Whats A Good Number Of Follicles
If you have at least ten follicles that are a decent size , chances are your doctor will be happy: thats enough follicles for there to be a good chance of at least one high-quality egg;inside, but not SO many that youre at risk of severe ovarian hyperstimulation syndrome .
Basically, you want not too many but not too few follicles, which arent too big or too small. Picky is a word that comes to mind.
She Wasn’t Expecting The Bloat To Be So Painful
Although one of her friends who’d also been through IVF had warned her that she might bloat after the egg retrieval, Victoria said she had no idea it would be so extreme.
“I am a personal trainer so I eat really healthy on a regular basis, and when I have a ‘treat’ meal, I do get really bloated,” she said. “I’m used to bloating. THIS was not normal bloating and nothing I could’ve been prepared for.
“The bloating is a result of your ovaries filling with liquid after the retrieval, and I was told to eat a high sodium, high protein, low carb diet and to drink a lot of electrolytes to prevent my body from holding onto the liquid.
“If my body isn’t able to dispel the liquid, this can result in a very dangerous condition called Ovarian Hyperstimulation Syndrome which can result in the loss of an ovary, kidney failure, and in rare cases, death.”
Victoria posted on her Instagram story saying that her ovaries had not recovered as quickly as she’d hoped from the treatment, so she isn’t able to workout or have baths for five days.
“My energy levels have been so down in the dumps,” she said. “But I am OK with giving my body as many days as it needs to recover, it’s just not worth the risk.”
It’s her first round of IVF, but she’d done two IUIs before.
Victoria has also been using her couple account to educate her followers about how the IVF process works.
In her latest post, for example, she explained what happens following egg retrieval.
The Photo Doesn’t Do Justice To The Pain She Felt
Victoria went on to explain that although it may not look “that bad,” it “felt a lot worse than it looked.”
“I couldn’t sit or stand or even move for the first three days without wincing in pain or bracing myself,” she said. “I’m used to having a really high pain tolerance and battling through, but this really knocked me on my booty.”
Victoria, 31, told Insider that the whole egg retrieval experience was “a lot more painful” than she’d been expecting.;
“Leading up to it, I had to do three injections in my lower belly every night for 11 nights,” she said. “Those were a piece of cake. Even the bloating leading up to the retrieval wasn’t that bad.
“The morning of the retrieval I was calm and excited, and then immediately after the retrieval I was relaxed from the medication and anesthesia.
“The pain kicked in once the medication wore off, and I was in pretty intense pain for the following three days.”
But Victoria stresses that each woman will have a different experience with the procedure.
“It depends how many eggs they retrieve and it also depends on the type of ‘trigger shot’ you do,” she explained.
“Some women have no pain and can go to work the next day with minimal discomfort, and other women are bedridden for a few days.”
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Ive Been Told Ill Need To Take A Trigger Injection Before Ivf Egg Collection Why What Does The Trigger Injection Do
Your eggs need to go through one final stage before theyre ready to be collected: they need to complete a process of;maturing called meiosis, which in turn;causes ovulation to happen.
The trigger injection kickstarts this process, and you’ll need to administer it at a very;specific time usually 36 hours before your appointment for egg retrieval.
Why 36 hours? Its because ovulation will take place approximately 36 hours after the trigger injection gets into your system . The doctors need to collect those eggs just before ovulation takes place, but just after the eggs are fully developed and ready. Its a teeny tiny window of time, and you cant miss it.
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How Is Ohss Caused By Too Many Follicles
OK so this is bloomin complicated and it appears that;medical specialists still arent entirely clear on whats going on, but heres the general gist:
At the ovulation stage of every menstrual cycle, theres a hormone surge that causes the egg to break free from its follicle so that;it can travel into the fallopian tube, ready to be fertilised. In a natural cycle, the hormone is LH; in an IVF-assisted cycle, the hormone is often hCG which acts in very similar ways to LH.
