Egg Retrieval: 10 Evidence-Based Tips to Improve IVF

Egg retrieval is one of the most important steps in an IVF cycle. It’s that point where follicle stimulation, cycle monitoring and high emotions all converge. A good retrieval isn’t simply about collecting the eggs. It’s about cultivating and obtaining mature eggs – safely – and setting the scene for successful fertilisation and embryo development.

Here are 10 practical ways to improve the outcome of your egg retrieval. Most are clinic-led, but other steps are down to you.         

1. Ensure your clinic personalises your plan 

IVF protocols aren’t set in stone. The right plan depends on your age, AMH level, fertility history, previous cycle response, and other factors. The basic goal is to grow follicles at the right speed (very roughly, 2 mm per day). Clinics need to apply care and skill when creating your protocol.     

A carefully tailored plan ensures a fair number of mature eggs while keeping treatment safe. Updated ESHRE guidance sets out best practice. It lists 121 recommendations – all evidence-based – on how to manage ovarian stimulation and egg retrieval. These approaches have been significantly fine-tuned over time. There’s particularly good advice on low responders and those at risk of OHSS.

Speak to your clinic about its approach to IVF protocols. Ask if they follow the comprehensive guidelines above. And get them to explain the reasoning behind your specific plan, the medication proposed, any risk-reduction procedures, and the overall objectives of your treatment.           

2. Get proper pre-treatment checks before you start

If your ovaries and uterine environment haven’t been assessed, starting an IVF cycle isn’t sensible. Three months  or less before a new treatment cycle, you must have an transvaginal scan. A recent hormone profile blood test (measuring FSH, LH, AMH, TSH and Prolactin) is also important. Your clinic should ask for these as a matter of routine. Be wary if they don’t.   

A pre-treatment scan can identify ovarian cysts, a hydrosalpinx, fibroids or polyps that may affect your treatment and/or cause it to be postponed as a precaution. If you’ve had repeated implantation failure, a miscarriage, or abnormal scan findings, a hysteroscopy can detect issues a routine scan can’t. Press your clinic for other pre-treatment tests or procedures worth considering.

As for those blood tests, there are crucial for crafting a safe and effective protocol. 

3. Don’t chase high egg numbers at any cost

More retrieved eggs can be helpful, but more isn’t always better. Aggressive stimulation dosages may increase discomfort, medication costs, and the OHSS risk – especially in high responders and those with PCOS. The aim is a steady, controlled follicular response.

It’s ultimately about egg quality, not quantity. A recent study into high stimulation dosages for low responders failed to show that a large number of eggs from highly medicated IVF patients led to more live births. It challenged the ‘more is better’ approach. The right protocol is a careful balancing act, devised by clinics using their experience, judgement, and the best guidance. Every patient is different.

4. Consider mild or minimal stimulation if you’re a poor responder

For some patients – especially those with low ovarian reserve or a history of poor response – a milder approach may be best. Mild stimulation means lower doses of stimulating injectable medication, typically combined with pills like Clomiphene or Letrozole.

However this might result in fewer eggs, but their formation and quality could be better. Minimal-stimulation cycles often cost less, not least in lower medication costs. 

Mild IVF isn’t for everyone. It doesn’t guarantee better eggs or embryos. But evidence suggests mild stimulation can be a sensible option for certain patients. A 2021 systematic review looked at mild versus conventional stimulation across different responders, confirming what many clinics already knew: protocols should be bespoke to the patient. Ask your clinic if a mild cycle is an option. 

5. Give egg quality the best chance before treatment

You can’t change your age, but you can nurture the environment in which eggs develop. Most women are born with over 1 million eggs, which effectively hibernate until they’re needed. Egg maturation starts well before retrieval, so what you do in the lead-up to IVF treatment matters.

Focus on the basics: stop smoking, manage your nutrition, limit alcohol, try to sleep properly, and exercise moderately. If you have PCOS, insulin resistance, thyroid issues or high prolactin levels, getting those under better control before IVF is important.

6. Be cautious about supplements like CoQ10 and DHEA

Supplements are a hotly debated fertility topic. But evidence matters than magazine articles. CoQ10, an antioxidant, has marginally encouraging data for women with diminished ovarian reserve or poor ovarian response. No studies, however, are conclusive about its effectiveness.

A 2024 systematic review found CoQ10 was associated with improved IVF/ICSI outcomes in women with diminished ovarian reserve, but the authors also stressed the need for better-quality trials.

DHEA – another frequently-discussed fertility supplement – divides opinions more. Research from 2023 found that both CoQ10 and DHEA may improve clinical pregnancy rates for some patients. CoQ10 ranked particularly well for live births, and DHEA showed some benefit for egg yield and embryo quality. Use one or both only after discussion with your clinic.

7. Optimise sperm as seriously as eggs

Egg retrieval is half the story. If sperm quality is poor, fertilisation and embryo development can suffer. A proper semen analysis – optimally carried out less than three months before an IVF cycle – should assess at least these five parameters: volume, concentration, motility, progressive motility and morphology.

A sperm DNA fragmentation test is also an option, since genetically damaged sperm can affect outcomes. Most clinics don’t suggest this as a standard test. But forcing the pace sometimes works, so consider booking it anyway. It’s relatively inexpensive.              

Male-factor issues shouldn’t be an afterthought. Smoking, stress, excessive alcohol, obesity, heat exposure and poor sleep can all affect sperm quality. Because sperm development takes around three months, any meaningful changes should start well before egg and sperm retrieval day.

8. Be PCOS and OHSS aware

As mentioned above, PCOS patients can respond very dramatically to IVF stimulation, which raises the risk of ovarian hyperstimulation syndrome. Special care and planning is needed hear. Did you clinic assess you for PCOS? If not, why not?   

Most evidence continues to support strategies like lower starting doses, GnRH antagonist cycles, alternative trigger shots, and freeze-all cycles to reduce the OHSS risk. Studies into PCOS and IVF show that these approaches make treatment safer for high responders, although the risk is not completely removed.

9. Get  the trigger shot right

The trigger shot matters. It completes final egg maturation and sets egg retrieval in motion. If it’s applied at the wrong time, or incorrectly, you risk immature eggs and/or treatment cancellation. The classic HCG trigger is Ovitrelle. But an alternative is Decapeptyl 0.2. Applying both can boost egg maturity in some cases.              

Most egg retrievals happen around 36 hours after triggering, though your clinic will set the exact schedule. Follow your instructions precisely. Double-check time zones if travelling, store the medication properly, and ask for help if you think you made a mistake. Timing, and correct application, is key.

10. Freeze all embryos – but only when medically necessary     

A fresh transfer isn’t always best after egg retrieval. Freezing all embryos, and therefore not having a fresh embryo transfer, can be better in certain situations. Typically, this applies if the OHSS risk is high or if PGT-A testing is carried out.

Freezing all embryos, and transferring one or more later in an FET cycle, improves safety for some. It doesn’t mean freeze-all cycles are automatically better for every patient.

And a bonus tip. Embryos are always frozen after testing. But you don’t need to test all viable embryos. Testing and freezing some, then transferring a non-tested one in a fresh transfer, is an option that can make medical and financial sense. Ask your clinic what’s best for you