Help - Overstimulating! 1st IVF!

Hey Everyone

I'm not sure how this fits in (i'm still learning) but I had my first ultrasound on thursda - day 7 on Puregon - started on 125iu and drop tomorrow to 100iu. I was told that 125 was on the low side anyway.

Hey, I'm a cheap drunk, can't have caffeine - too sensitive to it and I can use panadol as a sleeping tablet so why not be sensitive to Puregon as well.

Actually I have been really concerned because i am "slightly polycystic" and they said that I could be overstimulated. But at the moment I have 12 follicles on my right ovary with 8 over 10mm and 13 on the right side with 4 over 10mm.

I've been very tired and think I might have to have some time off work. I'm not too bad, sometimes can't think straight. Don't have pain but a lot of sensations around ovaries.

Anyway any comments and/or suggestions/stories are more than welcome

:):fertilise:

it sounds like you'll have a good number to go to pick up i just wanted to wish you the best of luck rest heaps and plenty of water :hug:

sounds like you're responding quite nicely to the puregon hun! it's not unusual to feel a bit tired when you're on stims - in some ways it might be the meds, in others (well for me) i think it's related to the fact that we're constantly on edge through the whole process thinking "is it workin? am i doing ok?" and whatever other things run through our head!

slight overstimulation is actually fairly common when you have polycystic ovaries - having said that, your results from your scan don't sound like you're overstimulating at all - in fact, it sounds like a text book perfect result! it's common to "feel" your ovaries more at this point - you have to remember your ovaries would, on a normal month, produce one follicle - this time they're producing a lot more so they're swollen and will niggle heaps!

if it helps, i had my first full stim IVF cycle last November - i had 59 follicles over 10mm at my first u/s (after seven days of stim)! i ended up with 22 eggs collected - but, i didn't hyperstimulate where medical intervention was required at all. my ovaries were swollen and a bit ouchy for sure, but i didn't end up with Ovarian Hyperstimulation Syndrome at all. i've read of others with lesser follie counts who HAVE had problems.

it really is more about how your estrogen levels climb in relation to your follie count. at this point, it's not sounding too bad for you at all!

oh yeah, FWIW - i am have pretty severe PCOS and didn't get OHSS on my full stim IVF cycle - but i did get a mild case when i was doing IUI... there's no rule of thumb as to what will happen

good luck with your stim cycle hun!

Thanks Shazz

I appreciate it. I had another BT and Ultrasound this morning - officially overstimming now. 43 active follicles and 22 big ones. Will probably be stopping Puregon Monday - trigger that night then collection on wednesday. I just don't want it to be cancelled.

I'm thinking about taking most of next week off. I just get so tired. Feeling quite uncomfy now.

I really didn't know what to expect, don't know quality or qantity of eggs but can't stop thinking about all the women who have only a couple of follicles. We are all so different. This really is a roller coaster ride.
:pray:

Thanks Briggy's girl

Yeah, apparently my estrogen levels are rising quite rapidly. Hmmm ?? Its an amazing process!!

Belle, depending on how badly you are overstimming, prepare yourself for a few weeks off work, possibly some time in hospital, and the distinct possibility of a freeze all cycle with no transfer this time around.

I've had OHSS twice... PCOS and/or polycystic ovaries mean you have an increased chance of overstimming, and an unpredictable and variable response to puregon.

I've had two stim cycles - had OHSS with both and had to freeze all embryos both times. First cycle, my highest E2 level was around 14500, 26 eggs collected and three weeks of feeling like hell. 5 litres of fluid making my belly hugely bloated... 4 good blastocyst embryos in the freezer, two pregnancies, two miscarriages (for reasons unrelated to OHSS).

Second cycle, I was on less puregon (we dropped my dose much faster thant he first cycle), but my highest E2 level was somewhere scarily above 15500, 32 eggs collected, 7 blastocysts to the freezer. I was still crook for three weeks, but wasn't quite as sick as the first time. Only had about 2-3 litres of fluid in my abdomen, but DH decided I was going to hospital to recover this time... they kept me in for a week!

