Elena's episode: one change, four commitments, recovery and freeze-all
One signed change reaches instructions, the OR, anesthesia and the lab. Later an outside emergency visit for OHSS turns a planned fresh transfer into freeze-all.
Stage 5 of 9
Retrieval & recovery
Egg retrieval is an ultrasound-guided procedure under sedation that usually takes 15 to 30 minutes, followed by recovery in the clinic and structured check-ins at home. Afterward, the team watches for ovarian hyperstimulation syndrome (OHSS): an over-response to stimulation medicines that can cause rapid fluid shifts, bloating or abdominal pain in the days after retrieval. Symptom questions always go to the clinic's care team, and emergencies to 911.
The whole procedure team
A slot is confirmed only when every team accepts
Elena's retrieval moved with version 3 of her plan. Each team commits to the revised slot on its own, and the slot stays unconfirmed until all of them have.
Revised slotNov 1 · 07:00 PST · Room 2Plan version 3, signed by Dr. Mira Lee
- Room and equipmentProcedure deskAcceptedRoom 2 and recovery bay reserved
- AnesthesiaAnesthesia teamAcceptedAccepted the revised slot
- EmbryologyEmbryology labPendingAssignment not yet accepted
- RecoveryRecovery nursingPendingCoverage offered, awaiting acceptance
2 commitments pending. Not confirmed yet.
From the multi-party walkthrough. Team names are roles. Fictional patient data.
See it
Walkthroughs from this stage
Recorded from an interactive design prototype. Every patient, clinician and clinic is fictional, and EMR screens are modeled reconstructions.
Prototype walkthrough · Fictional patient data
Care coordination: procedure team, cost changes, consent and access
Every member of the procedure team commits to the slot, a mid-cycle insurance change rebuilds the estimate, consent lands on the right person's chart, and the interpreter is booked for every visit.
Elena's iPhone: the current instruction, an old link, an honest report
An old text link can't send Elena to a superseded injection time. Reporting a late dose is simple and honest, and urgent help is one tap away.
Patient and clinic, side by side
The patient's phone and the clinic's workspace side by side, so each reassuring screen shows the safeguard behind it.
Both sides
One stage, seen from both sides
For the clinic team
What the team coordinates
OvaFlow tracks the whole procedure team's commitment, anesthesia questions, a named discharge owner, post-retrieval symptoms, outside emergency visits and a change to freeze-all.
- Whole-team procedure commitment across OR, physician, anesthesia and embryology
- Anesthesia pre-procedure questions resolved before procedure morning
- Discharge checklist with a named nursing follow-up owner
- Post-retrieval symptom check-ins routed to a nurse, with 24/7 clinic and 911 contacts always visible
- Planned fresh transfer converted to freeze-all when the clinician decides, updating future bookings and lab plans
Operational checks at this stage (3)
- Hold any rescheduled retrieval slot as provisional until the physician, anesthesiologist, OR nurse and embryologist have each committed.
- Require a named nursing owner for the Day 1 post-retrieval call before discharge is marked complete.
- Route all patient symptom reports to nursing with prominent 24/7 clinic and 911 guidance, and reconcile outside ED visits with downstream transfer plans.
For you and your family
What you experience
Eggs are collected in a short procedure, and the care team checks in on your recovery afterward.
Questions you may ask here (3)
- “Who needs to be in the room for my egg retrieval, and how long will I be asleep?”
- “Which symptoms after retrieval are normal cramping, and which ones mean I should call the clinic's 24/7 line or 911?”
- “If I visit an urgent care or local emergency room for severe bloating over the weekend, how does my fertility doctor find out before a fresh transfer?”
Words you may hear (4)
- Egg retrieval
- A short procedure, usually under sedation, to collect eggs from the ovaries.
- OHSS
- Ovarian hyperstimulation syndrome: an over-response to stimulation medicines that can cause swelling, bloating or pain in the days after the trigger and retrieval, and sometimes later. Symptom questions always go to the clinic, and emergencies to 911.
- Freeze-all
- A clinician's decision to freeze all embryos instead of doing a fresh transfer in the same cycle.
- Discharge owner
- The named person responsible for follow-up after someone goes home from a procedure.
Questions about your own treatment go to your care team. OvaFlow never gives medical advice. In an emergency, call 911.
