Frozen embryo transfer/ OHS

[Flower1994]

We have been for our drug appointment and injection teaching on Thursday 29th of august and had a scan. I was aware before this that I had an endometrial cyst on one of my ovaries, just not aware of how big it was, but have been informed that since my last scan/ mri that was done in march it has grown and is now at 7.5 cm and have been informed that I will require surgery to have the cyst removed as I am at risk of ovarian torsion 😥 which I was not expecting to hear so currently my head is a bit all over the place, so feeling very emotional and quite upset, I have also been told that from my scan that I am at a higher risk of OHS because of the amount of follicles that I already have on my ovaries prior to any ivf medication and that I will need to be monitored slightly more closely when I start the injections I have also been told that there is the likelihood that once they have done egg collection it is likely that they may need to do a freeze all with the embryos and that I will have to have a frozen transfer at a later date. So just wondering if anyone has had to do a frozen transfer due to ohs ?

[Allotmenteer16]

Hi Flower, I can empathise with the disappointment you are feeling right now. It's so hard when you have geared yourself up for treatment and then something happens to delay it. I had the same with a polyp last year. Ultimately it will be better for you to have it removed and hopefully improves your chances when you get there.My clinic were worried about OHSS with me, I had it as late onset in 2019, when I was lucky enough to get a BFP and ultimately our daughter. It was actually because I fell pregnant that I developed the OHSS, luckily it wasn't overly severe, but uncomfortable.

I've just been through a fresh cycle and I was told there was a high chance I'd need freeze all because I had quite a few follicles and ended up with 21 eggs retrieved. Thankfully, this time I didn't get any symptoms of it, and at my embryo transfer on 21st they checked the size of my ovaries and for the presence of any fluid and it was okay so they proceeded. It's good they identify the risk with you as they can monitor you closely. A freeze all may be frustrating but equally you may end up being fine with it and not have to wait.

It's a long old process, with my daughter we were successful on our second treatment, so we're so lucky. This time it has been harder with lots of hurdles and set backs. It has definitely had adverse effects on my mental health, so what I would say is look after yourself and get support if you need to talk things through with someone.

[Londonlady2024]

Sorry to hear about your cyst, good that it was identified and that you are going to get it removed. I was at risk of ohss so was told was they will freeze my embryos. My dose was too high it seemed because I had quite a few embryos that were too mature and ended up with empty follicles. The egg collection before that one I missed on a few eggs because the egg collection was bought forward by 2 days so Dr wanted to give me head start on higher dose. I got 17 eggs and only 7 has eggs with only 3 fertilised hence my NHS clinic froze immediately as I had 3 or less (this is called pro nuclei stage). What turned out to be my worse cycle ever turned out to be my baby. I had all 3 embryos thawed and all 3 survived the thaw. I wanted a day double transfer so got that, only two survived to day 3 and I didn't want to risk of culturing to day 5. My little rainbow baby boy is now 6 weeks old.

Always remember, they know what they are doing and want to give the best chance. Everything has to be in sync with your body with a frozen transfer and with fresh transfer it may fail due to all the hormones esp those that respond very well to meds like myself at over 40. I have 4 fresh transfers and my only and one frozen was successful. I had my embryos frozen for 1 year because as I was not charged because of the ohss. We were self-funded patients. I just turned 44 last month.

I hope this is reassuring. Wishing you success x

[Eloquentia]

Hi Flower1994! That must be a lot to take in at once...Do you by any chance have PCOS? I do and similar to you, I had a cyst that was 7.5 cm and had to be surgically removed. It was a very straightforward procedure done laparoscopically and I could go home the same day. This happened some years before we embarked on the IVF journey. When we did, I was told I was at a higher risk of OHSS because of the many follicles and even with a lower dose of IVF medication and a special trigger, I had 32 follicles collected, 22 of which were mature eggs. 18 fertilised and we ended up with 6 embryos in the freezer. I did develop moderate OHSS around day 5 after egg collection so we didn't do a fresh transfer because that significantly exacerbates the risk of severe OHSS fed by the HCG doubling every two days or so. The OHSS was unpleasant but manageable. I was told to go on a protein rich diet with a few protein shakes or protein yoghurts per day to help absorb the extra liquid. A hot water bottle helped too. We have a baby girl from our second FET. So all in all, it was a hard journey but there are upsides to producing many follicles - it does increase your chances of a baby. Very best of luck!

[Flower1994 in reply to Eloquentia]

Hi no I haven't been diagnosed with pcos only been diagnosed with endometriosis and adenomyosis and was informed it was a chocolate cyst on my right ovary.

[K_LNB]

That’s a lot of “delay” to take in so it’s understandable you’re upset. I had an enforced freeze all after collection of 33 eggs (my clinic’s policy was freeze all if over 20 eggs) and it was probably just as well as I did indeed develop mild OHSS. One thing to ask is about cost - because the clinic enforced the delayed transfer (not me) I didn’t have to pay for the additional FET over and above a fresh transfer.

[Flower1994 in reply to K_LNB]

Fortunately we are doing our IVF treatment through the NHS as we meet the criteria so we are lucky in that respect so won't come at any cost

[Flower1994]

I would like to thank you all for your responses it's really appreciated and gives me a little more hope that even though it's looking more likely that we are going to have to do a frozen transfer at a later date that it could still work. I'm just going to have to sit and try to be a bit more patient with it all.