Is it normal to feel tenderness over an ovary on only day four of stims?

[PT8998]

Hi all,

I am on my first round of IVF and I am due to see my clinic tomorrow, so will of course mention it to them. I am just hoping to share experiences with others etc.

I had my baseline scan at the start of the week (Tues) and it was on my CD5 (no prior stims before scan) and I was told that I had 40 follicles on the right ovary, 12 on the left (I have PCOS). I am on a short protocol, injecting 125ui of Ovaleap in each evening. I have done four days worth, day 5 of stims being this evening. I have noticed today (maybe because I have had a lazy day) that my right ovary is a bit twitchy. I wouldn't even consider it sore, just twitchy, and I am now overthinking the OHSS potential. Has anyone else ever felt ovary activity this early on, and is this normal?

Thanks in advance for any insight!

Hello, I’d say it’s quite early, but perhaps not as you have PCOS. Since you had so many follicles before stims, this could be quite normal, but definitely mention it to your clinic as you say. I doubt you’re at OHSS risk yet, but they may want to adjust your meds after you next scan.

I’m doing mild, short protocol (8 days of Bemfola and 5 days of cetrotide. I don’t usually feel my ovaries being swollen until day 10, but I don’t have PCOS and usually get around 11 eggs.

@IslandStars

Hello, I’d say it’s quite early, but perhaps not as you have PCOS. Since you had so many follicles before stims, this could be quite normal, but definitely mention it to your clinic as you say. I doubt you’re at OHSS risk yet, but they may want to adjust your meds after you next scan.

I’m doing mild, short protocol (8 days of Bemfola and 5 days of cetrotide. I don’t usually feel my ovaries being swollen until day 10, but I don’t have PCOS and usually get around 11 eggs.

Thank you IslandStars! That's reassuring. I am on a protocol that has specifically been designed to minimise my risk and i have all faith in the team and their judgements! I will see how we go after the ultrasound tomorrow!

I am on Ovaleap, Fyremedal and Buserelin. I am not even having a hCG trigger to avoid OHSS!

I guess it's just first time nerves and worry - you just don't ever want anything to wrong or for the cycle to be abandoned I guess!

@PT8998 I have a AFC of 34, 17 follicles on each ovary and has a lot of pressure type pain when I was on the stims, I was only on low doses I’m a short protocol and only needed them for 8 days. So it wouldn’t surprise me that you’ve got some pain with 40 follicles in 1 ovary. Let your clinic know when they’re open, they should be monitoring your oestrogen which is the best indication of OHSS, they took a blood test when I had my first scan on day 6. I’d imagine they’re scanning you around then with a blood test too, if not then ask them too.

[quote Gardenlady543]@PT8998 I have a AFC of 34, 17 follicles on each ovary and has a lot of pressure type pain when I was on the stims, I was only on low doses I’m a short protocol and only needed them for 8 days. So it wouldn’t surprise me that you’ve got some pain with 40 follicles in 1 ovary. Let your clinic know when they’re open, they should be monitoring your oestrogen which is the best indication of OHSS, they took a blood test when I had my first scan on day 6. I’d imagine they’re scanning you around then with a blood test too, if not then ask them too.[/quote]
@gardenlady543 Thank you! I am indeed due to go in tomorrow (that will be my day 6 of stimming) so that will indeed be useful to make sure they check. They haven't mentioned much to me about each appointment, other than the dates and that I will be scanned. Fingers crossed they are able to check and get it under control!

@PT8998 I think they will be doing a blood test when you go in, but if not you can ask for one and let them know when you go in that you’re a bit worried as you’re at a high risk for OHSS.

I hope everything goes well for you, just so you know it did get uncomfortable for me. I found lying down the most comfortable before the EC, bending down was difficult. So don’t have too much planned!

[quote Gardenlady543]@PT8998 I think they will be doing a blood test when you go in, but if not you can ask for one and let them know when you go in that you’re a bit worried as you’re at a high risk for OHSS.

I hope everything goes well for you, just so you know it did get uncomfortable for me. I found lying down the most comfortable before the EC, bending down was difficult. So don’t have too much planned![/quote]
@Gardenlady543 Thanks for the heads up... I am a physio in the NHS, so the last few days will be fun on the lead up to EC! Haha!

Thanks, I am sure that all will go well, whatever the outcome is it's a needs must! I am just looking forward to it, it's all rather exciting!

@PT8998 oh you’re a physio I’m a doctor! My advice is you must take it easy. I know what you guys are like when demonstrating exercises and helping people mobilize. You need to limit physical activity especially twisting motions when the ovaries get bigger, because you can risk torsion. I had my work adapt my schedule, I was just doing afternoons office based from home, but I even had trouble sitting in the chair for just a couple of hours when my ovaries got really big. Most people don’t get the pain this bad, but it’s more likely with high AFCs. If it gets too much go on sick leave, it’s not worth pushing yourself and causing an injury.

