OHSS

[Loula]

I know this has been discussed time and time again but i wanted to put it to you lovely ladies and not just the DR's

If a lady is suffering from OHSS but with no other symptons other than swoolen ovaries (about 10cm each) and a bit of back pain, and feeling sick, not being able to walk to far or sleep

I understand that if a pg accures then the risks are great and that it all depends on the individual but what should you expect and roughly how long for ?????

Other than keeping fluids up, measuring stomach what else is there to do ????

[Lissie]

Loula,
I am not 100%sure but my latest SIVF book says that if you have the runs, are vomiting and are in a lot of pain call the clinic asap, otherwise after egg pick up your ovaries can fill back up with fluid and the full ovary feeling can last a few weeks. If unsure i would ring your co-ordinating nurse.

[butterfly_warrior]

Lou, there is basically nothing you can do but rest and keep fluids up. I was doing reasonably ok with mine until I got the stupid idea to go for a walk - even though I took it easy, it still made the OHSS so much worse. I also had a lot of drugs to help bring my levels down, stop my ovaries leaking so much and cope with the pain. We knew I wasn't going to be able to transfer as my levels were so high before collection so I started on the drugs straight away, but still didn't start to feel better until AF had essentially been and gone. Three weeks all up that I was completely out of action, and a couple more after that before I was back to normal.

I'd be very, very wary of proceeding with transfer. I know your symptoms don't seem anywhere near as bad as mine, and I only barely stayed out of hospital (more through stubbornness and refusal to go rather than not needing it), but I do know that pregnancy can make OHSS so much worse and longer-lasting.

It's such a difficult position to be in. Take care, Lou.

BW

[Loula]

Thanks ladies

BW - i was told there was no drugs that i could take to help lower my levels as they are way too high

[Chez67]

Lou

You poor thing! That sounds absolutely horrible. I am so sorry that this has happened to you. I agree with what BW has said - all of my research on OHSS supports it although I didn't have any symptoms nearly as bad as you do. I know that doesn't make it any easier for you but if you are in any doubt, call the nurses and ask, ask, ask - I did and I found them very helpful. I am sorry that I can't offer any more info than you already have. Take care and rest up - your health is the number one priority at the moment!
Cherylxx

[Keen]

I have had OHSS everytime I had a cycle Lou. And this time when we had success - everything worked out fine. Unfortunately rest and fluids is all you can do - the fluids help flush the excess hormones away...

If you like PM me your levels and I will be able to compare them with mine - although I imagined everyone gets affected differently...

[craigandsam]

I had moderate OHSS first cycle >20,000, mild second cycle >14,000 - both with no BFP.
Did very well third cycle with no OHSS symptoms <10,000 woo hoo so they gave me the final luteal support HCG injection. Then I immediately got mild OHSS but not as bad as 2nd cycle. All symptoms went away about 3 days after day 5 transfer so held no hope. But then 6 days after transfer I now have mild to moderate OHSS symptoms again. The pain and swelling ouch. Currently 9 days after transfer and 14 days after EPU and 12 days after final HCG shot.

I didn't have vomiting or diarrohea, rather constipation, bloating, aching, cramps in the ovaries and hips, intolerance of my normal clothes and sharp pains from my ovaries extending to my ribs. I can't move fast or stretch out or bend down. minimal weight gain though and the bloody headaches and inability to eat more than a small meal.

good luck with yours. I so hope for you. My symptoms at the moment are about 3 times worse than just after EPU, but not anywhere as bad as my first cycle. My FS did say to expect a large increase in symptoms if pregnancy occurred, but I didn't expect all symptoms to disappear then reemerge with a vengeance.

I'm very regular and AF is due today according to last 5 transfers (2 fet), but have no symptoms of AF this time. Just did a HPT and got a strong positive, but not getting my hopes up as it's the first time I've had that HCG support shot, and I have read and read it takes about 10 or so days to leave the system. Fingers crossed heaps but feeling much calmer this cycle.

