OHSS

Bare with me a little, as I’m writing this from mostly notes, 7 months after I experienced Ovarian Hyper-stimulation Syndrome (OHSS).

OHSS is a condition that affects women undergoing fertility treatment. Because during fertility treatment (IVF/ICSI) your ovaries are stimulated to produce as many follicles as possible, your ovaries become enlarged from the extra work they are doing and stimulation they are receiving. Once you have triggered ovulation and had those eggs collected from the follicles, those follicle sacs are left empty. If a successful pregnancy then occurs, the HCG pregnancy hormone floods your body, filling all of those empty follicle sacs back up with fluid.

I never asked but I would assume this does happen to every women when they’re pregnant… but as most women only release 1/2/3/4 (and likely only 2/3/4 if multiples run in your family!) then it goes unnoticed, as one follicle filling with HCG is nothing compared to 20+…!!

The OHSS I experienced was only ever considered mild-moderate. And I was fairly uncomfortable, scared, and poorly. I was hospitalised for two days/nights and placed on a protein transfusion drip due to low proteins in my blood. All fluid intake and outtake was monitored quite strictly which meant lots of peeing in cardboard potty’s!

I had not been a particularly high risk – as such – for OHSS, as at egg collection, 15 eggs were collected. With my clinic (and, I would think/hope all responsible clinics), if any more than 20 eggs were collected a “freeze all” approach would be taken and a fresh transfer of embryo/blastocysts would not go ahead within the 5 days after egg collection, giving your ovaries and follicles a chance to shrink back and return to normal (ovaries) or disappear (follicles).

At my final scan pre-egg collection however, I had been advised that 25+ follicles were seen and thus it was unlikely I’d be able to go ahead with a fresh transfer. I was disappointed to say the least, but now I understand why! And with hindsight, we wonder perhaps if all 25 eggs had been released from those 25 follicles, but for whatever reason 10 or so got lost or weren’t mature enough or what not… but then those 25+ follicle sacs started filling with the wonderful pregnancy hormone. Because… yes! We were finally pregnant!

After egg collection, I was given medication called Cabergoline which I took each evening for 8 days as prescribed. The day I stopped taking the cabergoline was the day I noticed OHSS symptoms kicking in. I was bloated and uncomfortable with sharp pains all over my tummy. After a call to our clinic, one of my favourite nurses advised this was a good sign, as if OHSS symptoms worsen, the chances are, you’re pregnant! It’s a funny position to be in; uncomfortable and ill, hospitalised, but really, it’s all good because you’re pregnant!

By the early hours of the night after, good old V&D had arrived. At 6am that morning I was convinced nothing could have survived the amount of vomit and diahorrea is expelled from my body that night, and that is when I first peed on a stick. Having peed on the stick, I felt like I was about to faint, so I left the test on the side of our sink and belted it back to bed. When I left the test, it was negative. Minutes later I felt more sickness coming so ran back into the ensuite, only to stop dead at the POSITIVE pregnancy test staring me in the face! I couldn’t believe it!

yes, I did SEVEN tests in the end! ❤️

Completely empty, the V&D finally stopped, but the OHSS didn’t disappear. Throughout that day I was progressively just feeling worse and worse – I actually can’t remember a lot as I was pretty out of it! I just remember being quite uncomfortable/quite a lot of pain, my temperature couldn’t be controlled and I felt swelteringly hot, despite it being December – 4 days before Christmas! James eventually called our clinic in a worry and they called us up, which is when it was noticed my proteins were low. On the journey up, I couldn’t have anything touching my stomach – I had a loose fitting dress on and had to hold the seatbelt away from my belly area – for the entire 40 mile journey! I was pretty weak and faint, and when I was finally admitted to the ward – which was literally across a small car park from our IVF clinic, I had to be wheel-chaired over as I couldn’t walk!

For me, I was bloated. Hugely. And that seemed to cause crazy discomfort and heat! That was the most noticeable thing about me. I was 4 weeks pregnant, but I looked 5 months! My ovaries were quite dramatically enlarged, and follicles were filled with fluids. A woman’s ovaries usually measure between 3-4cm. Mine were each 11cm+, covered in follicle sacs which were filled with fluid, some of which were measuring up to 6cm! My belly circumference when I was admitted to hospital was around 38″!! Pre-pregnancy, I was about 27″!

After a couple of days in hospital I was determined to get out for Christmas, but also so we could host our annual neighbourly Christmas drinks! In hindsight this was probably not my best idea as I wasn’t much fun – still bloated and uncomfortable but very glad to have the drip out of my hand and be home for Christmas! The hospital and our clinic were quite pleased with me as I was eating EVERYTHING – no longer a concern for underrating, I couldn’t get enough food, and whilst a high protein diet is recommended for OHSS, they were happy for me to eat what I needed (carbs!). Again as an avid avoider of carbs (particularly white!) pre-pregnancy, this also probably wasn’t my best idea as it would have been such a shock to my system and bloated me more – but that’s all the baby wanted for 20 weeks and so needs must! It’s also recommended that sports drinks help with OHSS, and I have to say – I found the below pictured electrolytes added to water helped me massively – I thought those electrolytes were destined to go out of date as I was no longer running long distances, but they were used up quickly to reduce the OHSS!

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