Pregnancy and OHSS

[nicnad]

Hi all, Just found out Wednesday that our first IVF was successful. Yippee! Problem is that I have Ovarian Hyperstimulation syndrome and it is in full force. I had 2.5 litres of fluid drained on Thurs and it's coming back. I feel so uncomfortable that's it's hard to be happy and think about the pregnancy. I don't mean to sound ungrateful but this is awful. I look 4-5 months preg and I'm only 4 weeks. We don't want to announce the preg so soon, but it's hard to hide. Would love to hear other stories re this and how long it lasted and if anything helped.

[nbfun]

I don't have any info to offer to help but I wanted to say CONGRATS!!!!!!!!

nancy

[Ghost]

Hi all, Just found out Wednesday that our first IVF was successful. Yippee! Problem is that I have Ovarian Hyperstimulation syndrome and it is in full force. I had 2.5 litres of fluid drained on Thurs and it's coming back. I feel so uncomfortable that's it's hard to be happy and think about the pregnancy. I don't mean to sound ungrateful but this is awful. I look 4-5 months preg and I'm only 4 weeks. We don't want to announce the preg so soon, but it's hard to hide. Would love to hear other stories re this and how long it lasted and if anything helped.

I work at a clinic.

OHSS can last several weeks, commonly 2-4 weeks. It's caused by hCG acting on your follicles, making them produce many hormones, like progesterone and estradiol, but also another hormone called VEGF. VEGF in excessive quantities causes "vascular hyperpermeability", meaning that capilaries leak fluid into what is called the "third space". This causes fluid to build up in the abdomen and sometimes in the pleural space around the lungs, and it can become difficult to breathe. The loss of fluid from the blood stream can lead to serious side effects. In very rare cases, OHSS can be fatal. Not to scare you, but be sure you take this condition very seriously.

Tell your RE everything. Everything. Do not hesitate to seek emergency care if you feel you need it.

On the plus side, it does not seem to put much extra risk on the pregnancy. It actually correlates with successful outcome, perhaps because the best pregnancies produce the most hCG.

Congratulations on your pregnancy.

[nicnad]

Thanks for the support and info. Good luck on your IVF. I'm 39 too and "normal". My DH (41) and I have unexplained secondary infertility. Our son was born in 2005 and we have been unable to conceive since then. We did IVF so that we could say that we tried "everything" to give him a sibling. I can't believe that it worked the first time! The odds we were given were only 30%. We only transferred 2 embryos for fear of triplets. Now I'm worried about twins! (although I would accept it, just seems overwhelming!). We have our first u/s on Sept 16 so we'll know then. I would encourage anyone trying IVF to be hopeful cuz I really didn't think that it would work the first time, but it DID! Now, if only this OHSS would subside, I'll be happy...

Nicole (from Canada)

[margi26]

I had severe OHSS and had to be drained 3 times from my abdomen and three times from my lung space...it was completely miserable and I'd be happy to share more specifics if you like.

PLEASE follow Ghost's advice and report everything...I tended to minimize because I didn't want to be a bother--and I landed myself in the hospital.

Congratulations on your pregnancy--the only reason mine didn't work that time was because I had the misfortune of having a double ectopic pregnancy.

Take care of yourself!!! And again, congrats.

[nicnad]

Thanks Margi,

It really is scary. I can't believe all that happened to you! It feels good to connect with someone who understands... We have decided not to tell anyone about going thru IVF so I feel really alone going through all this. I have this big secret and am having trouble hiding it... Everyone says that it can last 2-4 weeks. I hope that means from egg retrieval, cuz then I would be 2+ weeks already... I have to admit I'm disapointed about all this. I'm thrilled that we are having a baby, but each hour of feeling so incredibly bloated and nauseated, makes me feel just awful all around. I keep hoping and praying that it will pass soon and I won't need more drainage. I found it to be very painful... thanks for writing... I really appreciate it.

NIcole

[nancy1]

Hi Nicole,

I had moderate OHSS. I looked like I was 4 months pregnant from the get go! No draining needed for me. Was uncomfortable for like 12 weeks at least, but went on to deliver a very healthy baby full term at 39 weeks. Hang in there!
nancy

[nbfun]

Nancy, (great name)

What an encouraging story to hear. Thanks for sharing with us.

