Ohss

[Sallyannc]

I am currently in my first round of IVF with ICSI.
i have PCOS. My FS thinks i probably barely ovulate at all.
i started my first FSH injections at 125.
i took them for a total of about 9 or 10 days in which the last 4 days my dose was dropped to 108.3.
i had over 50 follicles on my last scan and they since cancelled the cycle due to the high risk of OHSS.
i have been quite unwell for about 2 weeks and have an appointment with my FS next Thurs for a scan.
i want to do everything i can to get my body ready for another go as quickly as i can but i dont know what to do.
i was told rest is all i can do but i am really wanting to be proactive here.
i know i should call my FS but i have asked my nurses and they have said very little to help me.
can i take the pill or vitex or something similar?? i really want to get my body right so that i can get going again soon- i think this is going to be a long journey. i dont want any more delays if i can prevent it.

thanks for your help.

[DrSonyaJessup]

Hi Sallyannc,

PCOS can be extremely challenging for both yourself and your treating doctor. In a second stimulated cycle I would think your specialist will start you on a much lower dose of FSH (37.5 or 50 iu of FSH). It may be that you need to take this medication for longer than 10 days but hopefully there would be less than 15 follicles.

I would use an antagonist cycle and trigger with you with four sprays of Synarel which markedly reduces the risk of OHSS. There is some evidence that taking metformin reduces the miscarriage rate with PCOS and it would be worth considering this option.

Time will improve the symptoms of OHSS but you need very gentle stimulation when you start a new cycle. Keeping your weight within the normal BMI range is extremely important with PCOS.

Good Luck.

[Sallyannc]

Thank you so much for your response i really appreciate it.
AF came on Saturday night and i just want to get an idea of what is happening with my body now.
i know this is stupid and i should know what is happening but i just dont know whether this means the follicles are going to go with the AF or if i have to still wait a few weeks for them to reduce in size.

By the way- i used to take vitex and a range of herbal remedies to help with the symptoms. is any of this going to help now?

i am 29, and my BMI is good.
thanks soooo much.

[DrSonyaJessup]

Hi Sallyannec

It can take some weeks for the follicles to resolve. Your FS will do a USS prior to you restarting FSH to check that resolution has occured. Personally, I think waiting for this to happen is very important as I don't like the size of the resolving follicles to complicate the trigger date when I do a scan in the new cycle. A week or two delay if worth it if you get a excellent result in the next cycle.

Good luck.

Sonya

[Sallyannc]

Last question i promise...
i have a HUGE dilemma. we have booked a trip to thailand in september. it seems it will likely fall right in the middle of my bt.
what i was thinking was going to thailand and coming back in time for the bt. this would mean i am in thailand for about 6 days. i was told by my FS that i probably should not travel during my 2WW as it is my first and if something happens that i am not sure about i will want to be able to speak to someone etc.
i just dont know what to do. i dont want to postpone my treatment but my husband doesnt want to miss the holiday.
is thailand a safe place to be if i am very careful? is this something i should be worried about?
what would you suggest to your patient in the same situation?
thanks soooo much for your help.