Read the plain-language guide to IVFHandoffs and safeguards
Where work slips, and what holds instead
These are the moments the design is built around. Each safeguard stops or holds work; the decision stays with the clinician or the lab.
Where it slips today
- A rescheduled retrieval slot is booked before the operating room, anesthesiologist, embryologist and physician have all committed.
- An airway, fasting or medication question for anesthesia is still open on procedure morning.
- The patient goes home with discharge papers but no named nurse owner for the Day 1 recovery and fertilization call.
- An outside emergency department visit for post-retrieval bloating never makes it back into the fertility clinic's fresh-transfer plan.
What holds in OvaFlow
- Right ownerWhole-team commitmentA procedure slot counts only when every required team member has committed to it.
- Right ownerUrgent help, one tap awayRecovery check-ins show the clinic's 24/7 line and 911, with no automated symptom advice.
- Right ownerClinical questions go to a personDose and symptom questions are routed to a nurse, never answered by an automated reply.
Workflows here
Workflows at Retrieval & recovery
Each row opens the capability. Point at, focus or scroll to a row to see it in a recording from this stage.
- Ownership & handoffsOffer is not accept. Work changes hands only when the next person says yes.Seen in: Elena's episode: one change, four commitments, recovery and freeze-all
- Sources & signed changesEvery instruction traced to its signed source, and every change carried to the work it affects.Seen in: Elena's iPhone: the current instruction, an old link, an honest report
Stories
Stories that pass through here
Fictional people, told end to end.
Fictional patient data
Step-by-step timing & questions
How Retrieval & recovery unfolds day by day
Egg retrieval brings together the physician, anesthesiologist, operating room and embryology bench on a timed morning slot, followed by post-anesthesia recovery and structured surveillance for ovarian hyperstimulation syndrome (OHSS).
15–30 min procedure · 1–2h PACU · Days 1–7 recovery
Procedure-morning synchronization & 7-day post-retrieval surveillance
4-team slot & anesthesia check
Patient & familyYou arrive fasting (nothing by mouth as instructed) with a responsible adult to accompany you home.
What holds4-team commitment + anesthesia clearClinic, EMR & labOR, REI physician, anesthesiologist and embryology bench are all confirmed on the slot; open airway or medication questions must be resolved.
Ultrasound-guided retrieval
Patient & familyUnder intravenous sedation, the physician aspirates follicular fluid through a thin ultrasound-guided needle while you sleep comfortably.
What holdsWarm pass-through & ID witnessClinic, EMR & labFollicular aspirates pass immediately through the warmed pass-through window to the embryologist with two-identifier witnessing.
Recovery & named discharge owner
Patient & familyYou rest in recovery, learn how many eggs were collected, and receive written discharge guidance with 24/7 clinic and 911 numbers.
What holdsNamed Day 1 follow-up ownerClinic, EMR & labBefore discharge closes, a specific nurse is named to own the Day 1 recovery and fertilization call.
OHSS check-ins & plan conversion
Patient & familyYou log bloating, weight change, urine output or pain; any symptom prompt displays your clinic's 24/7 line and 911.
What holdsNurse routing + freeze-all syncClinic, EMR & labIf moderate/severe OHSS symptoms or an outside emergency visit occur, the physician converts a planned fresh transfer to freeze-all.
Worked example: Elena Rivera's Nov 1 retrieval, post-retrieval OHSS check-in & freeze-all conversion
Worked example · West ClinicFictional patient data
Elena Rivera's Nov 1 retrieval, post-retrieval OHSS check-in & freeze-all conversion
What the patient sees
After her Nov 1 retrieval, Elena reports abdominal bloating and rapid weight gain on her companion check-in. The screen immediately shows West Clinic's 24/7 on-call line and 911 rather than automated reassurance.
What the clinic team sees
Nora Ruiz, RN receives the symptom report, reconciles Elena's outside emergency department visit into the episode timeline, and Dr. Mira Lee converts the planned Day 5 fresh transfer to a freeze-all cycle.
Why it holds: OvaFlow never scores or triages symptoms on its own, and an outside emergency visit immediately halts a planned fresh transfer when the clinician converts the plan.
