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QUESTION: Dear Expert,
I live in India. I want to harvest my eggs but from all Iíve read, harvesting eggs is very painful and intrusive. Why is it not possible for a doctor to collect an egg from a sanitary napkin? Why canít they collect an egg when a woman has her period? Some time ago I googled and it sounded like it was possible to do this, ie collect an egg during a period. But if its possible, then no one would still go through the horrible process of harvesting eggs.

So, is it or will it be possible soon to collect eggs from a sanitary napkin or period? Is the west experimenting with any painless method of egg collection and is it on the horizon? Thanks.

ANSWER: Hello "a" from India,

I'm afraid your understanding of human physiology is not correct.  When you have a "period" it is the uterine lining that is being sloughed, NOT the egg.  The egg is not contained within it.  The egg stays within your body and is picked up by the Fallopian tubes.  There is no way to "collect" an egg unless the body is entered.  

In the early days of IVF, there were so studies that showed that "embryos" could be collected by washing out the endometrial cavity a week after ovulation.  But this was not for the purpose of doing IVF or getting the woman pregnant.  It was for experimental purposes only.

If you want to do IVF, the only method is by retrieving the eggs directly from the ovaries by passing a needle through the vagina and aspirating it from the ovaries.  In the U.S., this is done under conscious sedation so that you are asleep when it occurs and do not "feel" the procedure (otherwise it would be very painful).  I presume from what you state, that using sedation is not the usual way in India, so maybe you should go elsewhere to have it done.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate



---------- FOLLOW-UP ----------

QUESTION: Hi,
Thanks for your answer. Iím sure sedation IS the usual way in India too. But I once read some western womanís account of it and she spoke of how painful it was. Perhaps she was not sedated at the time.

Also, I read they give you hormones to stimulate egg production and that is what is so painful.

I have a low threshold of pain. things other women can endure I find very painful, even simple things like waxing. Also, Iím in my early 40s and am terrified of childbirth. Not just because its painful but because I fear my age will add complications.

So in this scenario what would you advise? Would it be best to harvest my eggs or risk going through childbirth myself? in india its also quite easy to hire a surrogate to carry your child. If I am not wiling to harvest my eggs, the child would be biologically the surrogateís which again would not be ideal. Naturally I want a child that is biologically mine.

Thanks again.

Answer
Hello,

Just to clarify, sedation "does not hurt" and stimulating egg, production does not hurt unless a woman's ovaries respond too strongly (ovarian hyperstimulation syndrome), in which case this is a complication of IVF and can cause other problems as well.  Because the ovaries have too many eggs (overstimulation), they ovaries become very tender.

In your situation, there are several factors to consider, but the most important one is your age.  If you are in your early 40's, they you need to understand that the chances of pregnancy, even with IVF, is low.  At the age of 42 years old, the pregnancy rate is 30% per cycle but the delivery rate is only 12%.  The reason for this decreased rate is because of the age of the eggs regardless of whether or not you use a surrogate.  For this reason, donor eggs are recommended.  If you are between 40-42 years old, then the chances are a little better and it would be worthwhile to try with your eggs first using a surrogate.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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