Can OHSS recur and how to avoid it? Is the body ready for an IVF?
Patient: Hi, My wife underwent IVF on 10th December 2009. ER( Egg Retrieval) was successful on that day .18 oocytes were recovered .but after two days pain started in her lower abdomin area and started increasing .The ART Specilist stopped the procedure of ET(Egg transplant) as ultrasound confirmed OHSS(Ovarian Hyper Stimulation Syndrom) .Ovaries size had increased (B/L Ovaries enlarged and cystic ( rt ovary - 8 cm, lt ovary - 7 cm, free fluid ++ve)) . She was hospitalised for 3 days.Specilist suggested Periodic Ultrasound . FET(Frozen Embryo Transplant) was planned after 2 months.After two montys no ET was done, as the thawed embryos were not of good quality as per the specialist (Embryos frozen : 4 (Grade 1A/2B)) . Medicine Suggested presentlly is Metformin- 1500mg, folic acid, colsprin - 75 mg. (These continued through out). Second cycle of IVF suggested from next day 2 . Some details: 1. Female Age : 31 2. Height : 173cm 3. Weight : 70 4. Reason of Infertility : PCOD (Polycystic Ovarian Disease), 5. Have you had any pelvic surgery? yes 6. Surgery Name : Adhesiolysis( Ovarian Drilling Done on both sides) (Year : 2006) 7. Findings : Both ovaries polycystic, fallopian tubes open 8. Medical problems and current medications of female partner: Suspected uterine Tuberculosis, had ATT (AKT - 2 / 4)medicines for 6 months. 9. In vitro fertilization (IVF) : yes Date : 10 Dec 2009 Stimulation Protocol : D21 onwards : Lupride 1/2 cc (14/11/09 to 8/12/09 (23 inj)), GonalF 225 ml (1/12/09 to 4/12/09 (4inj)), HCG ( 8/12/09 at 1 o clock at night) Dose of Hmg :300 Days of Hmg :D5,6,7 (5/12/09 to 7/12/09) Follicles grown :18-20 Eggs collected :15 (10/12/2009) Embryos formed :4 Embryos transferred :0 Embryos frozen :4 (Grade 1A/2B) My Question : 1. Is it possible that OHSS may reoccur? Spl suggests that if procedure starts on D2, probability reduces by 20%. 2. Is the body ready for 2nd IVF so soon? 3. I want to reduce chances of OHSS. Please suggest how to go about it. Doctor: higreetings.In PCOS there is always a chance of OHSS ,however drs can take precautions in preventing it by modifying the hormones used.but difficult to predict that it won't happen.since she has taken antitubercular treatment was hystroscopy done to see inside uterus? if so is it normal.you have to decide on that before IVF.please provide these details privately .can suggest more.regards