Stage 1: The Injections – Scary to Think About, But Manageable

What Happens: For approximately 10-14 days, you'll self-administer hormone injections (typically FSH and/or LH) to stimulate your ovaries to produce multiple eggs instead of the usual single monthly egg[4][5].

What It Feels Like:

• The needles: Modern fertility medications use very thin, short needles (similar to insulin pens) that are subcutaneous (under the skin, not deep into muscle)[5][6]
• Pain level: Most donors rate injection pain as 1-3 out of 10. You may experience minor discomfort, slight bruising, or redness at injection sites[4][7]
• Reality check: The anticipation is often worse than the actual experience. Once you've done your first injection, anxiety typically decreases significantly

Tips to Minimize Discomfort:

• Ice the injection site for 30 seconds before injecting to numb the area
• Inject slowly and steadily rather than quickly jabbing
• Rotate injection sites to avoid repeated trauma to one area
• Relax your muscles – tense muscles make injections more uncomfortable
• Your clinic will teach you proper technique; don't hesitate to ask for hands-on training

The "Trigger Shot": 36 hours before egg retrieval, you'll receive a final hormone injection (either hCG or GnRH agonist) to mature the eggs[8]. Some donors report this injection as slightly more uncomfortable than daily shots, but still manageable[3].

Stage 2: Ovarian Stimulation – Temporary Physical Changes

What Happens: As follicles grow in your ovaries (each containing an egg), your ovaries enlarge. This growth is intentional and necessary for successful egg retrieval[4][5].

What It Feels Like:

Common symptoms (experienced by many donors):

• Bloating: Feeling like you're retaining water or experiencing PMS symptoms. Your clothes, especially around the waist, may feel tighter[2][4][9]
• Pelvic fullness or pressure: A sensation of heaviness in your lower abdomen as ovaries swell[7][9]
• Mild cramping: Similar to menstrual cramps, typically manageable with over-the-counter pain relief[2][9]
• Breast tenderness: From hormonal changes[4][7]
• Fatigue: Feeling more tired than usual[7]
• Mood changes: Irritability, emotional sensitivity, or mood swings similar to PMS[3][4][7]
• Weight gain: Typically 3-5 pounds from fluid retention and enlarged ovaries[10]

Duration: These symptoms typically begin mid-stimulation cycle and fully resolve within days after egg retrieval[4][9].

Stage 3: The Egg Retrieval Procedure – You'll Be Asleep

What Happens: Under IV sedation (twilight anesthesia or general anesthesia), a thin needle is guided through your vaginal wall into each ovary via ultrasound. Eggs are gently suctioned from follicles[4][5]. The entire procedure takes approximately 20-30 minutes.

What It Feels Like:

• During the procedure: Nothing. You're fully sedated and won't feel pain[3][4][9]
• You won't remember the procedure due to the amnesic effects of sedation medications

Immediately After (Recovery Room):

• Cramping: Most donors experience period-like cramping for a few hours after waking[2][3][9]
• Grogginess: Mild grogginess from anesthesia (someone must drive you home)[4]
• Spotting: Light vaginal spotting is normal; heavy bleeding is not[10]

Stage 4: Recovery – Back to Normal Within Days

What to Expect:

Day 0 (Retrieval Day):

• Rest at home
• Mild to moderate cramping (take prescribed or over-the-counter pain medication)
• Some donors feel fine by evening; others prefer to rest

Days 1-2:

• Continued mild cramping and bloating
• Some fatigue
• Most donors feel well enough to return to light activities

Days 3-7:

• Gradual resolution of bloating and any remaining discomfort
• Your next menstrual period will likely be heavier than usual[3]

Recovery Tips:

• Stay hydrated (helps reduce bloating and supports kidney function)
• Eat protein-rich foods
• Use a heating pad for cramping
• Avoid strenuous exercise for about one week
• Resume normal activities gradually as you feel comfortable

When Most Donors Return to Normal: Research shows that 99% of egg donors resume normal activities shortly after retrieval and report no long-term pain effects[11].

Why Modern OHSS Rates Are Lower

Advances in reproductive medicine have dramatically reduced OHSS risk[15][16][20]:

1. GnRH antagonist protocols instead of older agonist protocols (lower risk)[13][18]
2. GnRH agonist trigger instead of hCG trigger for final egg maturation (can virtually eliminate severe OHSS risk)[13][18][20]
3. Individualized medication dosing based on your ovarian reserve testing[18][20]
4. Close monitoring with frequent ultrasounds and blood tests to track follicle development[4][7]
5. "Coasting" – temporarily stopping medications if response is too strong[13][20]
6. Freeze-all approach – if OHSS risk is detected, all embryos are frozen and no fresh transfer occurs, allowing OHSS to resolve[13][16][20]

Who Is at Higher Risk for OHSS?

