Fresh transfer versus waiting a month

[Anonymous]

Is anyone familiar with not being able to do a fresh transfer due to signs of posbbile OHSS? I just started stims, and our doctor mentioned that if he sees signs of OHSS before retrieval, he may decide not to do a fresh transfer and instead wait a month. I was a little surprised to hear this since this is the first time he mentioned it. I plan to ask more questions at my next appointment. In the interim, does anyone have a sense of how common this is? How would he know that a patient would experience OHSS pre-retrieval? What are the signs? I apologize if this is a dumb question - I am just learning all of this.

[Anonymous]

I went through this. I have PCOS, and the possibility of OHSS is elevated in women who are high responders to stims. My estrogen was getting very high, so I was switched to a lupron trigger, and we converted from a fresh transfer to a freeze all cycle. First FET from that cycle was 6 weeks later and resulted in my 3yo DD.
I had no reservations about this at all. I know several women who dealt with OHSS, one of whom was hospitalized because of it. I had no desire to experience that!

[Anonymous]

This happened to me. I waited two months and I’m glad I did. I was worn out after the IVF retrieval and OHSS and doubt a transfer would have been successful. I rested up and had a transfer two months later that worked.

Keep in mind that a frozen transfer has better success rates.

[Anonymous]

Yes. My first retrieval yielded 32 eggs. I wasn’t exhibiting any signs of OHSS but my doctor convinced me it would be safer to wait and do a frozen transfer. I was really disappointed because I was so ready for a transfer after going through so much. I did not develop OHSS. I waited two more cycles over a two month period and then did a frozen transfer. It was nice to have a break and be off of meds I will admit.

[Anonymous]

^ I am above poster, forgot to answer your questions about how to detect OHSS.

OHSS occurs when there is a hyperstimulation to ovulatory drugs resulting in a large number of follicles, and a large number of eggs. As another PP mentioned, 0HSS is a greater possible risk if you have PCOS; women in their teens or 20s and/or who have slim build/lower weight are also more likely to develop OHSS. However, it certainly happens to people who do not fit in to any of those categories but still have a overstimulation from meds.

OHSS does not set in until after ovulation (after trigger), but there are sometimes warning signs in the days leading up to retrieval. These would include identifying a large number of follicles (which could result in a large number of eggs) and
having a jump in hormone levels right before, during, and or after ovulation (trigger shot in a cycle). Your doctor will keep up your blood monitoring during this time.

If you have a large number of eggs retrieved (my doctor said anything over 20 made him look closely for OHSS) and OHSS becomes a possibility, there are a few proactive things you can do to lessen the symptoms (which are severe bloating and water weight gain which can cause breathing issues amongst other things). These include taking in a large amount of liquids (water or Gatorade, doctors vary which is better), eating lots of salty foods, and doubling protein intake. These measures combined can help the empty follicles, once the egg is retrieved, to dissolve, versus fill painfully with fluids which happens with the syndrome. Extreme cases involve hospitalization, and drainage of the third space in the abdomen. I know a couple of women who were hospitalized with severe cases and it is extremely unpleasant. One was in the hospital for nearly a month, but she had the most extreme case the hospital had seen. There isn’t a cure besides time, drainage, and monitoring unfortunately. The risk with going through with a transfer is if you wind up pregnant, and have the syndrome, it makes the symptoms doubly worse, and much more dangerous.

I’m sure others will chime in with more information or any corrections!

[Anonymous]

In order to have a good outcome from a transfer, they want your hormone levels and uterine lining thickness within certain ranges. If you end up with OHSS a transfer would be less likely to work, plus there's your health to consider. There are docs that favor frozen transfers only since the stim meds themselves can negatively affect the success of a transfer. Hopefully, you don't end up with OHSS, but in any case, doing a frozen transfer isn't at all bad (even if it's annoying to wait).

[Anonymous]

I have PCOS and so am a high responder. My fresh transfer did not take, but my two FETs did. I think that my body was better able to get pregnant with only the FET meds and not any stim meds.

[Anonymous]

This is OP. My transfer did in fact end up getting pushed to a FET. My doctor told me this after me retrieval, and I was very upset about it. I hate prolonging this process more than necessary. I am also just so worn out. But I wanted to come back and say thank you toe everyone who shared their stories. Your words were helpful and made me feel a lot better about moving to an FET. So thank you!

[Anonymous]

Anonymous wrote:This is OP. My transfer did in fact end up getting pushed to a FET. My doctor told me this after me retrieval, and I was very upset about it. I hate prolonging this process more than necessary. I am also just so worn out. But I wanted to come back and say thank you toe everyone who shared their stories. Your words were helpful and made me feel a lot better about moving to an FET. So thank you!

Just someone else here to say my wife has been pregnant five times, but two of those were miscarriages after fresh transfers. The FETs stuck.

[Anonymous]

FETs do have a slightly higher success rate (about 3-5% at most clinics). That said all of my FETs failed and I got pregnant on a fresh transfer during a second cycle of IVF. So you never know!

[Anonymous]

My fresh were failures and my frozen worked beautifully both times. And the frozen cycles were SOOOOO much easier to prepare for!

Good luck OP.