The hormone surge also acts as a signal to the ovaries to produce new and temporary capillaries. In a natural cycle, these capillaries invade the cells of your leftover ovarian follicle , in order;to deliver;cholesterol to those cells. Why? Because then the cells can produce progesterone , which will help to sustain the lining of the uterus in case theres a pregnancy.
These capillaries need to be made super quickly, and as a result, they wouldnt even pass the requirements of a corrupt building official in Turkmenistan: theyre pretty;darn leaky. The fluid portion of the blood leaks through the capillary wall, but its not really a biggie when you only have one dominant follicle : there wont be too many capillaries, and therefore there wont be too much leakage. Whats more, the important stuff the cellular portion of the blood stays in the capillaries and does what it needs to do.
See where Im going with this?
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What Other Complications Occur With Severe Ohss
Complications from OHSS can be severe. You may become dehydrated and pressure in your abdomen may increase from too much fluid. These problems can lead to blood clots forming within the blood vessels. Blood clots can travel to your lungs or to other important organs. This can be potentially life-threatening.
These complications can usually be avoided by recognizing the signs, symptoms, and laboratory evidence that OHSS is getting worse and getting appropriate treatment.
Practical Advice: 1st Day Recovery
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What Should You Eat In The Period After Ivf Egg Retrieval
To set you up for success post retrieval, here are the top 3 nutrition tips to remember when it comes to your diet. Youve got enough to stress about right now, I like to make this part as simple as possible!
High Antioxidant Foods
High-antioxidant foods have shown to help rid your body of the bad guys that can cause inflammation in your body and affect your fertility. Since your body is going to be under stress already, focus on adding the rainbow from fruits and veggies to your diet as each color of produce contains different antioxidants that can lower your inflammatory response!
Here are 3 of my top picks for high-antioxidant foods to add in post retrieval:
Cauliflower and Broccoli
Recipes to Consider
- Smashed Baked Potato Nourish Bowl Vegan + Gluten Free
- Sweet Hummus Recipe
Focus On Electrolyte Balance Hydrations + Sodium Foods
There is not a specific sodium amount to consume post retrieval. However, its important to speak directly with your healthcare team to ensure they provide you with the best recommendations for your health profile
Regardless of the above, you still need to be hydrating!
Here are 3 of my top picks for hydration to consider in post retrieval:
Fruit and veggie infused water
Electrolyte support drinks
Recipes to Consider
- Air Fryer Potato Wedges
How Long Does It Take For Ohss To Get Better
OHSS symptoms usually appear a few days after ovulation. Symptoms usually resolve within two weeks, unless pregnancy occurs. Pregnant women often continue to have symptoms for 2-3 weeks or more after a positive pregnancy test. The symptoms gradually go away, and the rest of the pregnancy is not affected.
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Can Anything Be Done To Reduce The Risk Of Pain And Complications After Egg Collection
If youre at risk of OHSS, read this article about how to avoid OHSS or treat it if you do;end up getting it.
Many of the treatments for OHSS can also be used for those who suffer from side effects but dont have full-blown OHSS:
- Make sure youre drinking enough water: your blood has lost a lot of fluid and is much more concentrated as a result, which makes your kidneys slow down . Water will help to rehydrate you and bring some fluid back into the blood. You ideally need to be drinking enough that;youre peeing out pale yellow urine every two hours.If you read any American IVF forums, youll see that their health professionals recommend that you DONT drink pure water but have fluids containing electrolytes instead. Thats because they provide sodium and potassium which are being lost in the fluid from your blood leaking out of your capillaries. British doctors tend to;disagree with this advice.
- Take paracetamol or codeine to manage the pain .
- Buy some trapped wind tablets and laxatives in advance, in case you suffer from trapped wind and/or constipation after the egg collection.
- Avoid all strenuous activity to make sure you dont accidentally get your now-MASSIVE ovaries in a twist .
- Monitor how often youre urinating, and what colour your urine is: dehydration is a sign of OHSS.
- Get yourself to a doctor if your weight is increasing significantly and youre not urinating anywhere near as often as normal.
