[sunny_skies]

Hi all,

We're in the process of IVF #2. Our first cycle, in 2008, was successful and our son was born last November. During the course of that cycle, however, I hyperstimmulated pretty badly and had to have fluid drained several times. Our retrieval is scheduled for tomorrow afternoon (fingers crossed!) and I've once again produced a LOT of follicles. (I have PCOS.) I'm fearful of hyperstimming again and am wondering if anyone has ever heard of anything that can be done to prevent it? I know last time the nurses told me to eat lots of protein and drink lots of Gatorade--this should be done after the retrieval, correct? Any other tips?

Thanks!

[Ghost]

Originally Posted by sunny_skies

Hi all,

We're in the process of IVF #2. Our first cycle, in 2008, was successful and our son was born last November. During the course of that cycle, however, I hyperstimmulated pretty badly and had to have fluid drained several times. Our retrieval is scheduled for tomorrow afternoon (fingers crossed!) and I've once again produced a LOT of follicles. (I have PCOS.) I'm fearful of hyperstimming again and am wondering if anyone has ever heard of anything that can be done to prevent it? I know last time the nurses told me to eat lots of protein and drink lots of Gatorade--this should be done after the retrieval, correct? Any other tips?

Thanks!

Yes, if that is going to help at all, it would be starting right after retrieval.

Alternatively, you might see if you can find a clinic that will trigger without hCG. The clinic at the University of Connecticut, for example.

[rachelannsauer]

I have PCOS also. My RE watches my meds very closely and keeps me on a very low dose. I stay in bed from ER to ET and drink gatorade only and eat tons of protein. Make sure you get some fiber too or else the constipation may set in which is not good. I also triggered with 1/2 the standard dose of HCG. That helped me both times

[GinaG31]

I also have PCOS and did have OHSS 2 IVF's ago. I have done 4 IVF retrievals all together. The 1st was BFP and I have a 22mo old son. I triggered with 2 injections of GnRH instead of hCG. With GnRH you have to start progesterone the day of retrieval because it doesn't support the lining the same way hCG does. TTC#2, the 2nd IVF I triggered with GnRH and was fine, BFN though. The 3rd one, we used hCG because my hormone levels seemed "safe" to do it. By the day of retrieval, I had so much fluid in my uterus from the high hormone levels that we couldn't transfer and had to freeze whatever fertilized, then I developed OHSS. I had to sleep sitting up for 6 nights due to the fluid leaking into my chest cavity when I layed flat and most of the bloating was that my ovaries were more than 3x the size they are supposed to be. Then, my FET failed and we did another fresh IVF, which we went back to GnRH and my ovaries were fine. Definitely look into using something other than hCG if you have PCOS and a history of explosive ovaries (that's what we call mine, lol). I had to take 2 months off after that and there's nothing more annoying than being forced on a break and wasting time. Good Luck!!!!!!!!

And yes, drink lots of gatorade. I drank about a gallon a day after retrieval, they sell it in powder form now so you can mix it by the gallon. Hope you get your BFP!!

[StillWaiting410]

You are right on track with the Gatorade and protein.

I have PCOS and always had to freeze all embryos due to risk of OHSS. My RE never considered it safe to do the fresh transfer.

Greatest luck to you!

[Ghost]

Originally Posted by GinaG31

I also have PCOS and did have OHSS 2 IVF's ago. I have done 4 IVF retrievals all together. The 1st was BFP and I have a 22mo old son. I triggered with 2 injections of GnRH instead of hCG. With GnRH you have to start progesterone the day of retrieval because it doesn't support the lining the same way hCG does. TTC#2, the 2nd IVF I triggered with GnRH and was fine, BFN though. The 3rd one, we used hCG because my hormone levels seemed "safe" to do it. By the day of retrieval, I had so much fluid in my uterus from the high hormone levels that we couldn't transfer and had to freeze whatever fertilized, then I developed OHSS. I had to sleep sitting up for 6 nights due to the fluid leaking into my chest cavity when I layed flat and most of the bloating was that my ovaries were more than 3x the size they are supposed to be. Then, my FET failed and we did another fresh IVF, which we went back to GnRH and my ovaries were fine. Definitely look into using something other than hCG if you have PCOS and a history of explosive ovaries (that's what we call mine, lol). I had to take 2 months off after that and there's nothing more annoying than being forced on a break and wasting time. Good Luck!!!!!!!!

And yes, drink lots of gatorade. I drank about a gallon a day after retrieval, they sell it in powder form now so you can mix it by the gallon. Hope you get your BFP!!

Great post.

Triggering with GnRH is very rare. More common is to trigger with a GnRH agonist (like Lupron). Either will cause a release of LH to mature the eggs, and LH is short-lived, so it can't support OHSS progression for long enough for serious disease to occur.

[germani]

I have specific question for those who experienced OHSS but did not proceed with ET. My ER was on Wednesday and my symptoms have gotten worse by the day. My amdomen is huge and I had 3 litres removed on Sunday. My abdomen was still huge after the drain but I was a lot more comfortable and lost 4 pounds that day. Now it is Tuesday night and I have regained 3 pounds and I am getting uncomfortable again. My question is how long does this take to resolve? I understand I may need to be drained again. Does it really take until AF? That is 10 more days! I need to go back to work ASAP!

[Ghost]

Originally Posted by germani

I have specific question for those who experienced OHSS but did not proceed with ET. My ER was on Wednesday and my symptoms have gotten worse by the day. My amdomen is huge and I had 3 litres removed on Sunday. My abdomen was still huge after the drain but I was a lot more comfortable and lost 4 pounds that day. Now it is Tuesday night and I have regained 3 pounds and I am getting uncomfortable again. My question is how long does this take to resolve? I understand I may need to be drained again. Does it really take until AF? That is 10 more days! I need to go back to work ASAP!

It can last as long as the hCG lasts. That's up to about 10 days after the trigger, maybe a day or two more.

[HouseNRaleigh]

I have a question for those WITHOUT pcos.... what percentage of women get this hyperstimulation and have to have fluid drawn off? When shows toward the end of the month, I call to schedule the IVF class, but don't start stims until Dec and this makes me a little nervous!!!

[virginiatech]

I do not have PCOS and just had a moderate case of OHSS on my first attempt at IVF. My transfer was canceled and we froze 8 embryos. It was an awful experience for me and one I was unprepared for. Here is some info I put together: A real-life guide to mild and moderate Ovarian Hyperstimulation Syndrome (OHSS) « Whitney & Erick