Donor had mild OHSS what do I do? and some other related questions

(6 posts)(5 voices)
  1. I'm matched with an in-house donor at SDFC for may. She just completed a cycle this past week - a huge number of eggs retrieved (over 40) but not surprisingly, she developed some mild OHSS. The nurse didn't actually call it that, but when I brought it up, she said that they had given her meds to stop that from happening - and the donor is still a bit 'tender' 5 days out. She also said they would stim her less for my cycle, with a goal of getting to 20 eggs retrieved (which I'm fine with). But I'm a little worried that this could indicate a problem on the next go round (mine will be her sixth cycle - and she's never had this issue in the past).

    The other curve ball is that the donor now can't make it during May because of work. She's committed to June, but timing wise, that means that she can't start stimming until the start of June, so probably a mid-june transfer. She's supposedly very reliable, so I don't think she'll keep on changing the dates on me.

    Everything above makes me want to reconsider ORM again - I had ultimately decided against them because they were more expensive for me than SDFC and they required the one day visit prior to starting a cycle (which I can't get them to waive). I've id'd a proven donor there who is available - so I could cycle in May potentially (although it would be a bit of a scramble in April, because I would have to go then for the one day workup - I can't make March because of my own travel constraints).

    And one more thing - SDFC wants you to have your final lining check with them - so I would need to arrive the day before retrieval, get my lining check the following day, wait five days for blast transfer, then bedrest. So I would have to be there for 8 full days. ORM lets you do the final lining check at home, so I would only need to be there the day before transfer and one day after (three days). I don't think this is a deal-breaker for me, but it does add another level of disruption if I stay with SDFC, especially if I have to go back for FETs (which may well happen, given that I'm fairly committed to doing eSET).

    All things being equal, I like both donors, they are both proven and supposedly reliable, and I would be happy with either one. But the OHSS really makes me nervous....

    Am I just making myself crazy?

  2. SDFC - has this donor done all 5 cycles with them? if so, how many eggs were retrieved the last 5 times and was the same protocol used each time? personally i think it's irresponsible of an RE to stim a donor that hard, especially since she's experienced. that said, i don't think the mild ohss will negatively impact a cycle you do in June, if anything the extra month will help her to get back on track. OHSS can lead to poor egg quality which is why i think it's important that you get to the bottom of it. maybe get the stim sheets and then wait and see if the eggs from this cycle are any good? i wonder if she was responding slowly to the stims so they amped her up or something...

    i would not hold it against SDFC that they want to be more thorough, and want you out there for the final lining check. if you go with them, just make the most of it and have a vaca in SD in June, not the end of the world
    but since you're a nurse, and a seasoned ivf vet, you're on top of the details yourself so this isn't as valuable to you.
    did you figure out the cost differential between each clinic? or are there any other factors that will influence your decision?

  3. It was her 5th cycle with SDFC and she's responded similarly (30-40 eggs) each time - this was just the highest number and the first time with some OHSS. I didn't ask the specific protocol. I do agree with you, that once they saw that she was a very good responder, they should have dialed back in earlier cycles. Funny how *now* the goal is for 20, but before it clearly wasn't!

    I did get two REs independent of SFDC to say that I shouldn't worry about it effecting the subsequent cycles, so that made me feel better.

    BUT, this allowed me to reconsider some of the other reasons why I was originally leaning toward ORM. I really do like the donor I potentially matched with there more. And she is still available. So while the cost will be a bit more for me (more like bringing in an outside agency donor - ORM really charges an arm and a leg for the donor management/recruitment fees compared with other in-house donor pools), I think I'm going to go to them instead.

  4. Hmm, I cycled at SDFC and my donor ended up with 39 -40 mature eggs. I think we ended up with 17 frozen eggs and 17 or so really good blasts. The stimm cycle was a bit stretched out since she developed a cyst - it didn't seem to affect the #/quality of eggs...

    I think we were her third ER - she did one "inhouse" and one at a clinic in another state.... Our ER was Jan-Feb of last year... When we picked her, I was a little freaked out by the # of eggs she had had in the past but was also told that it wasn't a concern...

  5. Just wanted to share my experience as it was similar to your situation. On the cycle before me, my donor overstimmed (not sure if it was officially OHS S) but they retrieved 35 eggs. My cycle was 3-4 months later and the docs adjusted her stim protocal and they retrieved 17. I cycled at ORM and they told me they would adjust her stims accordingly and it worked perfectly. But I too had the same concern. SDFC is one of the best so I'm sure they will watch it, not sure why it wasn't adjusted before but at least you made them aware.

    Also, pm me if you have other questions about cycling long distance at ORM.

  6. Hi Kate,

    I sent you a pm about my experiences with SDFC. Hope it helps.

    Dale

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