Again good luck. From what I've read if you become pregnant the symptoms slowly get worse until around 4-6 weeks after EPU and then start easing off. But then again every person is different. Make sure you weigh yourself morning and night as in severe cases you can put on 2 or more kilos in a day, by this time though you won't be walking (I put on 2 kilos in one day and couldn't get up or walk when I had moderate OHSS and I didn't even need hospitalisation then!). Sorry I don't give you much hope of the symptoms disappearing overnight but it does apparantly get better eventually.

[nic]

Just wanted to bump this back up and ask a question?
I know that you are suppose to keep your fluids up to avoid OHSS, and have been reading about drinking gatorade etc..

But, are you girls drinking only water? a combination of water and gatorade or just gatorade?

I read somewhere the other day that gatorade isn't good to drink because it contains salt, which obviously dehydrates you (though I imagine you would have to drink quite a lot of it for that to happen)

Nic

[{sarah}]

I did water only Nic and had no worries with OHSS at all. I was vigilant with it making sure I had 2-3L every single day & not much of anything else. If I did have a drink of something else I would just keep going with the water & wouldn't count other drinks at all. I don't drink coke or coffee either so no issues there with diuretics.

[craigandsam]

I've just spent 8 days in hospital with severe OHSS - even went into ICU! very scary. I still am 11kg over my pre OHSS weight and had 3.5L drained. Drink, drink and drink even though it hurts, monitor your output. Don't drink tea or coffee or any fizzy drinks (the pain is excrutiating!).

Good luck. It took 5 days to come on severely, then another 8 in hospital, i've been home 2 days and i've been told up to 2 weeks before the fluid will start to go.

The best news for me is that I'm pregnant. But gosh, my OHSS prior to this bout was nothing and I thought it was bad at the time. But when you're hooked onto a drip, catheter, and pain relief constantly plus blood thinners and albimum transfers and getting drained it's really scary and painful. My doctors said any drink especially milk and water is fantastic, just not coffee and tea.

[MissScarlett13]

Hi everyone,

I'm scheduled for EPU on Friday, and my doctor said I am potentially at risk of OHSS. I currently have about 13 follies (quite a few around 14mm and a few which are more mature), estrogen around 2000-3000 and I also have PCOS. My doctor has said that depending on what he finds on Friday, we may need to freeze any embryos which result, and do a frozen transfer next cycle.

Has anyone been in this situation? How do they decide whether the risk is high enough not to proceed with the transfer? And is there anything I can do to prevent OHSS? I know I need to drink lots of water and eat protein....

I thought OHSS only occurred in the case of very large numbers of follicles...

Can anyone shed any light on this for me?

TIA!

[butterfly_warrior]

oooh, me! That was certainly me, Scarlett!

First of all, let me just say that if they believe that you are at risk of OHSS and suggest that you freeze all embryos, go with it, don't argue. OHSS is nothing to play around with - I was sick for three weeks. Completely off work and virtually bed-ridden. If you are pregnant, it gets worse, and lasts longer - not something I would wish on my worst enemy!

When it comes to freeze all cycles - it's not so bad. I found it great to not have to muck around with the crinone and as I could later on use ovulation induction to do a natural FET, I was really happy with everything. I became pregnant on that first FET as well, so it certainly didn't effect the chances of things working or not working. Sadly, I miscarried at 8.5 weeks, but that had nothing to do with the fact that it was a frozen embryo, or the fact that I'd had OHSS.

I know the OHSS thing sounds scary, and it really is if you develop it, but if you follow their instructions, you will be fine. It passes in time, and won't effect later transfers with any frozen embryos you get.

I'm just going to have a quick chase around for my levels so that you can compare them with yours. Back in a tick!

BW

[butterfly_warrior]

Scarlett, below is a little summary of my puregon dosages and my estrogen levels as I went through my cycle.

5 days of 150IU, 283 - we get to double the dose of puregon.
4 days of 300IU, 2834 - clinic starts stressing and cuts my dosage back
2 days of 200IU, 9200 - I'm told told 10000 is the danger level so I'm running very close to OHSS here.
1 day of 100IU, 13200 - I'm in BIG trouble here, and told that transfer more than likely won't take place
1 day of 75IU, 14488.
Final dosage of puregon is withheld - the following day I just have a lucrin injection, and the day after that is my trigger, half strength (5000IU instead of 10000IU) to try to reduce the severity of the OHSS.

