area until the effects of the anesthesia have worn off, which can take anywhere from a few minutes to a few hours. (This is why it’s important to bring a buddy to drive you home!)

What happens during anesthesia in an egg retrieval?

If your doctor uses conscious sedation during the retrieval, the medication can take effect quickly (within seconds), so you’ll begin to feel relaxed and drowsy soon after receiving it. You’ll remain conscious and able to respond to commands during the procedure, but may not remember much about it afterwards.

If you choose deep sedation, you will go into a state of unconsciousness or near-unconsciousness rather quickly. You will not be fully aware of your surroundings and may not be able to respond to commands or communicate with the doctor. In other words, you’ll be in a deep sleep. 

If your doctor uses general anesthesia, you will be unconscious and unable to feel pain or sensation. General anesthesia is typically administered through an intravenous (IV) line or with a gas that you inhale. It is used to relax and incapacitate the muscles in your body, so that you do not move during a surgical procedure.

In any of these situations, your vital signs, such as heart rate and blood pressure, are closely monitored by the anesthesiologist to ensure your safety. The anesthesiologist will adjust the dosage of the medication as needed to keep you in a deep state of unconsciousness. After the retrieval is completed, the anesthesiologist will slowly reduce the level of medication, and you will begin to wake up. It is common to feel groggy and disoriented when you first come out of a deep sleep, but you’ll be back to yourself in no time.

How do you prepare for anesthesia during egg freezing?

Here are some ways to prepare for your egg retrieval:

• Inform your doctor about all the medications you are currently taking, including prescription and over-the-counter drugs, supplements, and herbs.
• Follow any instructions given by your doctor or anesthesiologist regarding eating and drinking before your egg retrieval.
• Arrange for someone to drive you home after the egg retrieval.
• Remove all jewelry and leave it at home.
• Wear comfortable, loose-fitting clothing to the clinic.

Your doctor will give you instructions for preparing for the egg retrieval, and it is important to follow their instructions to reduce the risk of complications during and after the procedure. 

Why do they use anesthesia and sedation during egg freezing?

Sedation and anesthesia are often used for egg retrievals to keep you still (so the doctor can successfully perform the procedure) as well as relaxed and comfortable.

You can work with your doctor to determine which method to use, based on your preferences and medical history. It is important to discuss the options and any concerns you have before the procedure. Your doctor can help you understand the potential risks and benefits of different types of sedation and help you make an informed decision about your care.

Can I do an egg retrieval without anesthesia or sedation?

While sedation is standard of care for an egg retrieval procedure, it is usually not required. Some women have had medical reasons for not wanting sedation, while others are concerned with the drugs used during sedation and are looking for a more natural course of treatment. If you don’t want to use anesthesia for your egg retrieval, it’s important to talk to your doctor in advance of the procedure. 

Most women prefer egg retrievals under sedation/anesthesia. But doing an egg retrieval without anesthesia is cheaper and faster, and does not require the presence or assistance of an anesthesiologist. Research has shown that it results in good satisfaction among the patient and the physician. 

A study of 100 women undergoing egg retrievals found that women who chose to skip sedation were significantly more likely to express fear of anesthesia. Those women experienced more pain during egg retrieval, but all but one said they would do the same in future cycles. 

What to do if you’re afraid of anesthesia

If you are afraid of anesthesia, it is important to communicate your concerns with your healthcare team in advance of the procedure. They can help you understand the process of anesthesia, your options, and what to expect. It may also be helpful to speak with an anesthesiologist, who can explain the specific medications and techniques that will be used during your egg retrieval.

You may also choose to bring a trusted family member or friend with you to your appointments, so that you have someone to support you and ask questions (you should also have someone with you at the retrieval as well).

Lastly, you may benefit from practicing relaxation techniques, such as deep breathing or progressive muscle relaxation, in the days leading up to your retrieval. I also found it helpful to listen to music through my headphones as the IV was put in and I went under sedation. Remember that your doctors are trained to keep you safe and comfortable throughout the procedure. You’ve got this!

Cofertility is in the “family” business, striving to make egg freezing and third-party reproduction more human-centered and accessible for all. Our Freeze by Co program allows you to freeze your eggs for free, when you give half to a family who can't otherwise conceive