ovary issues after ICSI
4 Replies
sblanton2 - May 17

Dr Jacobs,
I am 19 weeks pregnant with twins after my first ICSI cycle, we were thrilled to get pregnant the first time. However, I suffered from OHSS and then last week I had terrible pain in my right lower quadrant, vomitting and fever. Had to be taken to the ER the admitted me and after about 4 days the doctors took me in for surgery. Turns out my right ovary was 15cm and had torsed several times in my fallopian tube. They removed both and my clinic says this happens very rarely...like 1 in 5,000. What could have caused my ovary to not return to normal after the cycle? Both babies are fine.....thankfully.

Very respectfully,


B. Jacobs, M. D. - May 18

The hCG of pregnancy continues to stimulate the cysts that are part of the hyperstimuation. At least you have an ongoing pregnancy. Congratulations.


oct01 - May 19

Dr. Jacobs,

I'm 31 yrs old with all normal fertility tests and will do an ICSI cycle in July for male factor (high HDS and morphology levels).

I have a similar concern regarding OHSS. I realize that the chances are small but are some groups of women more vulnerable to it, such as women who respond well to low levels of stimulated meds?

Is this something that the RE can predict and prevent or is it just a fluke that happens sometimes?


sblanton2 - May 19

Your clinic should perform a test to test your ovarian reserve, that should let them know how best to handle your individual case. Some women have PCOS which can cause them to respond quickly to the meds. However, that was not what happened in my case. My CCT test results were great, I just responded much faster than the RE expected. OHSS is pretty uncommon but it does happen.


B. Jacobs, M. D. - May 19

The best way I have found to minimize the risk of hyperstimulation is to carefully monitor responce, and adjust the dose of FSH as needed. There is really no good way to predict who will hyperstimulate. Certainly young women, with good ovarian reserve are more likely to hyperstimulate using a microdose flare protocol. The safety of an IVF or other stimulation using FSH depends on the skill and judgement of the person managing the stimulation.
Good luck.



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