Monday, May 14, 2012

IVF Overstimulation is Horrible!

So it turns out that I have Ovarian Hyperstimulation Syndrome.

~Symptoms
"Symptoms are set into 3 categories: mild, moderate, and severe. Mild symptoms include abdominal bloating and feeling of fullness, nausea, diarrhea, and slight weight gain. Moderate symptoms include excessive weight gain (weight gain of greater than 2 pounds per day), increased abdominal girth, vomiting, diarrhea, darker urine and less in amount, excessive thirst, and skin and/or hair feeling dry (in addition to mild symptoms). Severe symptoms are fullness/bloating above the waist, shortness of breath,pleural effusion, urination significantly darker or has ceased, calf and chest pains, marked abdominal bloating or distention, and lower abdominal pains (in addition to mild and moderate symptoms).

~Complications
Symptoms generally resolve in 1 to 2 weeks, but will be more severe and persist longer if pregnancy occurs. This is due to human chorionic gonadotropin (hCG) from the pregnancy acting on the corpus luteum in the ovaries in sustaining the pregnancy before the placenta has fully developed. Typically, even in severe OHSS with a developing pregnancy, the duration does not exceed the first trimester."

~Treatment
Treatment of OHSS depends on the severity of the hyperstimulation. Mild OHSS can be treated conservatively with monitoring of abdominal girth, weight, and discomfort on an outpatient basis until either conception or menstruation occurs. Conception can cause mild OHSS to worsen in severity.
Moderate OHSS is treated with bed rest, fluids, and close monitoring of labs such as electrolytes and blood counts. Ultrasound may be used to monitor the size of ovarian follicles. Depending on the situation, a physician may closely monitor a patient's fluid intake and output on an outpatient basis, looking for increased discrepancy in fluid balance (over 1 liter discrepancy is cause for concern). Resolution of the syndrome is measured by decreasing size of the follicular cysts on 2 consecutive ultrasounds.
Aspiration of accumulated fluid (ascites) from the abdominal/pleural cavity may be necessary, as well as opioids for the pain. If the OHSS develops within an IVF protocol, it can be prudent to postpone transfer of the pre-embryos since establishment of pregnancy can lengthen the recovery time or contribute to a more severe course. Over time, if carefully monitored, the condition will naturally reverse to normal - so treatment is typically supportive, although patient may need to be treated or hospitalized for pain, paracentesis, and/or intravenous hydration.


I have not been able to return to work, I can't even wear my normal clothes. I look like I am about 5 moths pregnant and it is all fluid. I am weak, I can't breath and it is painful. They have drained the fluid from around my ovaries twice. The relief is instant but gosh.... it is a painful procedure to go through! I was told to eat salty food and drink sports drinks.

So, the good news is it goes away on it's own, eventually!!(I'm still waiting)

4 comments:

  1. I had OHSS, too. Though, when they drained me, they knocked me out and I thought it was a very easy procedure. My fertility clinic did it. After the first week and the first draining, my body started regulating itself a little better, and I didn't need to get drained again. I have gained weight, though, and my ovaries are still really sensitive, and it seems that is all from OHSS.
    Probably TMI, but I can't have sex yet...learned that the hard way!!! My ovaries cramped all night afterwards, and I wondered if I was going to miscarry.

    Good luck and hoping that you feel better soon!!!

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  2. I had OHHS not at all fun. I had 28 eggs collected & E2 over 10,000 at trigger. It showed up 2 days after EC but was surprisingly mild enough to go ahead with 5 day transfer. It was a week after transfer that the bloating & extreme pain came back - sure enough I was pregnant. This time It was really horrible, i just avoided draining and gained 5kg over 2 days very scary. I has to sleep sitting up for a while too, not fun. What really helped was tons & tons of gatorade every day, protein shakes, eggs and protein constantly and REST. I'm now 12 weeks and still bloated but it's getting a little better & no pain now.

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