OHSS and timing

[Anonymous]

Question about the timing of OHSS if you get it...If you make it through stim phase and eggs are retrieved, can you still get OHSS during the 2ww? I'm specifically talking about terms of IVF versus IUI. I potentially will be out of town during the 2ww following transfer and trying to figure out if I need to stay close to home because of a potential to get OHSS or if I would know that ahead of time?

TIA!

[Anonymous]

Yes, you can get OHSS after transfer and during the 2ww if you get pregnant (pregnancy makes it worse). I had no signs of OHSS at the transfer and developed severe OHSS during the 2ww. It required hospitalization and lots of fluid drained -- but I went on to have a healthy pregnancy and delivered a healthy baby.

[Anonymous]

Well...if you are at risk for OHSS...I would see if your doc would freeze all and do a frozen embryo transfer (FET). Your best bet is to avoid it all together, because it is NOT cool. I didn't even have pregnancy OHSS, only stim related OHSS during the 2WW and it wiped me out BIG TIME. Traveling and working would have been nearly impossible...

WLD

[Anonymous]

OP here. I guess my question is, will my dr know if I am at risk by the time retrieval happens? Or could I be gone and then have it come on suddenly without warning during the 2ww? My dr has already told me he will do a FET and freeze the embryos if it seems like I will get OHSS.

[Anonymous]

Well...your doctor can only 'guess' how you might respond, based upon your E2 (estrogen) levels.

But my RE told me (when I was lying there with a distended abdomen) that there was NO WAY he thought I would be having so many issues, because I was of AMA. He knew my E2 levels were high, but he just didn't think I would have such extreme issues. To make his point, he said, "there is a lady out there in my waiting room, that I thought would definitely have OHSS, and she is walking around with no issues. There is no way to know for sure, we just have to take precautions."

So to answer your question...yes, your doctor will know that you are at 'risk' by the time retrieval happens, but he won't be able to tell you that you will or will not get OHSS. It still isn't really understood why some women do and some women don't get it.

However, there is one paper in the literature, that discusses a woman who got OHSS during her spontaneously conceived singleton pregnancies. I don't remember what her 'issue' was...I think they were proposing a genetic variant as a cause...but, in general, the medical community doesn't really know...so, your doc can only go by what they see as 'risk' factors. PCOS and high E2 levels are two big factors.

WLD

[Anonymous]

Previous poster...what does "of AMA" mean? You've referenced that a lot in your posts and I am just curious as to what it means. Thanks!

[Anonymous]

I think AMA means advanced maternal age, I just call it old which is how I felt when I did my cycle, but it worked so I guess my eggs were in better shape than my AMA would have suggested!!

[Anonymous]

Hey AMA, what kind of protocol worked for you, I'm also an AMA gal??

[Anonymous]

I'm 39 with FSH-15 and low AMH who was successful with Natural cycle IVF, my DD was born in Dec.

[Anonymous]

I am WLD...and yes, AMA does mean Advanced Maternal Age.

I was VERY lucky and despite being 40 to 42 years old during my major fertility treatments, I still had great antral follicle counts, great hormone levels and responded to stim meds very well.

NOT NORMAL...so please, if you are of advanced maternal age, do NOT wait to get some more aggressive treatment if you want to have children.

I went through a normal IVF protocol...probably a bit more meds than a 30 yo would need, but certainly not the max amounts of stim meds. I also would get huge estrogen levels and mild OHSS.

Still, beyond all that, in 3 IVFs, I managed to get almost 40 eggs retrieved, 19 embryos to day 5 blast, a pregnancy in the first IVF (ended in m/c due to T18-trisomy 18), and then a pregnancy in the 3rd IVF which ended in genetically typical boy/girl twins.

WLD