In the end, I had 26 eggs collected. I woke up from my egg collection screaming and crying where all the other women just woke up and started chatting to the nurses. Seems to me that your levels are much lower than mine, 5 days before EPU I'd already hit the 9000 mark. In comparison, you may get OHSS, you may not be able to transfer, but you more than likely won't get as sick as I did.

Hope this gives you some comfort.

BW

[MissScarlett13]

Thanks BW - that definitely does give me some comfort.

[onthefly]

Hi
I don't know what my levels were, but based on them the clinic didn't think i'd get it (and only 14 eggs too)... then i did, right after the 2nd hCG support injection (neither of which I should have had).
Absolutely agree with BW - it's best to avoid OHSS if you can.
If you do go ahead, make sure you're drinking heaps of fluids and let the clinic know of any symptoms you get.
Good luck with your cycle!

[CeCe]

I'm in the process of my third IVF full stim cycle. With this cycle I've been using 300iui of puregon - up this time from 200 last cycle.

Last Friday my eostrogen was 4100. Yesterday it had jumped to 13,300 so I required another blood test today. Today it is 16,000. As a result they gave me the choice of cancelling the cycle as the trigger will also increase this level, or go to collection but do not do a transfer.

I've decided to continue with the collection - since I've come this far and cannot 'just let it go'. I'm really concerned the first cycle we only got two eggs and only one fertilised. The second we got 7, only 5 fertilised but most were fragemented so deamed not suitable to freeze - wouldn't survive the thaw.

Does higher eostrogen levels increase the quality of eggs or is this simply an age/diet thing? I'm so worried that all this will be for nothing and none will be freezable.

Anyway, any help, reassurance or advice would be greatly appreciated as I just feel like crying.

[butterfly_warrior]

Hi CeCe, I've been in your position before, and it really is a little scary!

I got a pretty bad case of OHSS on my first (and only) stim cycle. We went to collection and got 26 eggs, of those, 21 were mature enough to use, 15 fertilised, 12 made it to day 3 and 4 made it to blastocyst and were frozen. As you can see, we did pretty well in that department! We have had one FET cycle since then, which was successful, but miscarried at 8.5 weeks. We've had some time out, and are looking to get started on another FET cycle within the next week or so.

My levels were fairly similar to yours, but you're a bit higher than me. After 5 days of 150IU and no response, I was bumped up to 300IU for 4 days, with levels then shooting up so we then went onto daily blood tests and I had my dosage reduced each day. My final puregon dose was withheld, so I only had lucrin the day before my trigger. My trigger shot was at half-strength (5000IU instead of 10000IU), which they said was to try to keep levels down and reduce the OHSS.

When I woke up from EPU, I was in so much pain I was screaming and crying and every single sob sent waves of pain through my vagina - it was absolutely horrible, and I kept seeing the other women around me waking up fine, with no problems at all. The first few days weren't too bad, apart from the bloating, and I probably would have fought for a day 2 transfer if that's what we were going to do. On day 3 everything got really bad. In the end, I was bed-ridden for three weeks, and only barely stayed out of hospital. I hate to think just how bad it could have got if we had transferred and it worked - I didn't really start to get better until after AF had finished.

I know it all sounds scary, but having been there, I know that OHSS isn't something you want to muck around with. If I were in that position again, I'd go through with collection, and happily freeze all once again (it's actually great not having to use the crinone!). I have to be honest, and say that I'm told that OHSS can reduce the quality of the eggs, but it didn't seem to happen in my case.

I do want to wish you luck, and I'd really strongly suggest you do go with the freeze all option, and be prepared to be sick for a while after collection. You may come through ok, you may not... I do think transfers are just too much to risk in that case.

BW

[CeCe]

Thanks BW.

I've just been googling OHSS to see what to look out for as I couldn't remember. In my head I know it's not to be messed with ... it just seems like I've been focusing on the transfer as the completion of the cycle but now I just have to rethink that.

Thanks for your reply and support. My EPU is Thursday morning, so here's hoping for a good outcome - under the circumstances.