If you want to prevent fertility issues from becoming gut issues, this post has everything you need to know about preparing your body for IVF or egg freezing, and what you’ll need for post egg retrieval recovery (often the hardest part!). From my own experience, these tips will help you avoid the worst IVF side effects and feel better faster.
Here’s what this egg retrieval recovery post covers, in case you want to jump straight to the tips:
My Experience with Infertility and Egg Retrieval
Back in February 2020, I had no idea that a surprise pregnancy and subsequent loss was just the beginning of a long struggle to bring a baby into this world. (After all, there was a lot we weren’t prepared for in February 2020!). I wrote about my recurrent miscarriages in this post, which ultimately led to our decision to pursue surrogacy.
This new path offered many upsides—a womb with a stellar track record for growing babies, for one—and of course some parts of the experience that we had to grieve. One of the biggest drawbacks at the time, perhaps even more jarring than losing a lot of money and control, was that I would need to do IVF.
Being an author who focuses on hormone and gut health (more on my books here), I worried about how all the injections would impact my thyroid health and ongoing management of autoimmune disease. The cliché picture I had in the back of my head was of my own unhinged self-storming the house, jacked up on a cocktail of hormones, before collapsing into a puddle of bitter tears, raging to my husband about the unfairness of it all.
Perhaps it was because I had already been through some brutal medications to combat pregnancy loss, but the IVF injections ended up being one of the easier parts of the process, both emotionally and physically. It was the egg retrieval recovery that no one prepared me for. And my god, it was a bitch.
Being “naturally minded,” the first round of egg retrieval, I ignored much of my doctors’ advice to purchase Colace and Pedialyte. The second time around, I had learned my lesson the hard way, and developed my own arsenal.
This post is a (probably more detailed than you wanted) collection of my egg retrieval recovery tips—the things I’ve told girlfriends going through IVF after me, and a mini deep dive into why some of the side effects of egg retrieval can have a downwind impact on your long-term gut health.
There’s a lot of information on how gut health can affect fertility (here is a great podcast episode on infertility and SIBO). But not as much data on how the egg retrieval and IVF process can impact gut health.
However, I have collected plenty of anecdotal data over the years from people who really struggled with their digestion following egg retrieval, either reigniting a condition like SIBO or creating new problems.
There are several factors at play (anesthesia, antibiotics) that we do have data on, and more importantly, some tools to help combat the worst downsides.
But first, let’s start with some of the basics so you know exactly what to expect for your recovery post egg retrieval.
Short Term IVF Side Effects: Constipation, Bloating and OHSS
It’s important to note that everyone’s body is different and while I had a rather rough egg retrieval recovery, I know other women who walked out of the fertility clinic and went about their day–in their normal non-stretchy jeans!–like nothing had happened. You could be one of these lucky gals! And it is my sincerest hope for you that you are.
Most people will experience some bloating or distention, like a bad first day of your period with mild cramping.
Many patients feel woozy (slightly disoriented) from the anesthesia, and some will experience a sense of fullness or mild menstrual cramp-like discomfort. Sometimes there will be spotting, and you’ll likely get sent home with a pad or panty liner just in case.
How long do egg retrieval side effects and symptoms last?
The bloating often peaks a day or two after the procedure. So if you feel great on day one, try to still take it easy on day two. You will likely be able to go into work, but I wouldn’t count on any activities that are overly taxing.
In general, any athletic activities that involve bouncing or jostling are strictly forbidden until you get your period, which acts as a reset for your lady parts. This includes biking, running, horseback riding, yoga moves that involve twisting or inversions, even speed boats.
The biggest reason for this is to avoid Ovarian Hyperstimulation Syndrome, or “OHSS” for short. This is the most serious side effect you will encounter from egg retrieval, so it’s important to limit activities accordingly.
OHSS is a result of all that the process asks of your ovaries and often those who have a very successful round of egg retrieval (meaning many mature eggs grown) have a higher likelihood of developing outsized inflammation of the ovaries as a result.
It is a small percentage of fertility patients—only 3%–who are affected by OHSS, but it is important to have on your radar if you experience intense abdominal pain, nausea or vomiting.
