Painkillers after egg retrieval: what do we actually know?

Short answer: there is no scientific evidence that painkillers after egg retrieval reduce your chance of pregnancy. The available studies show no measurable harm.

The worry many patients have

Many women take no painkillers after egg retrieval because they have reservations. Occasionally there is a concern that paracetamol or ibuprofen might adversely affect the embryo.

What the science has examined

The decisive question is this: does taking painkillers between egg retrieval and embryo transfer lead to lower pregnancy rates? There is some direct trial evidence on this.

NSAIDs: diclofenac and ketorolac

The methodologically strongest study comes from Kailasam et al. (2008): a randomised, double-blind trial in 381 patients who received either a diclofenac suppository (100 mg) or placebo immediately after retrieval.

Implantation rates and pregnancy rates did not differ significantly between the groups – the figures were even numerically somewhat higher in the diclofenac group (38.9% vs. 32.6%), without that difference being statistically meaningful.

Mesen et al. examined ketorolac 30 mg intravenously immediately after egg retrieval in 454 patients retrospectively. Here too: no demonstrable worsening of the pregnancy rate, the live birth rate or the miscarriage rate.

What this means: in the studies available so far, no harm has appeared. That is a relevant and reassuring statement.

Paracetamol (acetaminophen)

On the specific question of whether paracetamol after retrieval affects the pregnancy rate, there are no randomised studies of sufficient quality. One smaller study compared paracetamol plus diclofenac with paracetamol alone (74 patients) and found no difference, but that does not directly answer the question of paracetamol versus nothing.

In clinical reality paracetamol is used worldwide after retrieval – and in early pregnancy too, where it is regarded as the safest painkiller. No IVF-specific problems have become known from this so far.

Metamizole (dipyrone)

For metamizole, IVF-specific data are missing entirely. What does exist are pregnancy studies: several prospective cohort studies and a 2025 meta-analysis (10 studies) found no connection between metamizole taken in the first trimester and birth defects, miscarriage or other complications. Use early in pregnancy therefore appears to be safe.

Why the suspicion arose in the first place

The theoretical worry is not plucked out of thin air: prostaglandins play a role in implantation, NSAIDs inhibit prostaglandins, so blocking them could do harm. That is a biologically plausible line of reasoning.

In practice, however, two factors work against it. First, the half-life of most painkillers is short. Ibuprofen and ketorolac are largely metabolised within a few hours. Between retrieval and transfer there are 3 to 5 days, which is a considerable interval.

Second, throughout the entire period of pain treatment the embryo is in the laboratory, not in the uterus. A direct influence on implantation is not even possible in terms of timing.

The studies confirm it: the theoretical harm does not appear demonstrably in clinical practice.

What does this mean for you?

If you are in pain after egg retrieval, a painkiller is a sensible decision and not one that demonstrably puts your chances of success at risk.

Paracetamol is the standard recommendation worldwide, including in pregnancy. It is the option with the broadest safety profile, even though direct IVF data are lacking.

Ibuprofen or diclofenac are the most directly studied for the period after retrieval through the available trials, with no measurable harm.

Metamizole can be used if paracetamol or NSAIDs do not agree with you or are contraindicated. The IVF evidence is missing, but the pregnancy data are reassuring.

Important: if your pain does not improve markedly after 2 to 3 days, or suddenly becomes more severe, call us. That can point to a complication we need to rule out.

Frequently asked questions

Question: May I take ibuprofen on the day of the embryo transfer?

Answer: Yes. Paracetamol or metamizole are also a safe alternative on that day.

Question: Is it normal to have pain after the retrieval?

Answer: Yes. Transvaginal retrieval is a procedure, and mild to moderate pain on the same day and the next day is common and normal. It should subside markedly within 2 to 3 days.

Question: What if I am unsure which painkiller suits me?

Answer: Talk to us – we will advise you individually, particularly if you are taking other medicines or have pre-existing conditions.

Conclusion

There is no scientific evidence that painkillers after egg retrieval reduce your chance of pregnancy. The available data show no measurable harm. Anyone who is in pain after egg retrieval and needs a painkiller should take one.

Your team at Praxis für Fertilität – Kinderwunsch- und EndometrioseZentrum Berlin

Sources: Kailasam et al. (2008), Reprod Biomed Online – RCT, 381 cycles, diclofenac after retrieval; Mesen et al. (2013), Fertil Steril – retrospective, 454 patients, ketorolac after retrieval; Bar-Oz et al. (2005), EJOG – prospective, 108 women, metamizole in the first trimester; Dathe et al. (2017), Pharmacoepidemiol Drug Saf – prospective cohort study of metamizole in pregnancy; meta-analysis of metamizole 2025, BMC Pregnancy and Childbirth. Medically reviewed, September 2026.