Your treatment cycle is carefully planned to keep the risk of OHSS to a minimum by selecting the most appropriate dose of medication to stimulate the ovaries. As overall only 60% eggs fertilise, 80-90% grow and as there is a difference between the growth potential of embryos formed, we do need a certain number of eggs to start with in order to be able to give you a good chance of success. Women with PCO also have a threshold below which they do not respond and above which they respond excessively ‘the all or none phenomenon’.
It is therefore a careful balancing act to give you adequate stimulation for both too little and too much could be detrimental to you and your treatment success rate.
We do monitor you very closely during the course of treatment to adjust the dose of medication.
- If the ultrasound scan shows too many follicles developing the treatment cycle may be cancelled before we get to the egg collection.
- We may recommend freezing all embryos resulting from that IVF cycle to be put back at a later date as we know that a pregnancy can significantly increase the severity of OHSS.
- As part of monitoring and early detection of problems, blood samples will be taken to have a baseline assessment on the day of your egg collection and periodically thereafter.
- We will also teach you how to monitor your fluid intake and output at home for review with us after the egg collection, usually twice a week.
- We give subcutaneous injection given to prevent thickening of blood leading to clotting. This is a prophylactic measure.
If we think you may be at risk, we will advise you. There are some measures you can then take to reduce the symptoms of OHSS, as follows:
- We advise you to maintain your normal oral intake of fluids and food. Please feel free to drink what ever you like and whenever you like but you do not have to force yourself to drink more than what you want.
- Watch the amount of urine you produce – you will be given a fluid chart where you can enter the amount of fluids you take and the measure of urine you pass in 24 hours. Please report if you have not produced more than 1 litre of urine in 24 hours.