When an appropriate follicular response to gonadotrophin stimulation has been achieved, the patient receives a subcutaneous injection of 5000 or 10000 iu of human chorionic gonadotrophin (HCG) to commence the final stage of oocyte maturation. Many women require more than one in vitro fertilisation (IVF) cycle and oocyte retrieval can be a painful procedure. Therefore, adequate sedation and analgesia is important for oocyte retrieval. The vacuum pressure for follicular aspiration should be less than 150 mmHg, since at pressures above this the rate of oocyte injury increases. Randomized controlled trials demonstrate that follicular flushing after aspiration does not significantly increase the number of oocytes retrieved or the pregnancy rate. During oocyte retrieval the aspiration needle should avoid endometriomas. This chapter discusses risks of oocyte retrieval, immature oocyte recovery and embryo transfer with embryo transfer procedures applicable in special circumstances.