If they suggest freezing all and not transferring - please don't fight it! OHSS is nasty, serious stuff, but frozen embryo transfers that follow are much lower stress and much easier on your body.

I really hope that you don't end up as sick as me - good luck for EPU!

BW

Hi Butterfly Warrior

Thanks for the info and yes everything will be frozen - transfer in a couple of months.

Hi Belle,

All the best with your EPU! I also have polycistic ovaries. The first time at IVF my E2 Levels got to around 9800. However, because I had a poor response to the stims the early in the piece, even though I had 25 eggs collected and 14 fertilised only 1 was good for transfer (the rest were immature). In an ideal world my follies probably needed to be a bit bigger, but had risk of OHSS. BFN unfortunately.
2nd time around on last day my E2 levels skyrocketed from 8000 (2 days prior) to 22000. They had to cancel my cycle - which was really unfortunate, but for the best as would have been in big trouble! Am hoping my FS gets it right with my stims this time!
Every situation is different and yes it can be a real rollercoaster ride, but there are plenty of us that have been through it and wil be here for you if you need! Its positive that at least you are going to have your EPU and can then let your body recuperate before having ET!
All the best
Mon :)

Hi Mon

Thanks for the words of support.

I am really quite scared right now and I hope that they do get enough mature eggs so that I don't ever have to do this again.

I'm drinking 2 ltrs of water and taking it very easy. I don't know if there is anything else that I can do.

Another BT and Ultrasound tomorrow - I hope things are ok.

:pray:

Is it true that if you do get full on OHSS that the worst of the symptoms appear after you have the trigger injection??

I read that it can happen anywhere up to 7 to 10 days after trigger.

Yep, definitely after the trigger, I'm afraid. :( If you think your ovaries hurt now...

I don't know whether it's the same for everyone, but for me I'd become very uncomfortable after trigger so that even walking hurt like hell because it would jiggle my ovaries around. There'd be a brief reprieve after EPU, the day following EPU I'd start to wonder what all the fuss was about, and why are we not transferring, I feel great?... And then, 2-3 days after EPU the worst of it sets in.

I don't want to scare you, but I guess it's better to be honest and upfront about what you are dealing with here. Rest is extremely important. Keeping your fluids up is absolutely vital - get gatorade and start guzzling! Especially after EPU, 2-3L of gatorade per day, absolute minimum. Buy the powder and mix it yourself - you get thoroughly sick of the taste after a while, but you need to do this. Don't do what I did the first time and think that you're ok, and you can go for a half hour walk on the second day after EPU... A high protein diet can also help, and rumour has it that sustagen is another good thing to drink.

Again, having learned the hard way - if you are in too much pain, or so bloated you can't walk, hospital is a damn good place to be! Check with your clinic on which one you should go to, as you need to be able to trust that the doctors there will know how to treat OHSS. The night I was admitted to hospital I freaked out a registrar who decided they'd do an abominal scan to see if they could see anything at all, but expecting to be able to find nothing until they could get me near an internal ultrasound probe... she found my enormously swollen ovaries sitting on top of my uterus, touching each other. It was all she could see. The following day when they took me for a proper scan after I was admitted, they measured my ovaries as something like 10cmx8xmx7cm. Grossly enlarged... painful, really not fun. The professor who did the scan explained (there was a med student in the room at the time) that if they didn't know my history, and just saw the scan pictures, they'd assume advanced ovarian cancer and be operating to remove my ovaries immediately. That's why it's important to get the right hospital and explain your condition carefully if you have to go.

That said, I know of other women who have been unable to transfer due to OHSS and have felt completely fine the whole way through.

BW

Thanks Butterly Warrior. All this info is real and very helpful.

I'm a very private person as far as work is concerned so while I won't be telling them exactly what is happening I will be telling them that I am having health issues and won't be in - at least for next week.