OHSS and fluid intake - just curious

BzeetyD

There have been a lot of posts about OHSS and fluid intake on the boards lately and I was just wondering what the correlation is. Does anyone know?

I'm not personally nervous about it, just curious, as it's a risk with IVF.

Thanks ladies.

AngnShaun

Do you mean to help with OHSS?

BzeetyD

Yeah, I don't know, I guess? Lots of posts were about not drinking water and only drinking gatorade and I wanted to know why, not for myself, but I was curious as to what the reasoning was.

AngnShaun

Yeah, you should drink something that has electrolytes in it.  Thats what i was told anyway... Also my friend told me that she could only eat small meals, if she tried to eat a big meal it was painful for her.  And she only was borderline OHSS... so i would imagine it would be worse for someone who actually had a bad case of it.

Roxie5739

You should be told as you are discharged from the ER. My instructions were high protein, lots of coconut water or Gatorade, lots of vegies but watch fruit as you need to be on a low sugar diet. I was strict on my self initially but once I started to feel better a day or so after the ER I just started to get back on the normal diet slowly. I am 7 days past now and completely fine and back to normal.

One tip - watch for constipation issues with the ER. I had it bad both times. I would recommend taking colace before the ER and as soon as you can after it and drink lots too. I did not for for ER#1 and was in a bad way for a while.

genmalone

****Ticker Warning*** 

 

As someone who recently spent 8 days in the hospital with severe OHSS I can offer what I've learned.  The ladies that are most at risk for OHSS are 35 or under, have PCOS, and have 20+ eggs retrieved.  I had all 3 and my RE actually knew I was at high risk before we even did the retrieval.  We almost didn't even do the transfer but my E2 stalled and therefore we moved forward.  Once my body started producing HCG that is when things took a turn for the worse.

They definitely encourage drinking Gatorade or Coconut water but you can over do it.  When I was admitted to the hospital my potassium was through the roof so at that point I was told no more Gatorade.  They wanted me to drink as much water as possible. 

I would just suggest staying hydrated.  And as PP suggested eat a high protein diet.  If you have OHSS you will probably only be able to eat really small meals.  I had so much fluid in my stomach that I couldn't hardly eat at all.  Also, Colace and/or plum juice is highly recommended.  Constipation on top of everything else is miserable.

MelleTX

Gen, you are my cautionary tale. I am so glad you are better!

I am at risk due to my high E2 so I will be monitoring my symptoms carefully. I started Gatorade today (day before ER), but just 20 oz. And I am cooking up some chicken breasts tonight so I can eat small meals over the next few days.

My RE has mentioned several times possibly having to freeze and transfer later, but I am hopeful.  

genmalone

MelleTX:

Gen, you are my cautionary tale. I am so glad you are better!

I am at risk due to my high E2 so I will be monitoring my symptoms carefully. I started Gatorade today (day before ER), but just 20 oz. And I am cooking up some chicken breasts tonight so I can eat small meals over the next few days.

My RE has mentioned several times possibly having to freeze and transfer later, but I am hopeful.  

Do you mind me asking what your E2 is?  Freezing is exactly what my RE recommended but I pushed for a fresh transfer.  He was adament that if my E2 was too high that was the only option.  It wasn't what I wanted to hear.  I will tell you that I literally lost 3 weeks not including the week between ER & ET.  Also, I knew the day after my 5dtET I had OHSS but it didn't get really bad until 12 dpER.  I still think I would of pushed for a fresh transfer if I had it to over again but the entire experience was really difficult.

The good news is that I feel completely better now!  I really wish you the best of luck and hope you don't end up with OHSS.  From what I've read and been told by my RE my reaction was not at all the norm.  I actually had mild OHSS last fall and it was uncomfortable but manageable.

Good luck!

pb_bride

*********** ticker warning ************

To answer your original question - when OHSS develops, one of the hormones secreted by the ovaries causes fluid to leak out of your blood vessels.  The fluid ends up as free fluid in your abdomen.

Gatorade/powerade/coconut water are liquids with electrolytes in them.  The electrolytes help to keep the fluid INSIDE your blood vessels instead of leaking out.  Whereas if you drink plain water, it has no electrolytes and so it's easier to leak out.

Eating high protein diet provides albumin, which is a large protein.  The albumin helps to keep the fluid stay within the blood vessels instead of leaking out.

