Ovarian (follicular) puncture detailed information sheet for the patient

Importance of Punctuality

Follicular puncture is a key step in the IVF (in vitro fertilization) program that requires maximum discipline. The date and time of the procedure are strictly individually scheduled by your reproductive specialist. Whether it is a standard protocol, a donor egg IVF or a double donation IVF program, the timing is not chosen at random and is calculated to the exact minute: it directly depends on the administration of the ovulation trigger (a medication given 34 to 36 hours before the procedure).

Very important: it is imperative to arrive at the clinic at the scheduled time. Irreversible processes of oocyte maturation are underway in the body. A delay of 30 to 60 minutes can lead to premature spontaneous ovulation. In this case, the oocytes will be released into the abdominal cavity and it will be technically impossible to collect them for fertilization.

Preparation for anesthesia and the procedure

The oocyte retrieval is performed under short-term intravenous anesthesia. This guarantees total comfort and absence of pain, but requires strict discipline for your safety and health. Fasting is a mandatory condition:

• Strict fasting: on the day of the puncture, it is strictly forbidden to eat or drink any liquids (even water). Smoking, chewing gum, and sucking candies should also be abstained from until the end of the procedure. The presence of stomach content can provoke nausea reflex during anesthesia, which is dangerous for the respiratory pathways.
• The last meal should be light and taken the evening before (usually 8 to 10 hours before the clinic visit). Dinner should not be heavy to avoid overloading the gastrointestinal tract before sleep.

Pre-procedure diet

To enable the doctor to clearly visualize the ovaries via ultrasound and perform the puncture safely, the intestines must be calm and not bloated. Gas bubbles in the intestines can obstruct the view and make access to the follicles difficult. Therefore, 2 to 3 days before the scheduled date, it is necessary to adjust your diet and exclude foods that promote fermentation and gas formation:

• To exclude: all foods rich in raw fibers and sugars that cause fermentation. This includes all kinds of legumes (peas, beans, lentils), all mushrooms, white cabbage and cauliflower, radishes, whole milk, carbonated drinks, dark and sourdough bread, pastries, as well as raw fruits and vegetables (especially grapes, apples, and pears).
• Recommended: easily digestible foods that have been heat-treated. Suitable foods include: boiled or oven-cooked lean meat (chicken, turkey, rabbit), white fish, light broths, cottage cheese, eggs, buckwheat or rice cereals, dry white bread or rusks, cooked apples.

Post-puncture diet

The period following the procedure requires taking care of your body, as the ovaries are hypertrophied after stimulation. For 5 to 7 days after ovarian puncture, it is necessary to follow these restrictions:

1. Physical rest: completely avoid intense physical efforts, heavy lifting, sudden bends and rotations of the torso. Intense workouts at the gym (running, jumps, fitness, abdominal exercises) are prohibited. Active movements can cause torsion of the hypertrophied ovary, which is a surgical complication.
2. Thermal regimen: any thermal treatment is prohibited, as it dilates blood vessels and can worsen swelling or cause bleeding. Do not bathe in baths, saunas, apply hot water bottles on the abdomen, or take hot baths (only a lukewarm shower at a comfortable temperature is allowed).
3. Sexual rest: it is recommended to abstain completely from sexual intercourse until the physician’s approval (usually until the start of menstruation or for at least 5 to 7 days). The ovaries are very sensitive during this period and can be easily injured. This is also important to prevent infections.

Concerning symptoms

After the procedure, it is normal to experience slight lower abdominal pain (like during periods), mild swelling, and light bleeding (usually brownish or pale pink). However, you should immediately contact your healthcare provider or go to the clinic if the following symptoms appear:

• Fever above 37.5°C, chills.
• Heavy vaginal bleeding with bright red color (more intense than normal period flow, requiring frequent pad changes).
• Sudden or worsening abdominal pain, feeling of bloating that does not go away after taking permitted antispasmodics or analgesics.
• Intense weakness, dizziness, loss of consciousness, nausea, or vomiting.
• Breathing difficulties or notable increase in abdominal volume.

FAQ: Frequently Asked Questions

Question: Will I feel pain during the puncture? 

Answer: No, the procedure is completely painless. Thanks to modern intravenous anesthesia, you will be put into a medicated sleep for 15 to 20 minutes. You will sleep throughout the intervention and feel no discomfort or pain.

Question: How long does the procedure take? 

Answer: The puncture itself (the process of collecting follicular fluid) usually lasts between 10 and 20 minutes, depending on the number of mature follicles. Afterwards, you will spend about 1 to 2 hours in a comfortable room under medical supervision until you fully recover from anesthesia and your condition stabilizes.

Question: Can I drive after a puncture? 

Answer: Absolutely not. Since anesthetic medications have been used, your reaction speed and concentration may be reduced throughout the day, and you may feel slight drowsiness or dizziness. It is recommended to be accompanied by a family member or spouse, or to take a taxi to return home.

Question: What can I eat immediately after the procedure? 

Answer: One or two hours after awakening, when the effects of anesthesia have completely worn off, a sweet tea and a light snack will be offered. On the day of the puncture, it is preferable to follow a protein-rich diet (meat, fish, dairy products) and drink plenty of still water (2 to 3 liters) to help your body recover more quickly.