IVF #4: End of Stims/OHSS

At one of my appointments during stimulation, (I think 11/26 maybe?) I was being checked by a doctor and nurse I normally don't see (but they're awesome too); it was just because it was the day of the week I was there on. 

I casually mentioned I was feeling nauseous after eating. (I'm telling you, this was the most casual mention of it because they kept asking how I was feeling and it was the only thing I could think of other than "good". lol). But holy cow, the second I said it, there were meaningful glances between doctor and nurse and lots of questions about my what my cycles were like before IVF and if I was having other symptoms. 

All the sudden we were being prescribed two new medications and we were put in a counseling room to talk to my nurse. I am so grateful Bryce was able to be there that day. Tiecha came in and went over the paperwork we'd seen before (and I knew I still had it at home in my binder of all our IVF stuff. They'd given it to us and had gone over it once when we first started.) 

It was about:

OVARIAN HYPERSTIMULATION SYNDROME (OHSS)

**The following info is my understanding of this syndrome from talking with my doctors, researching online and experiencing it myself. I am including I'm not a physician and if my explanations are off or whatever, don't blame me. :) Much of this info is copied directly from another website listed below **

*OHSS occurs in 10% of women undergoing IVF.

*Of those 10%, 1% have to be hospitalized for severe complications.

RISK FACTORS INCLUDE:

1. being under 35  (check)

2. having PCOS (check)

3. having a small body/frame (check)

4. extremely high estrogen levels during IVF stimulation (check)

5. undergoing IVF (check)

CAUSES:

"Normally, a woman produces one egg per month. Some women who have trouble getting pregnant may be given medicines to help them make more eggs.  If these medicines stimulate the ovaries too much, the ovaries can become very swollen. Fluid can leak into the belly and chest area. This is called ovarian hyperstimulation syndrome (OHSS). OHSS occurs only after the eggs are released from the ovary (ovulation)."

SYMPTOMS:

*Can range from mild to sever. Most women with this condition have mild symptoms:

1. Abdominal bloating

2. Mild abdominal pain

3. Weight gain

*In rare cases, women can have more serious symptoms:

1. Wight gain (more than 10 lbs in 3-5 days)

2. Severe pain or swelling in the belly area

3. Decreased urination

4. Shortness of breath

Taken from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004549/#adam_007294.disease.symptoms

SO, that's a bit of the info they gave me that day. 

It freaked me out at first because they gave me new prescriptions I hadn't been expecting and talked about possibility of hospitalization, which I had never really considered as a possibility. And Tiecha, bless her amazing heart, gave me her personal cell number and made me swear on my life that I would call or text her day or night with ANYTHING out of the ordinary or any questions or concerns. 

(When I just nodded the first time, she made me look at her and she literally made me promise out loud to follow her instructions.) 

The whole thing was so overwhelming. I hadn't been expecting any of that that day and I did NOT like how serious it all sounded. I cried. A lot. that morning.

Luckily Bryce is amazing and was awesome and helped me be calm about all of it. As calm as I could be at least. 

The next few days as I finished up stims were not super fun. Honestly really not bad considering everything but eating was difficult because I felt full all the time and afterwards I'd just feel really nauseous like it was going to all come back up. I felt like my food just sat up in my chest and throat and never would go down. But they gave me a script for meds to help with the nausea and I just had to monitor myself----nausea is ok but if you can't keep food down or especially if you get short of breath, that's when you have to really worry. Luckily I did fine the next few days.

Earlier I talked about how they monitor your estrogen during stimulation, which for me lasted 10 days.

This is what mine was like:

11/16: 

One injection

Estrogen: 54

11/19: (first day of stims)

Three injections

11/20:

Three injections

11/21:

Three injections

Ultrasound

Labwork

Estrogen: 240

11/22:

Three injections

11/23:

Three injections

Ultrasound

Labwork

Estrogen: 615

(PS: a woman's normal cycle estrogen gets up to about 200 tops)

11/24:

Three injections

Ultrasound

Labwork

Estrogen: 890

11/25:

Three injections

11/26:

Three injections

Ultrasound

Labwork

Estrogen: 1942

11/27:

Three injections

Ultrasound

Labwork

Estrogen: 2688

11/28:

Two injections

Trigger shot (makes you ovulate)

Ultrasound

Labwork

Estrogen: 4899

11/29:

no injections!!! :)

I hope you looked at those estrogen levels. I'm pretty dang proud I survived all of that.

Like I mentioned, in a normal cycle estrogen peaks around 200 at ovulation. They were trying to get me up to 3000. My numbers were steadily climbing at a good rate til the 27th. At that point they decreased my dose by half so that it would only increase another 500 or so.......

It almost doubled!  It increased by over 2000 in 24 hours. They couldn't have anticipated this. It just happened. But hey, I was definitely high enough, so I did the trigger shot (to induce ovulation) at exactly 9pm on the 28th.

**You have 36 hours from the time of the trigger shot before you ovulate** so I was scheduled for the egg retrieval on Friday, November 30th at 9AM.