Hi Jaas and OHSSguy,
i was surfing for puregon this afternoon and got the following info from rxmed. the following sounded very technical but it kind of help me to understand what i could be going through soon.
"Treatment consists primarily of bed rest, fluid, electrolyte and albumin replacement, and analgesics as needed. Generally, removal of ascitic fluid (paracentesis) should be reserved for the more severe cases of third space fluid shift or abdominal discomfort. "
(Albumin replacement - eat egg white)
Overstimulation of the Ovary During Therapy: To minimize the risk associated with abnormal ovarian enlargement in women receiving follitropin beta and hCG for the induction of ovulation and pregnancy, the drugs should be administered at the lowest possible effective dosage. Since follitropin beta may cause ovarian enlargement and/or hyperstimulation, patients should be assessed for signs of excessive ovarian stimulation during therapy and for a 2-week post-treatment period. Careful monitoring of ovarian response (i.e., ultrasonography and/or estradiol level determination) can minimize the risk of overstimulation.
Mild to moderate uncomplicated ovarian enlargement, which may be accompanied by abdominal distention and/or abdominal pain, occurs in approximately 20% of patients treated with gonadotropins and hCG, and generally regresses without treatment within 2 to 3 weeks. If unwanted hyperstimulation occurs, the administration of follitropin beta should be discontinued immediately. In this case, hCG must not be given because the administration of an LH-active gonadotropin at this stage may induce ovarian hyperstimulation syndrome, in addition to multiple ovulations. This warning is particularly important with respect to patients with anovulation or oligoovulation (polycystic ovarian disease and hypothalamic hypogonadism).
Clinical symptoms of mild ovarian hyperstimulation syndrome are gastrointestinal problems (abdominal distention, nausea, diarrhea), painful breasts, and mild to moderate enlargement of ovaries because of ovarian cysts.
Severe ovarian hyperstimulation syndrome (OHSS) is characterized by ovarian enlargement (large cysts prone to rupture) accompanied by hemoconcentration, decreased urinary output, ascites with or without pain and/or pleural effusion.
If severe OHSS occurs, treatment should be stopped and the patient hospitalized. Ovarian hyperstimulation syndrome develops rapidly within 3 to 4 days and generally during the 2-week period following the hCG injection.
Hemoconcentration associated with fluid loss into the abdominal cavity has been observed to occur and should be thoroughly assessed as follows: 1) fluid intake and output; 2) weight and abdominal girth; 3) hematocrit; 4) serum and urinary electrolytes; 5) urine specific gravity. Other monitoring should include serum albumin and total proteins. These determinations should be performed daily or more often if needed. Treatment consists primarily of bed rest, fluid, electrolyte and albumin replacement, and analgesics as needed. Generally, removal of ascitic fluid (paracentesis) should be reserved for the more severe cases of third space fluid shift or abdominal discomfort.