Dostinex for OHSS - The double-edge sword


#1

Hi there,

Just prior to my trigger shot for my ER, my Estradiol as at 22000 and my RE put me on Dostinex for OHSS. In addition, I only did half the trigger shot. I did end up with OHSS, probably a moderate case, but thankfully it did not get so bad that it would interfer with my ET. I was in a lot of discomfort, including a very swollen belly, my pants did not fit, I was quite sore and felt like I had been kicked repeatly in my tummy. My tummy is still swollen (I look a few month pregnant) but the majority of the discomfort is finally going away.

I’ve read on numerous sites that if your OHSS does not go away it could be a sign that you are pregnant. So now that I’ve had my ET, I am paranoid that my OHSS getting better is also a sign it didn’t work. Part of me would almost take the discomfort of OHSS if it meant my transfer was a success.

I’m just wondering if anyone took Dostinex for this OHSS, had their OHSS symptons improve, but still had a BFP from their treatment. These mind games are enough to drive anyone crazy! Thanks for any advice!!


#2

Both fresh cycles I had supe4 high E2 lots of eggs and ohss my RE didnt give me anything but both times my symptoms improved I have a healthy 2 yr old and im 18 weeks this time


#3

[QUOTE=allycat]Hi there,

Just prior to my trigger shot for my ER, my Estradiol as at 22000 and my RE put me on Dostinex for OHSS. In addition, I only did half the trigger shot. I did end up with OHSS, probably a moderate case, but thankfully it did not get so bad that it would interfer with my ET. I was in a lot of discomfort, including a very swollen belly, my pants did not fit, I was quite sore and felt like I had been kicked repeatly in my tummy. My tummy is still swollen (I look a few month pregnant) but the majority of the discomfort is finally going away.

I’ve read on numerous sites that if your OHSS does not go away it could be a sign that you are pregnant. So now that I’ve had my ET, I am paranoid that my OHSS getting better is also a sign it didn’t work. Part of me would almost take the discomfort of OHSS if it meant my transfer was a success.

I’m just wondering if anyone took Dostinex for this OHSS, had their OHSS symptons improve, but still had a BFP from their treatment. These mind games are enough to drive anyone crazy! Thanks for any advice!![/QUOTE]

Fresh transfer into a patient already presenting with OHSS is risky. The “half-dose” of hCG reduces OHSS risk a little, while Dostinex has been shown to reduce the risk of early onset OHSS but not late-onset OHSS. You described early onset OHSS. Embryo implantation might result in late onset OHSS, but not always. If it does, it would probably be worse than what you already experienced, and sometimes results in hospitalization. That’s why many clinics will freeze all embryos when OHSS is present or in patients at high risk.

Your OHSS symptoms will continue to diminish for at least one more day regardless of whether your blastocyst is implanting.

If you see worsening OHSS symptoms starting around Wednesday-Saturday or so, congratulations on your pregnancy. If not, then a pregnancy test is still needed. Absence of OHSS does not rule out a pregnancy. Your best-case scenario is, of course, a pregnancy that does not bring on late-onset OHSS. This is not unusual.

Best of luck.

PS: Just to clarify for US patients, your E2 level of 22,000 is probably in units of pmol/l. In the USA, E2 is routinely measured in units of pg/ml. 22,000 pmol/l is about 8000 pg/ml.