In my experience, though I never suffered from OHSS, the bloating and abdominal pain continued to be fairly debilitating for the full 10 – 14 days it took me to get my next period. I wouldn’t say this is the norm (at all), but if you are quite sensitive or prone to inflammation, you may be in this camp alongside me.
As with all things, knowledge and awareness (and the tools below!) make the side effects more manageable and less alarming. For my second round, though I was still uncomfortable for a similar timeline, I had a much better experience with egg retrieval recovery.
Long Term IVF Side Effects: Gut Health and Hormone Imbalances to Avoid
The long term side effects of egg retrieval are a little murkier, but we can break down what we know about the impact of some parts of the process on gut and hormone health.
Hormone injections can lead to estrogen dominance
Medications used in IVF and egg retrieval increase the level of LH and FSH, which in turn raises estrogen levels. This is one of the reasons why egg retrieval is not always recommended for women with a family history of breast cancer.
Estrogen dominance is a condition that is often talked about with regard to gut health and thyroid health. Regulating the proper amount of estrogen in circulation is a delicate dance, and our hormonal motherboard relies heavily on our ability to eliminate what’s deemed excess.
Too much estrogen in the body—either thanks to an inefficient liver, medications that drive levels up (as is the case with egg retrieval), a disrupted microbiome, or simply not pooping every day—can cause a cascade of problems in our gut.
Estrogen dominance can affect our ability to convert thyroid hormones. It can promote yeast overgrowth. And it puts you at higher risk of losing your gallbladder. If you have gallbladder dysfunction and you don’t make bile acid, you’re missing one important line of defense in the digestive process. This can lead to IBS and SIBO.
Anesthesia can cause constipation
Anesthesia not only knocks you out for your egg retrieval, it also paralyzes many of your internal muscles for the duration. Your intestines, for example, won’t be able to contract to push food through its tubing. Often it can take time after you regain consciousness for your digestive machinery to fully “wake up” and kick back into full gear. This is one reason for the feeling of bloating and fullness after an egg retrieval procedure.
I have some recommendations below for how to modify your diet (and supplement routine) to help make sure that any intestinal lagging doesn’t turn into a bigger gut issue down the line.
Antibiotics can damage your gut microbiome
Finally, there are the antibiotics administered intravenously during the egg retrieval itself.
These are often not discussed with the patient – I would have had no idea if I didn’t ask about it! These drugs are to make sure you don’t develop any infections after the procedure. But coupled with some of the other aspects of egg retrieval mentioned above, they can fan the flames of digestive issues afterwards.
It’s fairly well known at this point that antibiotics can have a devastating effect on the diversity of your gut flora. Broad spectrum antibiotics can kill up to 1/3 of your beneficial bacteria in your large intestine. These gut critters impact everything from digestion, to mood to memory. And fostering diversity is one of the biggest thing we can do for our overall health.
In addition to the microbiome issue, antibiotics can also stunt your intestines by impacting your migrating motor complex, the nerve cells that power the clean-up wave after a meal. A breakdown in the migrating motor complex is one of the biggest SIBO and IBS root causes.
This is why it’s important to go into egg retrieval recovery with your microbiome in mind. Read on for some of my tips to offset the antibiotics and support your gut motility.
My Essential Tips for Recovery After Egg Retrieval
Eat an anti-inflammatory diet during injection phase
The best way to ensure a less painful egg retrieval recovery is to limit inflammation during the first phase of the IVF process. This can also improve your egg retrieval outcome! At the very least, during egg retrieval, try to avoid alcohol, sugar, and caffeine (unless you’re someone who metabolizes it well). I have more information on why this vice trio is so helpful for supporting your liver. And remember, promoting natural liver detox is one of the best ways to combat estrogen dominance after retrieval.
When it comes to managing bloating and giving your intestines a leg up, I have more diet tips for things to focus on post-egg retrieval below.
Start stool softener before retrieval
During the last few days of injections, as your eggs get increasingly large, you can start to experience some of the digestive side effects I mentioned above. On a very basic level, the more room your reproductive organs take up in your abdomen, the less space your intestines have to push food through your system. This can often result in constipation, which is then compounded by the effects of anesthesia and antibiotics.
So the best course of action is to make sure that you’re not already backed up before going under for the procedure. Though I resisted it during my first round of IVF, one of my TOP TIPS for friends going into this process is to stock up on Colace and to start the stool softener a few days before your retrieval, in conjunction with your trigger shot.
