E2 Levels and OHSS

ChrystyVOG · Post by **ChrystyVOG** » Sat Jan 19, 2008 10:36 pm

Hi girls I am so worried. I am going through my first IVF, though I am not new to injections.

I am 37, normal cycles only missing 1-3 ovulations a year but still normal menses even when I don't ovulate.

Antral follicle count was 3 or 4.

CD8 (5 days of stims 300IUs Follistim)
E2 657
4 follicles 7mm-10mm

CD10 (2 additional days of stims 300IUs hMG, switched meds)
E2 1466
6 follicles 9mm-14mm

CD11 (1 additional day of stims 300IUs hMG)
E2 2574
7 follicles 10mm-14mm

I have 2 additional injections of hMG to go before another blood draw and scan on CD12. This day I will likely have the hCG injection at 10:30 at night for retrieval 2 days later in the morning.

Do you think I am at risk for OHSS?

Has anyone had OHSS? What happened? How did you feel prior? What was your E2 level and how many follicles did you have?

Much appreciated! I am very concerned. It's Sunday here (I live in Tokyo) and the office is closed today.

Chris

TammyS · Post by **TammyS** » Sat Jan 19, 2008 10:45 pm

I dont know for sure...but was under the impression that you are more at risk for getting OHSS when you have lots of follicles ...like 25 or more. However, if you feel that you cant breathe, nausea, and bloating ....you should get checked out.

ChrystyVOG · Post by **ChrystyVOG** » Sat Jan 19, 2008 10:52 pm

I have not had retrieval yet so no OHSS. I am just worrying about it....I know i need to stop...bad energy, I need positive good thoughts.

So thanks for your reply...makes me feel better. I too have been reading and it's like lots of follicles for OHSS. I maybe have a few hiding he said but I would say no more than 10 total. I feel good about the follicle count since I started antral follicle count at 3 or 4.

Thanks,

TammyS · Post by **TammyS** » Sat Jan 19, 2008 11:01 pm

No problem Chrysty. I know how hard it is to keep the positive mental attitude all the time. These meds can make us worry more than need be, too. I find that some days I feel very confident and positive that this is gonna work....and other days....I am expecting that I will get OHSS or that I wont have any eggs or that none will fertilize or that it just wont work. Believe me ...every girl here has felt scared and nervous at some point. The one thing that I have learned is that when I do feel scared and worried....is that I need to stop. breathe. and realize that IT WILL WORK! Maybe not even the first time. But IT WILL WORK. And all I have to do is keep believing and praying and keeping the positive mental attitude going....even when I dont feel like it. The best thing you can do is believe that it will all be okay and it will all work out. The power of the mind is an amazing thing. We are all here for you to vent to...cry to...laugh with...and share the journey with. Good Luck.

Ghost · Post by **Ghost** » Sun Jan 20, 2008 3:09 am

ChrystyVOG wrote:Hi girls I am so worried. I am going through my first IVF, though I am not new to injections.

I am 37, normal cycles only missing 1-3 ovulations a year but still normal menses even when I don't ovulate.

Antral follicle count was 3 or 4.

CD8 (5 days of stims 300IUs Follistim)
E2 657
4 follicles 7mm-10mm

CD10 (2 additional days of stims 300IUs hMG, switched meds)
E2 1466
6 follicles 9mm-14mm

CD11 (1 additional day of stims 300IUs hMG)
E2 2574
7 follicles 10mm-14mm

I have 2 additional injections of hMG to go before another blood draw and scan on CD12. This day I will likely have the hCG injection at 10:30 at night for retrieval 2 days later in the morning.

Do you think I am at risk for OHSS?

Has anyone had OHSS? What happened? How did you feel prior? What was your E2 level and how many follicles did you have?

Much appreciated! I am very concerned. It's Sunday here (I live in Tokyo) and the office is closed today.

Chris

I've never seen a case of serious OHSS at your response level (7 follicles). Not much worry until 20+.

shammara17 · Post by **shammara17** » Sun Jan 20, 2008 3:35 am

Hello,

I am 3 days post transfer and my doc was really worried about OHSS. He waited until day 5 blastocyst to make sure. My ovaries behave in a PCOS manner, my estrogen was 6,000 and 33 eggs were retrieved.

I bloated horribly and gained 5 lb. Luckily a turned the corner and lost the weight and then some and the bloating reduced. However he did tell me it was an all or nothing thing. In his exact words I was the Titanic and missed the iceberg this time.

Talk to you doc if you have any concerns and good luck.

jt - ivf at 41 · Post by **jt - ivf at 41** » Sun Jan 20, 2008 2:57 pm

Hi ChrystyVOG,

I have OHSS -

My E2 level was extremely high at 13,000 - 31 follicles - only 4 eggs!!!!

You will know immediately if you have it once you trigger,...I knew the next day. My stomach grew to look as though I am 6 months preggers, and walking became quite uncomfortable.