Where OvaFlow fits
How OvaFlow works beside the clinic's own EMR and lab
Coordination companion
What OvaFlow coordinates
- Four-role procedure commitment (physician, anesthesia, OR, embryology) and pre-op question closure
- Named nursing ownership for Day 1 post-op follow-up and routing of patient symptom check-ins with 24/7 and 911 contacts
- Reconciliation of outside emergency visits and cascading updates when a physician converts fresh transfer to freeze-all
System of record
What stays with clinicians & the EMR
- Performing sedation, follicular aspiration, and post-anesthesia recovery assessment
- Clinical evaluation of ovarian hyperstimulation syndrome (OHSS), fluid management, and emergency triage
- Deciding whether to proceed with a fresh embryo transfer or convert to a freeze-all strategy
Common questions at this stage
Questions from patients, families and clinic teams
View all 4 stage questions & answers
What happens during an egg retrieval procedure and how long does recovery take?
According to SART and HFEA patient guides, transvaginal ultrasound-guided oocyte retrieval typically takes 15 to 30 minutes under intravenous sedation. Patients usually rest in the clinic recovery area for 1 to 2 hours until alert and comfortable, then go home with an accompanying adult and a named nurse scheduled to call the next day.
Sources: [6] SART Patient Guide (2026) · [7] HFEA Patient Guide (2026)
What is ovarian hyperstimulation syndrome (OHSS), and when do symptoms appear?
OHSS is an exaggerated response to ovarian stimulation and trigger hormones in which fluid shifts from blood vessels into the abdomen and third spaces. Early symptoms—abdominal distension, nausea, rapid weight gain, decreased urination or shortness of breath—typically appear within 3 to 7 days after trigger and retrieval (or later if pregnancy occurs). Any concerning symptom must be evaluated promptly by the clinical team, and severe symptoms such as difficulty breathing or chest pain require calling 911.
Sources: [8] ASRM Practice Committee (2024) · [5] ESHRE Guideline Group (2026)
Why does a doctor switch from a fresh embryo transfer to a 'freeze-all' cycle after retrieval?
If a patient has high estradiol levels, a large cohort of retrieved oocytes, or post-retrieval OHSS symptoms, pregnancy hormone (hCG) from a fresh transfer can significantly worsen and prolong OHSS. ASRM guidelines recommend vitrifying all suitable blastocysts ('freeze-all') so the ovaries and hormone levels return to baseline before a frozen embryo transfer (FET) in a subsequent cycle.
Sources: [8] ASRM Practice Committee (2024) · [6] SART Patient Guide (2026)
Why can't a retrieval time be moved by one person on the calendar?
Unlike an office visit, an egg retrieval requires four synchronized clinical functions: the REI physician, the anesthesia provider, the procedure room nurse, and an embryologist at a warmed workstation ready to receive follicular aspirates at a precise hour after trigger. OvaFlow keeps a slot provisional until all four teams commit.
Sources: [9] ASRM Practice Committee (2022) · [6] SART Patient Guide (2026)
Clinical & operational sources for Retrieval & recovery (4 primary guidelines)
- [6]SART Patient Guide (2026) — ART Step-by-Step Guide: Oocyte Retrieval and Embryo Transfer8–12 day stimulation window, 35–36 hour trigger-to-retrieval interval, 15–30 minute sedated retrieval, Day 5–6 blastocyst culture and progesterone support.
- [8]ASRM Practice Committee (2024) — Prevention of moderate and severe ovarian hyperstimulation syndrome (OHSS): a guidelineRisk factors, alternative trigger strategies, post-retrieval symptom surveillance and elective freeze-all conversion.
- [5]ESHRE Guideline Group (2026) — Guideline on Ovarian Stimulation for IVF/ICSI (v2.3 update)Individualized gonadotropin stimulation, ultrasound and estradiol monitoring cadence, trigger criteria and luteal phase support.
- [9]ASRM Practice Committee (2022) — Comprehensive guidance for human embryology, andrology, and endocrinology laboratories: management and operationsContinuous specimen witnessing, chain of custody, culture-media lot traceability, warming authorization and cryostorage records.
Along the spine
Keep walking the journey
Plans can change at almost any point. See how a change of plan is handled.
See it with your team
See a retrieval slot every team has accepted.
We'll go through the prototype walkthroughs for this stage and the questions your team would ask first.