First egg collection and OHSS – what to expect

Before the procedure
We were instructed to arrive at the hospital at 8.40am to complete some paperwork, finalise surgery fees ($500 for the procedure) and prepare for the egg collection. Daniel sat with me for about 10 minutes before he had to go to the IVF clinic down the road to do his part. It’s strange to think that we were in separate hospitals for this whole process!
I was called in by one of the nurses and sat with her in a waiting room. She took me through a few things and I signed a consent form, put hospital tags and hair net on and changed into a gown and robe. I was visited by the anaesthetist, another nurse and then my FS. It was great to see my FS there. He put my mind at ease but also reminded me that I was at risk of Ovarian Syperstimulation Syndrome (OHSS) due to the large number of follicles I had at my last scan. Due to this risk, I knew that it was highly likely we would not be able to proceed with a fresh egg transfer five days later.

OHSS occurs when there has been an over response of the ovaries to the stimulation medications. Women who have PCOS, are aged under 30 years and have 20+ follicles retrieved at egg collection are at higher risk of overstimulating. Symptoms include abdominal pain and distention, severe bloating, nausea, fluid retention, weight gain, vomiting, shortness of breath, reduced urine output and pain not relieved by Panadeine or Panadol.

The nurse then walked me into the theatre and I got onto the bed. My FS was cracking some jokes while we waited for the anaesthetist to arrive which relaxed me but I couldn’t help but notice how many people were in the room. At least I knew I was in good hands. The last thing I remember was my FS holding my hand, telling me everything would be ok and saying “sweet dreams” while the anaesthetist inserted the drip in my arm to put me to sleep.

During the procedure, an ultrasound probe is inserted through the vagina and a needle is passed through the ovary into the follicles. Fluid from each follicle is drained to retrieve the eggs.  

Waking up in recovery
20 minutes later I was in recovery with a heat pack on my tummy. They gave me pain relief almost immediately. I felt sharp pain low in my abdomen but it soon spread all over. I was desperate to know how many eggs had been collected and the first thing I did was ask the nurse. She handed me a note from my FS which confirmed he had collected 25 eggs and that they would be frozen for a transfer at a later date. They continued to give me pain medication. The more eggs retrieved, the more invasive and painful the procedure is. You should also expect a longer recovery time.

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After a little while I was moved to a recliner chair and given something to eat. I felt quite uncomfortable and it was difficult to move. As time passed I was asked to empty my bladder and get changed when I could. The walk to the bathroom was painful. I’ve always thought I had a pretty good pain threshold, but this pain and bloating was a whole different feeling. Little did I know over the next few days, the pain would get much worse and I would gain 7kg of fluid.

Trip to emergency
The nurses discussed my risk of OHSS with me and said they would be monitoring me closely over the next week with daily calls and weight monitoring. They also told me that if the pain got worse and I developed symptoms of OHSS, to go straight to emergency at the Royal Women’s Hospital as it was the Easter long weekend and the clinic was closed. The following night I ended up at the RWH where they gave me pain medication, took bloods samples, measured how much water I drank and my urine output weighed me and measured my abdominal girth. I spent the night in hospital and Daniel was sent home. I was given a prescription for stronger painkillers and was on bed rest until symptoms started to improve. I was also told the pain and bloating would get worse before it got better and that my weight could continue to increase with fluid.

The following week at home
I lay on my back for the next week, barely able to move. I couldn’t sleep on my side, couldn’t sit up on a chair, couldn’t laugh, cough or sneeze and was in agony when I did. I’m not joking when I say I looked six months pregnant. Each night I cried myself to sleep in pain. I’m not one to take painkillers – I need to have a pretty bad headache to take Panadol. Every four hours on the dot, I was taking the next two pills I could. Each morning I weighed myself and my weight was steadily increasing. 1kg, 1.5kg, 1.3kg, 1.2kg, 1kg…..in total I gained 7kg of fluid. I vomited in the first couple of days and my whole stomach was so tender. At one stage, I had a fluid shift which was pretty scary. The 7kg of fluid in my stomach started moving to my sides and back. Wherever the fluid was, was rock hard to touch. It made it difficult to breathe at times and I would get puffed out just from talking.

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severely bloated, carrying 7kg of fluid in my tummy

Daniel was my saviour during these days. I couldn’t walk up the stairs to our bed, so we slept downstairs in our spare bedroom for the week. I would dread going to bed at night. There would be no TV to distract me, no one to talk to, nothing to keep me busy and all I could think about was the pain I was in. I barely slept for the first few nights and was exhausted during the day. Daniel would heat my heat pack every couple of hours, and cater to my every need. Lucky for him it was a long weekend as he ended up pretty sleep deprived too!

I can assure you that if you face OHSS, it does get better with time, even if you think it will never pass and your ovaries feel like they’re going to explode. I promise you that there is light at the end of the tunnel! Rest and take all the time that you need to recover.

Embryos
The day after your collection, you will receive a call telling you how many eggs fertilised. Out of the 25 collected, 19 were mature and 16 were fertilised. They keep a close eye on them in the lab for the next few days. At day five, we had six embryos to freeze.

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