My DR went ahead with the transfer - ONLY because I had only two embies left to transfer on day 3 - and he felt freezing them might not be a great idea. (they might not make it)

I am currently on bedrest (or trying to be - very hard)- and drinking 2 litres of Gatorade every day (yuck!!!) I don' t care to ever see another bottle of this once I am done! I have gained 9 pounds - and still look quite pregnant. I am going in every couple of days for a check with DR. and measuring my belly and weight daily.

I may have to have some fluid drained - but am on my 2ww - so we want to leave things alone until we know if I have a BFP or not...if not - symptoms will go away much more quickly than if I am.

My advice to you is drink Gatorade now - it does help - and take it easy!!!

Wishing you all the best - and a speedy recovery!!
xoxo
joanna

Ghost · Post by **Ghost** » Sun Jan 20, 2008 4:00 pm

jt - ivf at 41 wrote:Hi ChrystyVOG,

I have OHSS -

My E2 level was extremely high at 13,000 - 31 follicles - only 4 eggs!!!!

Let me guess...triggered with hCG?

jt - ivf at 41 · Post by **jt - ivf at 41** » Mon Jan 21, 2008 4:14 pm

I was called ovidrel (250mg). Not sure if that is HGC?

Ghost · Post by **Ghost** » Mon Jan 21, 2008 5:09 pm

jt - ivf at 41 wrote:I was called ovidrel (250mg). Not sure if that is HGC?

Yes. 250mg of Ovidrel is about 6,700 IU of hCG.

sugabeanzs · Post by **sugabeanzs** » Mon Jan 21, 2008 5:33 pm

I dont know about my levels but I too have OHSS. I only had 12 eggs removed. I hear it is worse with more follicles though. The symptoms did not start for me until the day after ER. I had severe SEVERE abdominal cramping and could not expand my lungs thus had to go to the ER to get pain meds and IV. I am still on some pain meds when needed but it is much much better. My ovaries got so enlarged that they hit my peri (something or other) which made all my other organs expand and get tender. I also was very nauseated and threw up once (which I was thankful that went away first). I think I had a mild case though because I am already doing better. Some people have to be hospitalized and get fluid drained. I would say not to worry! Just drink Gatorade after ER and that should help some.

Best wishes!!!

goosemis · Post by **goosemis** » Mon Jan 21, 2008 8:26 pm

Your stats seems a bit like mine, and my RE was very worried about me going into OHSS. In the end I ended up coasting and was very glad for it. I didn't want OHSS if it turned out BFP. Basically, I felt very tender around where the ovaries are until about 2 days after ther retrieval. We were worried about my E2 levels not going down after the retrieval. RE said if we weren't able to do the HcG on time, we would have had to freeze the embryos, wait for my ovaries to "relax", then do a frozen transfer. My husband and I agreed with the RE that my safety/health was more important. While we waiting for the go ahead on the HcG shot, I did some surfing and did find some articles saying that giving the HcG shot could lead to OHSS in situations like mine. The preferred protocol is to allow the patient's ovaries to "coast" before giving the HcG. Also if you go into OHSS and get pregnant, the symptoms could be worse.

Hope this was not the case for you, but you might want to ask you RE about whether it's safe to administer the HcG at your E2 levels.
_________________________________________

My Cycle:

Cd2 1/4/08 Started Gonal-F@150, Menopur@1cc

Cd6 1/8/08 Had 32 follicles, E2 = 731, discontinued Menopur

Cd8 1/10/08 follicles below 18mm, E2 = 1707. RE advised may need to "coast" before HcG is given to prevent OHSS

Cd9 1/11/08 some follicles now >18mm, E2 = 2715, Gonal-F discontinued, tender at ovaries, discomfort standing up

Cd10 1/12/18 E2 > 5000. Nurse advised unsafe to administer HcG above an E2 of 2500, more uncomfortable, so bloated I get full after eating a couple of bites and don't want to eat or drink too much, had to work from home in bed, tummy hurt so bad from the "stretch".

Cd11 1/13/08 E2 dropped to 3500. RE approved HcG scheduled for 10pm, still so bloated I get full after eating a couple of bites and don't want to eat or drink too much.

Cd13 1/15/08 retrieved 16 follicles, ovaries still tender, still felt bloated, but not as before

Cd14 1/16/08 - ovaries still felt tender, still felt bloated. Nurse said that should be normal as my enlarged ovaries were pushing my organs "up" and because there were more follies retrieved, still uncomfortable, but able to eat a bit more.

Cd17 1/19/08 - Transfer day. Less tender, not as bloated. RE said this was still normal.

Cd18 1/20/08 - 1dpt, no tenderness and bloating finally.

E2 Levels and OHSS

E2 Levels and OHSS

Re: E2 Levels and OHSS

OHSS

Re: OHSS

HGC

Re: HGC

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