Nancy

[claud662]

I found that salty foods, protein, and drinking tons of diluted gaterade helped with the symptoms. Good luck and congrats!

[nicnad]

Thanks for the tips. I took the week off work. I've regained the fluid that they drained last Thurs. Although I have a little less pain and nausea. I really hope to avoid another drainage. I just want this to resolve itself. Congrats on your pregnancy. thanks everyone. It helps to connect with others...

Nicole

[amanda1027]

I I just had my first ER yesterday and fear I too may be hyperstimulating. They retrieved 35 eggs and my ovaries are quite large from the mass production. My estradiol level was 4,200 on last Saturday. I am so terribly uncomfortable I can hardly walk to the bathroom. I am so bloated I look about 6 months pregnant and am beginning to become short of breath. The nausea is starting to kick in too. When do you decide to call the doc and let them know? I talked with the nurse this afternoon and told her of my discomfort but it has since gotten worse. What does draining entail? Can I still be implanted on Thursday if I am hyperstimulating? I am starting to panic. Any advice?

[PA_FA]

Amanda...read Ghost's response earlier. If this is getting worse call your RE back immediately or go to the hospital.

Nancy-Congrats on your pregnancy!

[nicnad]

Hi Amanda,

My hyperstimulation started after retrieval, but on transfer day, they told me that this was "normal" and 2 days later I was fine. It re-started about 1 week after the transfer and I was told that it was a sign that the embryo(s) had probably "stuck" and that pregnancy hormones had reactivated the OHSS. By the day I found out the positive results (yay!), I too was huge and had gained about 11 lbs (all in the belly!) and was essentially miserable. I saw the Dr this am and will have to get drained again tomorrow morning. They basically use a belly u/s to see where they can poke the needle. They can only freeze the first layers of skin so when they popped through to the abdomen, it hurt like !#*! Once the draining started, the pain went away. They drained 2.5 litres and I'm guessing that it will be at least the same amount tomorrow. You do feel better afterwards, but it's disheartening to worry that it will come back.. It's a day procedure and I was there for about 2.5 hrs. Urgh... I'm eager for all this to pass so that I can focus on the pregnancy. Good luck and let us know what happens! I hope you can have your transfer as scheduled. What a crazy process we've gotten into, eh?

Nicole

[margi26]

Amanda,

Definitely don't minimize...call your RE and let them know all the symptoms...I ended up hospitalized for weeks and was completely miserable--at least partly because I talked to the nurse who minimized my symptoms. Make sure your RE knows and is able to assess all your symptoms before deciding whether to continue with transfer or whether it is safer for your body to postpone and go on to FET instead. 35 eggs is an amazing amount!

My advice is for you to call and insist on being seen tomorrow.

Good luck and take care.

[Ghost]

I I just had my first ER yesterday and fear I too may be hyperstimulating. They retrieved 35 eggs and my ovaries are quite large from the mass production. My estradiol level was 4,200 on last Saturday. I am so terribly uncomfortable I can hardly walk to the bathroom. I am so bloated I look about 6 months pregnant and am beginning to become short of breath. The nausea is starting to kick in too. When do you decide to call the doc and let them know? I talked with the nurse this afternoon and told her of my discomfort but it has since gotten worse. What does draining entail? Can I still be implanted on Thursday if I am hyperstimulating? I am starting to panic. Any advice?

Keep your clinic informed of everything. Don't hesitate or hold back. It could be a very important detail.

Fluid is drained with a needle. Abdominal fluid is drained either directly through the abdomen or through the vagina. It's fairly common to get an IV after the fluid is drained, often with albumin. Or they might ask you to drink Gatorade or other fluids. Most patients feel much better after the fluid is drained, but it can return in 2 days, and again, and again...

The symptoms after an hCG trigger usually fade in about 10 days. If you get a fresh transfer and the embryos implant, then the OHSS often returns more strongly than before. That's why many doctors will not transfer fresh embryos in a patient with OHSS, but will freeze them all instead. No worries. The pregnancy rates with "freeze all" cycles are pretty good.