Patient: Dr. Malpani, I’ve been reading a lot about IVF egg retrieval. One thing that confuses me is this: sometimes women are told they have many follicles, but after the retrieval, only a few eggs are collected. Why does that happen?
Dr. Malpani: That’s an excellent question—and you’re right, it’s something many patients struggle to understand. Let’s break it down. A follicle is a fluid-filled sac in the ovary that usually contains one egg. During ovarian stimulation, we aim to grow many follicles, because each one has the potential to yield an egg. But just because you see ten follicles on ultrasound doesn’t always mean we’ll get ten eggs.
Patient: Why not? Isn’t egg retrieval a straightforward process?
Dr. Malpani: It should be—but the truth is, several factors can reduce the number of eggs collected. Some of these are unavoidable, but many have to do with the quality of the surgical technique and the time the doctor spends on your procedure.
Patient: Can you give me some examples?
Dr. Malpani: Of course. Sometimes, ovaries are difficult to reach because of adhesions from previous surgery or endometriosis. That makes egg collection technically challenging. But often, the problem lies in how the procedure is performed:
- Inexperienced surgeons may not be skilled at navigating tricky ovaries.
- Inadequate anesthesia can cause discomfort, leading to a rushed or incomplete procedure.
If follicles aren’t flushed, sticky eggs may remain inside.
Some doctors are in a hurry, trying to finish quickly because they have too many cases in a single day.
Instead of carefully aspirating each follicle, they may prioritize speed over precision.
Patient: That sounds worrying. Are patients told about this?
Dr. Malpani: Sadly, no. Many clinics present the lower egg count as a problem with the patient’s body, rather than admitting that it might be due to operator inexperience or a rushed procedure. Some even boast about how “efficiently” they complete egg retrievals, but in IVF, speed is not the same as quality. Egg collection should never be a race.
Patient: So what should patients do to protect themselves?
Dr. Malpani: You need to ask the right questions. Find out who will be doing your procedure and how experienced they are. Ask whether anesthesia will be adequate and whether follicle flushing is part of their protocol. Remember, the goal of IVF is not just to collect eggs, but to maximize your chances of creating healthy embryos. That requires time, patience, and attention to detail.
Patient: Thank you, Dr. Malpani. It feels empowering to know what really happens behind the scenes.
Dr. Malpani: That’s exactly the point. The more you understand, the better equipped you are to make decisions that protect your body and your money. IVF is too important to allow corner-cutting. Always choose a clinic that treats your eggs with the respect they deserve.
Dr. Malpani: For direct advice, you can get information to any query related to your IVF treatment from my Twin instantly at https://www.drmalpani.com/chat-w-chatbot/index.html