My theme this year is IVF/ICSI, a process we’re starting at the moment and today it’s H for Hyperstimulation.
As with any medical procedure, there are risks involved in IVF treatment. These are all explained to you at the beginning of the process, but if you’re anything like me they’re all kind of abstract until you’re actually faced with them first hand.
Ovarian Hyperstimulation Syndrome, or OHSS, is just one of those risks. During a woman’s normal cycle she will develop one (sometimes more) follicles in her ovary which will release an egg at ovulation. The drugs you take during IVF ramp up the follicles so that rather than having one or two developing during the cycle, you will end up with many more. The exact number depends on a number of factors, every woman is different, but the more large follicles (measuring roughly 17mm on an ultrasound), the more eggs she is likely to produce.
Hyperstimulation occurs when a large number of follicles develop and once the eggs have been released these become little fluid-filled sacs. As you can imagine, it’s bad news when these start to fill up with fluid, especially if you have a lot of them, as it can put pressure on your body, resulting in breathing problems among others. To illustrate this, during my cancelled cycle my scans showed me going from roughly sixteen follicles to twenty-eight on one side and over thirty on the other. Due to the risk involved we had to cancel.
Unfortunately I still suffered the breathing issues as well as pain which put me in hospital, which did make me realise just how dangerous hyperstimulation can be. I’ll admit that initially I thought it couldn’t be a bad thing really, because you need eggs to make embryos, so surely the more eggs you get, the more embryos you have a chance of getting. But it’s not worth it at the cost of your own health.
You can still experience hyperstimulation if you do get pregnant as well, this is not good for you or the baby as it puts extra pressure on your body at a time when it needs all of your reserves. This is why the hospital we are at now has a ‘freeze all’ policy. This means that if they collect twenty-one or more eggs during my retrieval they will be allowed to fertilise and then the resulting embryos will be frozen in order to allow my body to recover.
When I was faced with the possibility of this during my original, cancelled, cycle I was upset. Having been on the other side of hyperstimulation I can now see that it is clearly the best thing in order to keep you fit and healthy so you have the best possible chance of a successful cycle next time.
If you’re going through IVF or ICSI treatment the thought of having to cancel a cycle is crushing, but remember that your medical team will not do it without a very good reason. They want your treatment to work and they want you to stay healthy. It’s a process which is unpleasant enough without making yourself seriously ill.
It's worthwhile checking the symptoms of OHSS just so you know what to look out for if you're warned you're at risk of it. Don't do what I did, which is start to feel a tightness in my chest and difficulty breathing and decide that the sensible thing to do is to walk the dog. ;-)
And if you’re supporting someone going through it, be there for them if a cycle is cancelled; it could be for any number of reasons, from poor response (not producing enough follicles) or hyperstimulation. They’ll be upset and they’ll want someone to be an ear for them. Don’t say ‘it’s for the best’ because it won’t feel that way at the time, but let them know they’ve got a shoulder to cry on if they need one.