Unlike a laxative, stool softener is mild and usually won’t result in swinging too far in the other direction into diarrhea.
If you want to take it one step further, you can try to limit intense woody vegetables, nuts, seeds, legumes, corn and anything else that takes a few days to make it through your system leading up to egg retrieval. More on this below!
Continue to make sure you’re pooping
Even with the stool softener, that first poop after egg retrieval can be a hard one to come by (pun intended). You will likely need to continue the Colace for a few days until your bloating has subsided and there’s not so much inflammation in your abdomen. But there’s no shame (or risk) in taking it until your period arrives and everything calms down.
During my second post egg retrieval recovery I think I went through 2 boxes! And I was much happier for it.
If the stool softener alone isn’t moving the needle, you can supplement with other anti-constipation methods. Here are some of my favorites:
Even though I encourage giving up sugar during your retrieval process, afterwards the most important thing is that you stay hydrated and replace essential minerals and electrolytes. This can be done through Pedialyte, yes. But if you want to avoid the dyes, coconut water and some all natural electrolytes will also do the trick. Here are my favorite brands:
Give your belly room to breathe
If there were three things I recommend buying for egg retrieval recovery it’s colace, electrolytes, and loose fitting overalls.
As I mentioned, I know women who walked out of surgery in skinny jeans, but I personally could not wear anything with a waistband (like not even boxer shorts) for a full week after egg retrieval. I am an extreme case, but for the first few days I recommend having something quite comfy on hand that won’t put any pressure on your abdomen. This will ensure your digestive and reproductive organs have as much room as possible to function.
Drawstring pajama bottoms (like scrubs!) work well since you can adjust where they hit and the amount of pressure. But I swear by these chic, cheap linen overalls. They were the best $25 I ever spent and I still wear them all the time when I’m having a bad gut day.
Make a (non-electric) heating pad your best friend
Nothing feels better during the worst bloating phase than a heating pad on your abdomen. I recommend using one that’s filled with rice or seeds that you can stick in the microwave to heat. Many electric options involve plastic that, when heated, can off gas. This one is one of my favorites.
Take probiotics and prebiotics to offset antibiotics
Fertility doctors can be quite wary of any vitamins or supplements during the retrieval process, as certain herbs can interfere with the cocktail of medications you’re on. So check with your practitioner about whether probiotics or prebiotics are alright to during your protocol. If they are, fantastic. If not, you can start immediately post egg retrieval.
Probiotics are of course important for re-seeding the gut and encouraging any healthy bacterial populations that were decimated by antibiotics to grow back. However, an underappreciated truth is that they are so much less important for promoting good gut health than prebiotics. Ideally you will take both in tandem.
For those who have dealt with IBS, check out my recommendations for Probiotics for SIBO in this post. Otherwise, here are some of my favorite products:
Reduce bloating through diet
Especially if you’ve been eating carefully during the retrieval process, being done can make you want to dive immediately into a bowl of mac and cheese or a goblet of wine. I get it, trust me. But you will feel so much better if you postpone the comfort food bacchanal by a few days (or until your bloating has subsided and bowels returned to normal).
Try to avoid too much dairy and heavy foods. On the flip side, raw salads or vegetables are also going to give your gut a lot to process.
One tactic is to follow a low FODMAP diet, which reduces certain fibers that can be irritating to the gut or hard to digest. But more broadly, my advice is to focus on simple, cooked foods—especially purees or detox soup—that will be easier for your intestines to breakdown and move through your system. Here are some recipes to check out:
You can even check out this post on the best foods to eat after tooth extraction – it includes a lot of soft easy to digest things!
The final word on egg retrieval recovery
I know these egg retrieval recovery tips might seem like a lot to process, but know that you don’t have to do all of the above all at once. These are tools to have in your kit if your side effects are on the more severe side—like mine. But you shouldn’t fear the process. I think most people, myself included, can say that once you are on the other side, doing IVF or an egg retrieval wasn’t as bad as you thought.
If you take certain precautions, the IVF process doesn’t need to impact your gut or hormone health in the long-term. You will get back on your feet, and one day, hopefully every penny and spot of stool softener will be worth it! Now that our baby girl is here, I know I would do it all again in a heartbeat.