OHSS chance - need advice / help


#1

Hello,

I was hoping to get some advise from people who dealt with OHSS - to get some feedback and advise.

I am going in to ER on Sunday, and I have high estradiol level (4,000+), lots of follicles being created and PCOS, I’m also 32 years old.

The criteria for OHSS risk is: number of follicles taken out / age (young) / estradiol levels. The question becomes, should the doctors do the transfer (assuming all goes well in ER) or freeze / let me get better (if I develop OHSS) and then do the transfer in few weeks… not sure… I hope you can help me with some advice…

Not to develop ohss, are there any preventions possible? gatorade, acupuncture, etc…???

Thank you in advance…

Vicky


#2

Hi. On one of my cycles, my RE came to me after the retrieval and said that I was headed for OHSS and we had to post pone the transfer. I was disappointing but if I had gotten pregnant, it would have been terrible and life threatening. I ended up extremely sore and bloated. I had to sleep sitting upright for 6 nights because if I layed flat, the fluid from my abdomen was leaking into my chest cavity. I could hear gurgling in my breathing and it was hard to breathe. I would see how it goes, if your estradiol is high, then it is likely but see what he finds when he is in there. On that cycle I only had 21 eggs retrieved, but I have had as many as 35 eggs and on that one I was fine to transfer so it mainly has to do with your levels. Good Luck, I hope you are able to avoid it. If not, drink lots of gatorade. I actually bring it to ER and start drinking as soon as I wake up and then I drink like a gallon a day until transfer and even after, lol. There is really no way to prevent it before it happens except keep your levels lower so if you’re on your way already, just take it easy. If you are too full, they may have to drain the fluid. I just escaped that because I didn’t go in right away, but finally I was so uncomfortable but the fluid had started to decrease by then. GL tomorrow. Let us know how many follies you get and what the outcome will be with transfer.


#3

The only way to prevent OHSS is to use lupron trigger, which is possible with an antagonist protocol. If it is not an option, then you may try to get a lower dose of HCG (5,000) or even LH trigger which your body metabolizes faster. I had OHSS after the trigger for about a week, it was truly miserable, and I could not sleep because of breathing issues. Since I did not have PCOS and started to improve the day before transfer, we went with ET, and transferred one. I did not have OHSS during pregnancy, fortunately. Once the symptoms set in, there is little you can do, other than pump the liquid out surgically (the same process they use for ER). I personally don’t think drinking lots helps. Drs recommend it so you don’t get dehydrated and hypovolemic, but since more of the liquid will eventually escape into your abdomen it will just make you feel worse. Unless you are dehydrated, I would be careful with lots of liquid. The same with salt, better stay away from it. Some sources say protein helps break the cycle of escaping liquid and jump starts the kidneys. I tried whey protein, and it did nothing. Good luck!


#4

i ended up with OHSS my E2 was over 6000 after coasting a few days and i had over 30 eggs collected. there was talk of freezing and not transferring however we ended up putting back 2 embryos after triggering with half the dose of HCG. I was miserable and unable to get out of bed for close to 10 days. Drink lots and lots of fluids and eat lots of salty foods. If given the chance sometimes its better to freeze


#5

Dont do the transfer! It will only make OHSS worse…I got it during my IVF cycle immediately after the retrieval (49 eggs collected, rediculous!), so we cancelled the transfer…it was terrible, I wouldnt wish that pain on anyone…


#6

No go!

[FONT=Comic Sans MS]I agree with the others… don’t do the transfer if you are believed to be getting OHSS. If you do get pregnant, it will get horribly worse & even if you don’t, it is so painful & your body is in turmoil! I developed OHSS at time of ER, so we fertilized & froze the eggs! Wait until your body calms down & do the FET next month. [/FONT]


#7

Hi there,

I had OHSS back in September. I am 31, have PCOS and my est. level was about 3,600. We transferred one embryo and kind of glad it didn’t take b/c my symptoms went away right away. They said if it had taken, the symptoms can last for the entire first trimester!

My doctors also recommended gatorade, but I just read online that pedialite is better b/c there’s less salt.

OHSS doesn’t make things any easier. Best of luck!


#8

Excellent post.

Yes, a Lupron trigger ends the risk of severe OHSS, as long as they don’t do something stupid like using hCG for luteal support. An LH trigger is a great choice too (a Lupron trigger works by releasing LH from the pituitary), but LH is currently available in 75 IU vials (Luveris), and you’d need many, many vials to get a decent trigger. Maybe a hundred or so.

Lupron trigger cycles require more luteal support than IVF cycles that used hCG.

IV albumin helps OHSS a little. I agree the whey protein is of little value, and I am also skeptical of drinking lots of fluid.


#9

Thank You Everyone!

Hi Ladies,

Thank you so much for your feedback!

Here is what happened:
I had my ER on 11/29 and they got 30 eggs -> 21 mature -> 19 fertilized with IXCI.
The doctor told me in ER that the protocol is, for my age / estrodial level / number of eggs retrieved, to freeze eggs, and let the body get better, but not to put a woman to high risk of extreme OHSS.
The difference in my case is that I needed PGD - day 3 biopsy, and they don’t see many good results from frozen cycles, only from fresh, therefore they were willing to risk with me.

I felt like crap for the entire week and only 12/7 I felt like using the computer / actually sitting down! which is CRAZY… I drank a lot… I had a belly - the size of 5 months pregnant (at least!) woman!!!

I had my ET on Friday, and now I feel a lot better. I hope that it’s not a sign of BFN, since I really hope I am pregnant…

anyone else had their symptoms go away when BFP?