Oh, OHSS. Tips Here!

We’re lucky to live in a time and in a country with the medical technology, systems and staff to have an egg retrieval. But, OHSS can be yet another unpleasant side effect of the IVF process. Oh, OHSS.

It might be something your clinic told you you’re at risk of, or you’re just worried about it. I get it. I was high risk and have gone through OHSS multiple times and come out of it with a smile on.

But whatever the risk, the key is to be prepared both physically and emotionally, so that you can conquer it head on and so that you’re more in control and ready in every way possible for the next steps on your fertility journey.

Here’s how, starting with some FAQs:

What is OHSS?

Ovarian Hyperstimulation Syndrome.

What is it, really?

In IVF (or for freezing eggs for your future self and/or for others), it’s a reaction to all the medicine you’ve been taking in the lead up to egg retrieval, that ends up beefing up your ovaries with liquid so much so that it puts pressure on your belly.

How likely is it I’ll get it?

Some argue everyone who goes through to egg retrieval (or close to it, if it’s cancelled) has at least a very mild case of OHSS. You’re at higher risk if you’ve had lots of eggs retrieved and/or high estrodial levels. To reduce the likelihood of OHSS, your RE might give you additional medication (e.g. Dostinex) and a (non HcG) trigger shot containing lower estrodial.

What are the common symptoms?

Bloating and fatigue. You might feel like you have bloating similar to when you get your period. Others feel like they’ve swallowed a giant watermelon, so mega pressure. In more severe cases, troubles breathing, vomiting and/or shortness of breath. Those are much less likely to happen.

---

7 Tips

Here are 7 tips to prepare you so you’re feeling more like yourself on the other side! However, above all else, always follow the directions of your fertility clinic.

1. Rest, rest and rest some more. 

• Plus, rest. Seriously, try to rest as long as you can. OHSS can come on a few days post retrieval (!).
• You also want to rest because your don’t want to risk snapping your ovary which is tender and swollen.
• If you feel like moving around, don’t go far. It might surprise you that you can’t stay up too long. Fatigue may last 1 to 3 weeks.
• You might find it’s more comfortable to sleep on your side.

2. Hydrate and eat salty snacks.

• Drink up! It doesn’t have to be Gatorade. Only if that’s appetizing to you. Drinking water + eating salty foods works great and is healthier than adding needless sugar.
• Watermelon added to your diet is also helpful. It’s high in water content but has lots of juicy nutrients as well to boost your immune system.
• Broth like Vietnamese noodle soup or chicken soup will be effective at hydrating you with those electrolytes plus may feel comforting.
• Eat protein too, like salty peanuts and hard boiled eggs with crunchy salt sprinkled on.

3. Have measuring tape and a bathroom scale ready for daily check-ins.

• You’ll need to monitor your OHSS whether it’s just getting started or getting worse.
• Measure your belly and weigh yourself daily. Your clinic should give you directions on that. As always, follow their protocols.
• Keep checking that you’re peeing enough. If you’re drinking loads of liquids, you should be taking frequent trips to the toilet. Water in should roughly equal water out.

4. Warm your belly with heat for comfort.

• Get as cozy and comfortable as you can as you go through this. Whatever that involves.
• Have a hot water bottle or electric heating pad or magic bag that you heat in the microwave ready to go once you’re back from the clinic.
• Warm your beautiful belly during the day, however much feels good. (If you’ve had a fresh embryo transfer, then stop the belly heating).

5. Prepare for the self care you’ll need.

• You’ve been through a lot. Your body and your emotions have been put through the wringer. This is the  time to be very gentle with yourself, physically and mentally.
• Lots of women take 2 to 5 days off of work, whether it’s vacation or sick days or even short term disability.
• Your self care regime may be listening to calming music, audio books, watching nostalgic movies or shows, journalling, incense or scented candles, Skype or phone calls with a pal or family member, or something weird but comforting. No judgment, just do you.
• Keep away from any vigorous yoga or activity that contorts your body and might twist your ovaries. Again, be very gentle with yourself.

6. a. If you’re having a fresh transfer, then this:

• It’s a special few days while you prepare for pregnancy. Do what you need to do to prepare yourself mentally for this exciting journey.
• Consider using the app Mindful IVF, or journalling, reading pregnancy books or whatever it is to feel mentally well and ready for this step.
• If you have a partner, talk to him/her about how you’re doing.
• Keep taking your prenatal vitamin with folic acid. (Consult your doctor for details)

6. b. If you’re having a freeze-all and planning a frozen transfer later, then this:

• In addition to nurturing yourself from OHSS, you’re about to devote your pre-pregnancy self to whatever you need to do for a few weeks or months before your embryo transfer.
• This is a special time to prepare for pregnancy. You’ve got time.
• Perhaps you’re taking on more hours at work or a side hustle to pay for medications and procedures.
• Consider focussing on self care, eating all the pregnancy foods you won’t be able to eat, and creating a healthy eating and exercise regime to make your body pregnancy-ready.
• Maybe you want to think about everything non-pregnancy related by working on a home project or travelling with friends or your partner. Take the time to focus on the areas of your life that YOU feel you need to.
• If you have a partner, talk to him/her about how you’re doing and what you also need together over this period of time.
• If you need a surgery before transfer, you’re preparing for that step.
• Keep taking your prenatal vitamin with folic acid. (Consult your doctor for details)

6.c. If you don’t have embryos to transfer or have a cancelled cycle, then this:

• I’m sorry. It can be overwhelming when you have been working so hard and doing everything right. It’s really unfair.
• This is an especially important time to give yourself self care and to evaluate all the areas of your life and all the ways this will affect your next steps. Get to know how you feel and what you need, communicate with your partner and/or anyone else you need to consult. Make sure it’s ALL areas of life this affects.
• Your clinic probably learned a lot about your individual case from this cycle so that knowledge is powerful. So often the first cycle or two can be tests to see how your body responds. Your fertility team will have learned from these past cycles to inform plans for your next cycle.
• There are so many more options for next steps on this creative baby making journey. Grieve that it wasn’t how you wanted it to date, whether it was plan B,C, X or Y.
• You are amazing and this does not define you.

7. Do something to celebrate!

Cheers to you!! Your egg retrieval (or cancelled cycle) is a huge accomplishment, no matter what the outcome is. What will you do to celebrate? Even if it’s small, celebrate this milestone. I celebrate you!

Here’s a short overview of OHSS from Astra Fertility Clinic in Ontario, to give you some of the technical terms and peace of mind that you’re doing everything right.

Book a call with me if you want more personalized support. I’ve had OHSS twice and I can walk you through it.