[hapaclp]

I'm at day 26 of my cycle, I did round of Gonal-F days 4-14, trigger shot (Pregnil) day 15. I went in for an u/s day 13, nothing abnormal, no hyperstim. Days 15 and 16 I felt fine, starting day 17 I was having stomach cramps and slight bloating. By day 19 I started researching online and found out I might have had OHSS, I went to my RE the next day and found out I did - my ovaries were 7cm, I was having intermittent stomach cramps and super bloated. She told me usually the symptoms won't go away if you do end up pregnant. I was still horribly bloated Saturday night, I woke up yesterday and the bloating was gone but was still having mild cramping and very tender breasts. Same thing today, it feels like the cramping is more in more uterus now than my ovaries (but maybe that's cuz I want it to be since that would be more likely to be a pregnancy symptom than cont. OHSS). I know I only have a couple more days to wait but I'm going crazy in suspense, with the diminishing OHSS does that mean I'm definitely not pregnant?
If I'm not pregnant this cycle, am I going to have to skip one cycle before continuing treatment? If I don't have to wait would it be better to try a cycle of Clomid? (I've never done Clomid - I went right to injectibles because I was unable to buy Clomid where I live.)
I have hypothyroidism but am taking medication which regulated all my hormone levels to the ideal levels, before taking meds I never ovulated, now that my levels are regulated will I ovulate naturally? I'm scared to do another round of injectibles after reading so many horror stories about it - even though mine was considered moderate I only gained 4 lbs and never needed pain meds to relieve the cramping. If I do injectibles again, will I always get the OHSS? It seemed like the Hcg shot really caused it - are there other options to trigger?
I know this is really long and I asked a bunch of questions! I would appreciate answers to any or all ?'s and curious to know about other people's experience with OHSS.
Thanks!

 

[Julia'sMom]

All I'll say is don't rule out pregnancy yet. OHSS can be different for everyone. I know one gal with ivf was at severe risk, but then avoided the symptoms and was indeed pregnant. I only had a mild case after ivf and the bloating went down, and then came back around 5-6 weeks pg and lasted until around 9-10 weeks. Unfortunately, you're just going to have to wait and see.

As far as next cycle, yes I think they'll want your ovaries to settle down before stimming them again. They can lower the injectible dose if that caused the OHSS. You can also use less trigger, basically, there are quite a few options for avoiding it next time around and your dr should be able to help guide you.

 

[soso-lynn]

While it is true that OHSS is more frequent in cycles that result in pregnancy, it does go away after a week or so in the vast majority of cases, pregnant or not. The cases that do drag on are normally because of a pregnancy though.

At the clinic I work at, we have patients with more than 3 follicules on injectibles take a month off before trying again. We do not normally give them a clomid cycle in between, but if they insist, we will have them come in for a day3 ultrasound to assess the situation before starting the meds.

In the case of OHSS, the doctor will normally reevaluate the meds and discuss options with you. They may advise you to wait 2 cycles depending on the severity of the situation. Many of the patients who get OHSS do IVF after that with a protocol designed to avoid it. They usually do well with those. Many others do IUIs again. It is not normally recurring under decent medical care.

I do not know anything of your medical history, but Gonal-F days 4 to 14 seems like a lot. May I ask what the dosage was? The first cycle with injections, we normally combine clomid or femara with injections on days 5-6-7-8 or just 5 and 7 with an ultrasound on day 9. I only see people doing only injections after many, many tries and, even then, it is normally something like day 3-7 with ultrasound on day 8.

 

[hapaclp]

I was on 75ui dose. I went in on day 9 for u/s, no obvious large follicles so I was told to continue the injections. When I went in day 13, u/s showed 3 large follicles, largest was 19. So my Dr. told me to do my injection that night and the next night then do my trigger day 15. This was my second cycle of Gonal-F. The first cycle I didn't trigger because the Dr. told me to skip injection for a day then restart then skip again because I was having horrible side effects and follicles were growing very quickly. By day 14 I had no mature follicles. This cycle we had planned to actually lower the dose after day 9 but instead cont. My body reacted very differently this cycle than last. I had almost no side effects compared to the last one.

I just heard about Femara today, not sure if I can get that here. The reason I didn't just start with Clomid was because I live in Costa Rica and the entire country was and is out. I ordered some online in Jan. and it just got here last week. So rather than injectibles, I wanted to try that next. If I have to I'll skip one month, guess I'll find out at my appt. this Weds.

What happens when people do injections days 3-7 only? Do the follicles then cont to grow on their own?

I know I'm not getting the best infertility treatment, that's why I am really hoping people here can help answer my questions. I was going to find a new Dr but my period started early since I had a friend visiting and my cycle moved towards hers. I can't find a doctor who only specializes in infertility. All the doctors I find are gyno/infert. I guess there's not as much of a demand here since it costs so much?

Since my husband has healthy, normal sperm, my Dr. also told me to try naturally timed on the right days of course. Is this not effective? Should I be doing IUI?

TTC #1 off and on since 4/07, first saw infertility Dr. 1/09

Thanks so much!