When To Call Your Doctor About Ohss Symptoms
Please know that as our patient you are ALWAYS welcome to reach out to us with questions or concerns. However, dont be surprised if after your egg retrieval you dont feel totally back to normal until your first period, which generally occurs 10 days after retrieval.;
Concerning symptoms and ones where we would definitely want to hear from you are listed above under the OHSS symptoms.;Specifically, though, keep an eye out for vomiting, shortness of breath, >1lb weight gain in 24 hours, and decreased urine output. These are all signs that your ovaries are swelling and putting pressure on your diaphragm. After speaking with a nurse, we will generally bring you in to perform an ultrasound and bloodwork.
Luckily, it is rare for an OHSS case to catch us off guard. Based on your physical characteristics and hormonal bloodwork, we will know if you are at risk for OHSS before you even get started. If we suspect you are at risk, we will use special medications and change your protocol to greatly reduce your risk. We will also advise that you freeze your embryos and wait for your ovaries to recover before you attempt pregnancy.
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I Have Ohss How Do I Get Rid Of It
Unfortunately, despite taking all manner of precautions, you may still end up with OHSS. When it comes to how to treat it there’s both good and bad news. As is tradition, let’s start with the bad.
The bad news is that the answer is nothing. Theres absolutely nothing you can do to get rid of or cure OHSS. The good news is that the condition is self-limited: it will run its course, which usually takes around two weeks. After the trigger injection, youll have no reason to inject any more of the stuff, so youll have no more hormone surges and the OHSS will clear up.
Thats not to say you wont need monitoring and/or treatment, of course just that itll definitely go away at some point soon.
If youre pregnant and you have late onset OHSS, your symptoms too will be self-limited; its just that itll take a lot longer because it takes longer for the hCG to leave your system.
What To Expect At Your Ivf Egg Retrieval
You will be asked to check in to our Norwalk office approximately one hour before your scheduled procedure time. Once youve been greeted by our front desk staff, you will be taken back to our operating room, shown your private prep and recovery area , and given a gown and cozy socks to change into .
You will then meet with our OR nurses who will go over paperwork and start your IV. Youll also meet the anesthesiologist and the reproductive endocrinologist who will be performing your procedure that day.;
Ever wonder what the difference between a Reproductive Endocrinologist and Fertility Specialist is?
Please note, our doctors rotate through the operating room covering all seven days of the week. Therefore, you may or may not see your primary doctor on egg retrieval day. If your egg retrieval doesnt happen with your primary doctor, dont worry! He or she will be monitoring your progress remotely and getting updates throughout the day.
The egg retrieval is an extremely safe and relatively simple procedure that averages 15 minutes from start to finish. Our anesthesiologist will administer medications through your IV so that you are comfortably asleep the whole time. Once asleep, the fertility doctor will place an ultrasound probe vaginally and look at your follicles on the monitor. This step is identical to what you experienced during those early morning monitoring appointments.;
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What Can You Not Do After Egg Retrieval
Avoid heavy lifting and vigorous exercise, as ovaries are still enlarged during this time and may be tender. Gentle walking is fine. Avoid alcohol or caffeine. Avoid tub baths, hot tubs, Jacuzzis, swimming or immersing oneself in water from the time of the egg retrieval until after the pregnancy test.
The Third Level: Ovarian Hyperstimulation Syndrome
Imagine NOW, that instead of 12 employees being hired and squeezing into one office, that all 45 are hired! We can squeeze all 45 in the door, but they are scrunched tight, uncomfortable, literally pouring out into the hallway. This is what happens during OHSS.
While approximately 15% of IVF patients experience mild hyperstimulation symptoms, such as bloating and menstrual like cramping, most will never suffer from moderate or severe OHSS.
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How Do The Doctors Determine Which Trigger Shot I Should Have
There are two main types of trigger injection:
- The hCG trigger injection, which is usually used by people whove been on the long protocol. Brand names include Ovitrelle, Pregnyl and Choragon.
- The GnRH agonist injection, which is usually used by people whove been on the short protocol. Brand names include Lupron and Synarel.
Read about the IVF process from start to finish if you want to learn more about why different drugs are used for different protocols.
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