The issues with severe OHSS are that 1) it's very uncomfortable with free fluid in the abdomen and can cause trouble breathing; and 2) with the fluid leaving your blood vessels, you are actually "dehydrated" even though there's fluid everywhere else. 

That was the reason why my RE did not want me to go on my scheduled trip to Amsterdam.  Because of the dehydration issue, I was at a much higher risk of developing blood clots during the flight.

Good luck to you, and try to down another one or 2 more of gatorade/powerade/coconut (32oz) water a day.

cindyc24

I had moderate OHSS. During my stims my RE mentioned I was at a higher risk because my estradiol levels sky rocketed during the first 3 days of stims and my ovaries were VERY large. We proceeded with the ER and I retrieved 18 eggs. 

My RE told me to drink Gatorade or anything with electrolytes, but limit it. If you drink too much it will cause more discomfort. I was also on Cabergoline (if you are at risk ask about this) and that was the thing that kept me out of the hospital. Protein was also recommended.

It was a horrible week of bloating, nausea and vomiting for me, but I realize it could have been a lot worse had it been severe and required a trip to the hospital. Yes the constipation / bloating combo is not fun  

BzeetyD

pb_bride:

*********** ticker warning ************

To answer your original question - when OHSS develops, one of the hormones secreted by the ovaries causes fluid to leak out of your blood vessels.  The fluid ends up as free fluid in your abdomen.

Gatorade/powerade/coconut water are liquids with electrolytes in them.  The electrolytes help to keep the fluid INSIDE your blood vessels instead of leaking out.  Whereas if you drink plain water, it has no electrolytes and so it's easier to leak out.

Eating high protein diet provides albumin, which is a large protein.  The albumin helps to keep the fluid stay within the blood vessels instead of leaking out.

The issues with severe OHSS are that 1) it's very uncomfortable with free fluid in the abdomen and can cause trouble breathing; and 2) with the fluid leaving your blood vessels, you are actually "dehydrated" even though there's fluid everywhere else. 

That was the reason why my RE did not want me to go on my scheduled trip to Amsterdam.  Because of the dehydration issue, I was at a much higher risk of developing blood clots during the flight.

Good luck to you, and try to down another one or 2 more of gatorade/powerade/coconut (32oz) water a day.

Thanks - this is what I was looking for, I just wanted to understand why and where the fluid was coming from. Thanks for doing such a good job of explaining!

MelleTX

genmalone:

MelleTX:

Gen, you are my cautionary tale. I am so glad you are better!

I am at risk due to my high E2 so I will be monitoring my symptoms carefully. I started Gatorade today (day before ER), but just 20 oz. And I am cooking up some chicken breasts tonight so I can eat small meals over the next few days.

My RE has mentioned several times possibly having to freeze and transfer later, but I am hopeful.  

Do you mind me asking what your E2 is?  Freezing is exactly what my RE recommended but I pushed for a fresh transfer.  He was adament that if my E2 was too high that was the only option.  It wasn't what I wanted to hear.  I will tell you that I literally lost 3 weeks not including the week between ER & ET.  Also, I knew the day after my 5dtET I had OHSS but it didn't get really bad until 12 dpER.  I still think I would of pushed for a fresh transfer if I had it to over again but the entire experience was really difficult.

The good news is that I feel completely better now!  I really wish you the best of luck and hope you don't end up with OHSS.  From what I've read and been told by my RE my reaction was not at all the norm.  I actually had mild OHSS last fall and it was uncomfortable but manageable.

Good luck!

My E2 levels:
Friday, 4/6 - 2300, cut Follistim dosage in half
Sunday, 4/8 - 4000, no more stims 
Monday, 4/9 - 5900, coasting
Tuesday, 4/10 - 5100, trigger 

mdluv21

My E2 was 10k at trigger (this is the highest number I have ever seen) and I was freaking out.  At my first E2 check after 6 days of stims I was already over 5k and my RE told me absolutely no other fluids except one large gatorade a day.

 I was able to go ahead with my transfer and later when fluid started to develop around my ovaries, because I had not drank ANY water, just one 32 ounce Gatorade a day, the mild dehydration enabled my kidneys to absorb the fluid and I never had to be drained even after becoming pregnant with twins with very high beta levels,

I did not have on glass of water until after I was 6 weeks pregnant.

I have seen lots of other posters and their REs say other things but this is what I did and I 100% believe it let me do my transfer and kept me out of the hospital with severe OHSS after I was pregnant.