@Gardenlady543 Indeed, I am! Yes, my plan is to not do anything that is too heavy. I am lucky at the moment to not have too heavy of a caseload and my immediate team know (I thought it was a risk vs benefit - just incase I did need to duck out of anything and to avoid the awkwardness). I am just going to see how things go, I am in this week, tentative egg collection week of the 18th. But we will see how things go. Scans booked in for tomorrow and Friday already (?more if needed). I am hopeful for EC early that week!

Hi @PT8998 I was just wondering how you're getting on? I'm on day 4 of Stims and have quite tender ovaries already. I have PCO but not PCOS, 14 follicles on one ovary and 10 on the other.

Hey @roxyfoxy89 I am now a week past egg collection! I ended up with 55 follicles total on my last scan before egg collection. They were all ones that were >5mm so probably had more that they didn’t even bother looking at.

Are you short (antagonist) cycle?

That's great! Have they done a freeze all?
Yes I'm on a short cycle. Starting to feel pulling and twinges already do I'm getting a bit worried 😬

@roxyfoxy89 yeah - freeze all here as lots of follicles and swollen ovaries! That’ll just be a lot of the follicles beginning to expand! Do you have any scans coming up soon?

@PT8998 I have a scan on Friday, I'm thinking egg collection will be the following Monday or Wednesday. Did you have a hcg trigger shot? I have gonasi or buserelin but not sure which one I'll be told to take yet!

@roxyfoxy89 perfect, they will be able to see exactly what’s going on then!

I didn’t do a hCG trigger, I had buserelin as my protocol was designed to limit OHSS as much as possible.

I was on ovaleap stims, fyremadel down regs and then buserelin for my final injection ☺️

@PT8998 sounds similar to mine 😊I'm on bemfola stims, fyremadel and either buserelin or gonasi trigger depending on how I'm looking at the scan. I've been feeling lots of activity so they've brought my scan forward to tomorrow morning!

That’s good! It’ll be reassuring for you @roxyfoxy89 if you get to see what’s going on in there! Do you know when egg collection is booked for, roughly?

@PT8998 so at my scan yesterday they saw 15 follicles over 10mm and several other little ones. I've got another scan in the morning with a view to trigger tomorrow and have egg collection on Monday 😬their threshold for OHSS prevention is more than 15 follicles over 10mm=freeze all, so at the minute I'm borderline. I imaging by tomorrow morning I'll be over that threshold so on a freeze all.
Do you know when you'll be able to have your FET?

@roxyfoxy89 nice! I was at the OHSS risk/freeze all cut off point well before my egg collection!

I’ve been told after withdrawal bleed and then a “natural” period. Big problem being... I don’t have periods naturally 🤦🏻‍♀️ So I’ll be waiting for some time. With my normal schedule, I’ve been advised it’ll likely be about May/June time.

Good luck with your scan tomorrow! Exciting that you may well be triggering soon! I had my egg collection done two weeks ago Monday! ☺️

@PT8998 apologies for the radio silence, ended up feeling quite unwell in the run up to my trigger. I triggered early Sunday morning (no hcg as oestrogen was 21,000!) and had egg collection at 4pm yesterday. They got 23 eggs, just waiting to see how many are mature enough to fertilise! I'm on a freeze all cycle which I'm actually happy about. I can't think of anything worse than being pregnant on top of how I felt last week! I'm on medication as they suspect mild OHSS - so bed rest and plenty of fluids for me this week! X

@roxyfoxy89 that’s okay! No need to apologise at all! I get you with the feeling unwell, I was struggling with an ear infection over my egg collection - it wasn’t pleasant!

Congrats on your egg collection! What great numbers to start with! How are your numbers looking now? I am also on a cycle which will be a FET - I am just coming to the end of my withdrawal bleed now!

@PT8998 so only 11 were mature and 6 fertilised 😬not the numbers we were hoping for! On our day 3 update the embryologist said we had lost one, had 2 that were doing okay but lagging a bit and 3 that looked promising. It's day 5 tomorrow so I've got my fingers crossed 🤞 but they embryologist did say there was a chance that none could make it.
Good luck with your FET, how long after your EC did your withdrawal bleed come if you don't mind me asking?

@roxyfoxy89 anything can happen! I hope you get some good news tomorrow 🤞🏼

It took me bang on two weeks. I was expecting it much sooner. I read a lot of people saying it took them about 5-7 days. Typical that mine took 14!!

@roxyfoxy89 hope all is going well for you!