Known risk factors include[13][15][18]:

• Polycystic ovary syndrome (PCOS)
• High ovarian reserve (high AMH levels, many antral follicles)
• Young age and low BMI
• Previous OHSS history
• Retrieval of ≥20 eggs[21]
• Rapidly rising estradiol levels during stimulation

Important: Your clinic will screen for these risk factors and adjust protocols accordingly.

Signs You Should Call Your Doctor Immediately

Mild symptoms (normal and expected):

• Mild bloating and abdominal fullness
• Mild nausea
• Weight gain of 2-3 pounds

Warning signs requiring immediate medical attention:

• Severe abdominal pain or swelling
• Persistent nausea and vomiting
• Rapid weight gain (>2 pounds in 24 hours)[12]
• Decreased urination or dark urine[12][13]
• Shortness of breath or difficulty breathing[12][13]
• Severe bloating that worsens instead of improving
• Pain in your leg (potential blood clot)[12][13]

Critical point: OHSS is preventable and manageable when caught early. Don't hesitate to contact your clinic if something doesn't feel right.

How NGC Clinic Prevents and Manages OHSS

At NGC Clinic, OHSS prevention is a top priority:

• Comprehensive screening to identify high-risk donors before stimulation begins
• Individualized protocols based on your specific ovarian reserve
• Frequent monitoring (typically 7-10 clinic visits during stimulation)[7]
• Modern trigger protocols using GnRH agonist when appropriate
• 24/7 access to medical staff if you develop concerning symptoms
• Clear written instructions on warning signs and when to seek help

Our goal is an OHSS-free clinic through careful protocol selection and vigilant monitoring.

Research findings:

• Studies measuring anti-Müllerian hormone (AMH) – a marker of egg reserve – show no decrease in AMH levels in donors who underwent multiple cycles over several years[10]
• No convincing evidence links fertility drugs used in egg donation to adverse health outcomes like ovarian cancer[3][22]
• Women are born with approximately 300,000 eggs; even retrieving 12-25 eggs per cycle for six cycles (ASRM's maximum recommendation) does not meaningfully deplete your egg supply[10]

The bottom line: Multiple studies confirm that egg donation does not impair your ability to conceive naturally in the future[7][23].

Positive emotions reported by donors:

• Pride in helping others achieve parenthood
• Sense of purpose and meaning
• Empowerment through the donation process
• 91% of anonymous donors report being moderately to extremely satisfied with their experience[3]

Challenging emotions some donors experience:

• Hormonal mood swings during stimulation
• Anxiety about the medical procedures
• Questions about genetic offspring in the world
• Stress related to time commitments

Important: Reputable clinics require psychological screening and counseling to ensure donors:

• Fully understand the process
• Have realistic expectations
• Are emotionally prepared for donation
• Have access to ongoing psychological support if needed[4][24]

• Have an extreme fear of needles or medical procedures that causes severe distress
• Cannot commit to the time requirements (multiple clinic visits over several weeks)
• Have/had substance use issues
• Have certain medical or genetic conditions
• Have body mass index (BMI) outside the acceptable range
• Are over 30 years old (age limits vary by program)[7][10][24]
• Have had severe OHSS in the past[21]
• Have psychological concerns about genetic offspring

Deciding to donate is a personal choice that only you can make. Being honest with yourself about your motivations, concerns, and limitations is essential.

• Study 1: Donor Pain Perception and Experience (2022)

  Study: Retrospective survey of 246 U.S. egg donors[1]

  Key findings:

  • Most donors ranked pain as minimal to moderate throughout the process
  • Altruistically motivated donors and donors who already had children were less likely to experience unexpected pain levels
  • Those informed about pain risks experienced less unexpected discomfort
  • 92.3% of donors reporting negative experiences also reported unexpected high levels of pain – emphasizing the importance of informed consent

  Conclusion: Proper education about what to expect significantly improves donor experience.

• Study 2: OHSS in Egg Donors by Trigger Type (2023)

  Study: Survey of 289 egg donors across 801 cycles[21]

  Key findings:

  • OHSS risk varies significantly based on protocol used
  • GnRH agonist trigger with <30 eggs retrieved: Very low OHSS risk
  • hCG trigger with >30 eggs retrieved: Significantly higher OHSS risk
  • Prior severe OHSS is a strong predictor of future OHSS risk

  Conclusion: Modern trigger protocols can dramatically reduce OHSS risk when properly employed.

• Study 3: Long-term Donor Satisfaction

  Study: Multiple studies examining donor satisfaction[3][7]

  Findings:

  • Vast majority of donors report positive experiences
  • Many donors donate multiple times
  • Key predictors of satisfaction: clear information, supportive clinic staff, meeting expectations
  • Dissatisfaction correlates strongly with unexpected pain or complications