I have questions about my symptoms or situations during this treatment cycle.

 

5.1 I am concerned about the nature of my discharge and/or my cervical mucous during this cycle.

You can get many types of discharge when you are on ovulatory stimulants. Usually, cervical mucous will be seen in injectable cycles after the E2 is greater than 200 or so. How much is observed varies very much from patient to patient. Fertile mucous is clear and very stretchy -- similar to egg whites. Often women are not even aware of it, as most of it tends to stay up by the opening of the cervix. You generally cannot predict ovulation, success, or lack of success based on cervical mucous or presence of a discharge when on ovulatory stimulants. Also, vaginal suppositories such as Crinone can create orange or brown discharge in normal situations. Any unusual spotting or discharge needs to be checked by your physician. Note that Clomid often degrades cervical mucous. This needs to be checked by your physician as well.

5.2 I had my egg retrieval. I had more eggs/fewer eggs that I expected. What factors are at work in egg retrieval numbers?

The number of eggs retrieved is largely a function of age, responsivity, stimulant/Lupron protocol, good monitoring, and a bit of luck.

5.3 I have a yeast infection! Will this hurt my chances or affect my ovulation predictor kit test results?

This will not affect your OPK results or your chances for pregnancy. Check with your doctor on what you use to treat it.

5.4 I am in treatment and I am sick! What should I do?

First, you need to consult with your doctor. In the meantime, a simple mild cold should not interfere with pregnancy. If you are running a low-grade fever, chances are it will not interfere with pregnancy. If you have had a fever of 101+ for sustained levels of time, that would be a sign of decreased chances of success. Your doctor may recommend Tylenol. He will also prescribe the best antibiotic for your situation, if you have a bacterial infection. Try to avoid OTC medications until you speak with your doctor, if possible.

5.5 Is it safe to take over the counter (OTC) drugs during treatment?

Over the counter drugs can have significant effects on various systems. It is extremely important that you consult your RE before taking an OTC drug during your treatment cycle. This includes herbal remedies and vitamins.

5.6 I am afraid that I might have ovarian hyperstimulation. What can you tell me about this?

First, if you are concerned about the possibility of OHSS you should call your clinic as soon as reasonably possible. OHSS (Ovarian HyperStimulation Syndrome) is when you have an unusually large number of mature follicles that release. When these follicles release, there is an unusually high concentration of estrogen-rich fluid in the peritoneal cavity, and the ovaries are generally enlarged far beyond their usual plum size - in some cases, they can swell to softball size. In milder cases, women experience bloating and some pain from the oversized ovaries.

The treatment then is just a matter of rest and staying well hydrated. In more severe cases, the estrogen in the peritoneal cavity causes fluid to leak out of the circulatory system into the peritoneal cavity. This can cause marked discomfort and bloating, and can cause difficulty breathing due to pressure on the diaphragm. In the most severe cases, the leaking of the fluid will lead to hypovolemic shock and organ damage because of a lack of perfusion. Although there are exceptions, generally you do not see severe OHSS until the Estradiol gets into the 5000+ range. Mild hyperstimulation can occur at lower levels. As long as your doc keeps a close eye on your dosage and development, the chances of anything other than mild discomfort (especially on a non-IVF cycle) are minimal. The best pre-ovulation predictor of hyperstimulation is the E2 level, but it is not a perfect predictor. If you experience symptoms of OHSS, you should always play it safe and check with your doctor.