OHSS question

[k-rose]

Just wondering when the symptoms come of hyperstimulation and if I should be worried. My last estrogen level before my HCG trigger shot was 6300. The nurse didn't seem worried, but that seems high to me as when I was doing IUI's they didn't want my levels over 2500. Now that I am doing IVF, I know they can be higher, but my clinic so far haven't told me to do anything, although I don't have any symptoms yet. My egg retrieval is tomorrow. I think I read something that you don't get symptoms until after you ovulate??? I have heard something about drinking a lot of fluid. Just wondering of those that have had major symptoms, what your levels were???

Kelly

[CarolynB]

Hi Kelly

I cannot re-call all my levels although know that I was over 4,000 but I was very very bloated in my tummy (felt huge) and had lots of smaller follies even on quite a low dose of stimmies which they could see on my earlier scans.

I was told to drink at least 2 litres of water a day, drink plenty of milk and eat lots of protein (I ate lots of smoked salmon!!). They told me that it can occur after EC and before ET so to keep taking the water then especially if you have a lot of follies at EC.

I had around 20+ follies and some 13 eggs collected. They were worried that I might have to go to a complete freeze. They made me rest up and I drank loads of water. I was going to go to work between EC and ET and decided against going to work so I could just take it really easy with my feet up.

On ET day they asked if I had been sick or dizzy. I had not been to they let me go ahead.

I hope that this helps you. Good Luck for your tmt. Hope that you have a good number of eggs. Let me know how you get on.

Love Carolyn xxx

[Latina]

Hi Kelly;

Sorry that I can't no help you with you I don't remember my #.What I know is that you need to drink lot of fluid...especially gatorade that was my DR suggested.
I have been out of the forum for while...I had scans, seen my baby's HB 2 times, then I went for another one and the HB was slow...then I went for another scan at 8 weeks and my baby's HB stopped.
I had a D&C end of June...I could not M/C naturally, it was painful Emotionally to go through.
It is so cruel to have this taken away, Especially what we have to go through to get our Dream!!

I get so happy for you when I read that you are on your second treatment GOOD LUCK !! on your ER tomorrow!!
I hope this treatment is a complete success this time!!

Sara

[Ghost]

"6300" is indeed very high if those units are the usual pg/ml. In Europe they sometimes use pmol/l, in which case "6300" is only about average.

Since you post from CA, I suspect your units are pg/ml. 6300 is very high.

How many follicles? This is the best predictor. With that 6300 E2 reading, I'd guess you had more than 20, perhaps 30 or so?

How much was your hCG dose (usual is 10,000 IU)? This is also predictive, although less so than E2 and follicle count.

OHSS can come in either or both of two phases. The first is after the hCG injection, the second is during the hCG rise following pregnancy.

[Emma27]

LOL my levels were 24,000 yes i did not add an extra 0 on there by accident, so i do not think that yours are anything to worry about.

As you can imagine i had OHHS.

However on my 1st fresh cycle my levels were 18,000 and everything went fine with egg collection etc.

So do not worry too much!

[k-rose]

Well, they got 25 follicles and I did have the 10,000 units HCG shot. I questioned the nurse, and they did want me to have that amount. We'll see. I'm just sore right now from the retrieval and have a little bloating but not too bad.

Kelly

[Ghost]

K-Rose,

According to some publications, your chance of severe OHSS is in the range of a few percent. Odds are you won't get it, but at my clinic, that is unacceptable risk.

Good luck with whatever comes.

[Ghost]

LOL my levels were 24,000 yes i did not add an extra 0 on there by accident, so i do not think that yours are anything to worry about.

As you can imagine i had OHHS.

However on my 1st fresh cycle my levels were 18,000 and everything went fine with egg collection etc.

So do not worry too much!

Emma,

I see you are posting from Europe. The usual units of measure of E2 in Europe is in pmol/l. The conversion factor to pg/ml is to divide by 3.671. So 24,000 pmol/l = 6500 pg/ml. That's is still a very high value, little wonder you got OHSS.

K-rose posted from California, where the usual unit would be pg/ml.

If your 24,000 value is in pg/ml, well, that's higher than sky high. I've never heard of a value like that. That could correspond with more than 100 follicles.

[k-rose]

Sara, I am so sorry to hear about your loss. Do you have a history of miscarriages or anything? I couldn't imagine going through this and then losing it, but know I have a chance of that also as everyone does. I just found out that there were 19 mature eggs (I am still amazed as I only had 2 last time if you remember). We are doing ICSI, so I'm hoping a good amount fertilize. I am starting to have a lot of bloating, so it's hard to drink that much, but I'm trying!!!

Do you think you are going to try again?

Kelly

[Emma27]

Hiya Ghost

My levels were that high that they had 'coasted' me for 3 days and they were still going up, i suffer with PCOS which apparently also increases your chance of OHHS.

The hospital told me that if they had not withdrawn all drugs, except down regs and given me the 'trigger' shot then i would have been dead!, i had to go in each day after cancelled cycle and have bloods tests!

They were even keeping an eye on me this time as i had responded so well in my first fresh cycle (30 folicles on each ovary, however only 14 mature eggs retrieved) and my levels were apparently 'normal' 9,000 or something at one point and then they just doubled and kept going up!!!

So i am not sure what units they were measuring in!!

The things we have to do for babies!

[Latina]

Hi Kelly,
Of couse I remember you had only 2 last time...is amazing how well you respont this time. Good For You !!! I am very sure that you are going to have good amount to freeze too
No I don't have a history of miscarriages...my Dr sugested a BW and we are waiting for the result! Since am 39 We are considering a egg donor
for my next cycle, will see...I know is a very hasd decition that we have to make!!

Kelly, Take good care of youself and let me know how your doing.
sara

[k-rose]

Just wanted to post and let you know that amazingly with my estrogen at 6330, I did not get OHSS. I had some intense bloating the day of the egg retrieval and the next day, but I have since had my transfer 5 days ago, and no symptoms since. I thought for sure I would have more symptoms. Thanks for all your responses.

Kelly