Ovarian Hyperstimulation after embryo transfer

[wendy1969]

warning! It can happen to you too! I heard of it happening while youre taking the meds to make eggs but not after the transfer of embryos.

I just suffered through it and had to be hospitalized.....no fun! Has this happened to anyone esle?

[rikirees]

I was hyperstimmed on my first IVF cycle almost to the point of hospitalization. Needless to say I didnt have my transfer cuz the Dr. said it would continue if I got pregnant for up to 3 months! I feel your pain. It was the most painful I have EVER encountered. I made me ask myself if all this was really worth it. Hang in there! Did you get your results yet?

[wendy1969]

Hey, thanks! I ask myself the same question if its really worth messing up my biological system so badly afterall its not my infertility its his and why do we women have to pay? It really sucks sometimes. I got the OHSS five days after they transfered two embryos. No results yet. my doctor wants to test on day 12 if not positive then day 14 which is on this Wed. and Fri....I will let you know.

How about you? Are you on your 2ww now?

[Vlada]

Hi,
I got sever OHSS and i was in the emergency room for 8 hours , they gave me 5 iv's. I got mine right after the egg retrieval and it got worse after trasfer, but i am definitely feelling much better now, all the symptoms are gone. I test on Tuesday, the 8th, but I have a vey strong feeling that i am not pregnant, there is that ilttele tiby biny hope though
Vlada.

[amh6967]

you always read about how OHSS is rare, and uncommon, but so many girls on this site have had awful experiences with it.
almost seems as if there is some sort of cover up or something.
in my paperwork from my clinic is says that the chances of developing OHSS are between 1-2%, which is extremely low... but i cannot help but be paranoid, ever though my RE reassures me i have nothing to worry about. i have 50+ follies, and 2 more days of stims left.
for those who develop OHSS after ET are there warning signs before hand that RE's watch out for?

[rikirees]

amh6967:
One of my causes for OHSS was the E2 level. At retrieval my E2 was at nearly 3600. In my last cycle (non OHSS- different Dr.) My highest E2 was 2400 and he got 34 eggs (25 fetilized). Unfortunately, once they know you are possible a OHSS they watch the numbers a lot closer. Sometimes it is just too late! I froze all 25 and just had 3 blasts trasnsfered on Friday. Now I play the waiting game.

[Ghost]

amh6967:
One of my causes for OHSS was the E2 level. At retrieval my E2 was at nearly 3600. In my last cycle (non OHSS- different Dr.) My highest E2 was 2400 and he got 34 eggs (25 fetilized). Unfortunately, once they know you are possible a OHSS they watch the numbers a lot closer. Sometimes it is just too late! I froze all 25 and just had 3 blasts trasnsfered on Friday. Now I play the waiting game.

E2 does not cause OHSS, but is an indicator of risk. The best indicator of risk is the follicle count.

In a natural cycle, one egg ovulates from one follicle, and one corpus luteum forms.

Following ovarian stimulation, many follicles mature. In those with significant risk of severe OHSS, many large follicles appear. These follicles also produce E2, hence the correlation with E2 level.

Then comes the usual hCG trigger. hCG causes the follicles to release a hormone called "vascular endothelial growth factor", or VEGF. VEGF seems to be the direct cause of OHSS.

One way to end OHSS is to trigger with something besides hCG. The most obvious alternative is a GnRH agonist (like Lupron, Buserelin, or Synarel). Unfortunately, most clinics use an agonist for pituitary suppression, and for pretty obvious reasons, you can't use it for both suppression and the trigger. So the only way you can use the agonist for trigger is if the patient is antagonist-regulated.

If triggered with the agonist instead of hCG, severe OHSS is almost impossible. Not only does it not cause the corpra lutea to release VEGF, it actually kills the corpra lutea, creating a condition called complete luteolysis. No corpra lutea, no VEGF, no OHSS. This theoretically makes severe OHSS impossible, and the published results agree with that theory. Nobody has published a case of severe OHSS after trigger with any GnRH agonist.

There's a lot more to this, but this is just an internet post.

[bali]

ghost,

I have a few questions for you i hope you can help me.

First my HCG level on the 30th of april it was 404(first test) on the 2nd of may it was 790 and on the 7th of may it was 3,620 are these good or great numbers i mean is it doubling they way it should?


Second question is i did my scan on the 7th and there was nothing for the doctor to see he even sent me to a radiologist and he could not see anything either except that he ruled out ectopic. could it be that is just too early for them to see anything, on the 7th i was six week pregnant and 4 weeks gestation. I have my other scan on the 15th. I am really going crazy here and need some answers. My thinking is why is my hcg level going up and still they cannot see a sac?

I really appreciate if you can shed some light on this.

Thanks- bali

[eristrawberry]

i too developed OHSS 8 days after embryos transfer. (which is two days ago). i look like i'm six months pregnant. i waiting on lab work that the dr drew yesterday to figure out if i need blood thinners. it was amazing to see my ovaries on the ultrasound monitor yesterday. my ovary was so large it would fit in the screen. i didnt realize how serious this could be.
anybody have to take injection blood thinners for OHSS?

erica

[heather0701]

I was borderline OHSS and was put on blood thinners to keep it from developing. It started to happen after my transfer and I would get SEVERE cramps to the point where it would make me nauseated!! It was some of the worst pains I have ever experienced. This was all before my pregnancy test which was positive. The nurse said the pains were so bad because my ovaries were shrinking up, which usually means you are pregnant!!

[Ghost]

ghost,

I have a few questions for you i hope you can help me.

First my HCG level on the 30th of april it was 404(first test) on the 2nd of may it was 790 and on the 7th of may it was 3,620 are these good or great numbers i mean is it doubling they way it should?


Second question is i did my scan on the 7th and there was nothing for the doctor to see he even sent me to a radiologist and he could not see anything either except that he ruled out ectopic. could it be that is just too early for them to see anything, on the 7th i was six week pregnant and 4 weeks gestation. I have my other scan on the 15th. I am really going crazy here and need some answers. My thinking is why is my hcg level going up and still they cannot see a sac?

I really appreciate if you can shed some light on this.

Thanks- bali

Sorry about the late response. I just saw your post to me.

Your hCG levels are not quite doubling, but doubling is not the proper rule anyway. It's just a good rule of thumb.

By now they must have figured out the answers to your questions. If we are not seeing an intrauterine sac by 6 weeks gestation, we get very suspicious of an ectopic. I hope it worked out well for you.

[eristrawberry]

i found out yesterday that i am pregnant (HCG of 477). the drs suspected i was pregnant because of the late onset of the OHSS. the dr informed me that because i am pregnant the OHSS will last several weeks. if i was not succesful in getting pregnant it would last about a week. the drs did say that OHSS does not affect the pregnancy at all (thank god).
good luck to everybody dealing with this (OHSS).

erica