Pregnancy and OHSS

I have developed late-onset ovarian hyperstimulation syndrome (OHSS). This is a condition in which the ovaries swell because of increased HCG levels and cause the body to release fluid into the abdomen instead of flushing it out of the system properly. It can occur as a result of the trigger shot prior to egg retrieval, or in my case, because of a positive pregnancy when HCG levels are rising quickly. It varies in severity from mild to severe and can include symptoms such as bloating, cramping, decreased urine output, decreased appetite, fever, weight gain, shortness of breath, etc. There is no actual "treatment" for late-onset OHSS because it is pregnancy-related. All they can do is monitor symptoms and do maintenance therapy, such as procedures to drain some of the fluid, encourage increased intake of fluids that contain electrolytes (like Gatorade), increase protein intake, and increase salt intake.

My case was determined to be moderate. My RE says he sees this in approximately 1 out of every 100 patients and was able to confirm my fluid retention with a ultrasound that showed fluid in all four abdominal quadrants. He was sure I had at least 2 liters of fluid, but they were only able to drain 800 ml. I have experienced some relief in that my swelling is not as severe as it was and the fluid seems to move around from my belly, to my hips, to my back and sometimes seems to decrease in volume slightly (especially after eating my protein and salty foods). I have been assured that OHSS doesn't negatively impact pregnancy, may be an indication of multiples, and is actually a good sign that pregnancy is progressing appropriately.

This OHSS may last anywhere from couple of weeks to the end of my first trimester which means that it is very likely that I may look 5-8 months pregnant for at least 2 more months. None of my pants fit (except for my few pairs of stretchy pants), so I am having to take myself shopping for some maternity clothes to get me through until I can fit into my old clothes again (whenever that may be).

This makes keeping my secret pretty tricky. I had explained at work that I had surgery (I told them I was having a cyst removed when I was actually having IVF) and this is an uncommon complication. It is true...this isn't a common condition and it is related to IVF. However, I'm waiting for other people to start asking because I have literally ballooned overnight.

We told our families on Mother's Day. I'm only 4.5 weeks pregnant, but given the slight complication and the holiday, we thought we could use the extra support. Our closest friends won't be told until after our first ultrasound which has been scheduled at the end of this month (I'll be 7 weeks by then). Other friends, relatives, work people, and general acquaintances will be told after 12 weeks. Almost everyone knows how long we've been trying and how difficult this journey has been, so we want to make it as special as we can when we share our news to each group.

At this point, I hope and pray that this pregnancy goes well and that this OHSS is the only major bump in the road.

BFP

Well, transfer day arrived and we only had 2 blastocysts that made it. We had planned to transfer 2 which meant we didn't have any left to freeze. The blastocysts we had were graded BA and AA, so they looked good. I'm not sure what happened to the other 8, but that left my husband and I to feel a sense of defeat and desperation for at least one of our two little blasts to stick since we wouldn't have anything left to do a frozen cycle later if necessary.

Transfer went well and I felt nothing essentially until four days later when I woke up feeling strange. I felt bloated and fat (I don't usually feel like this, especially when I first wake up), had noticeable cramping and strange pains here and there and my appetite changed...either I wasn't hungry, or was craving foods that I don't eat very often. This went on through the next day as well, so I caved and decided to start testing early. I fully anticipated a negative test this morning when I was testing 6 days after my transfer (and three days early), but it immediately turned positive.

I am cautiously optimistic about this. I know it could be a false positive, but I plan to continue testing until my blood test in three days. In the meantime, I have an appointment to get my progesterone level checked tomorrow, so I might mention it to my RE, but this is the first time I have ever had two lines show up on a pregnancy test, so I'm enjoying the moment for now.