Ask Your Case Manager

The following are Frequently Asked Questions of our Case Managers:

What is Ovarian Hyperstimulation (OHSS)?

OHSS is defined as a rare, unpredictable, complication of pharmacologic ovarian stimulation occurring during the second half of the menstrual cycle or during early pregnancy. It is a self-limiting condition which resolves itself if no pregnancy is achieved or once the placenta begins to establish function at approximately 6-8 weeks of pregnancy.


This complication affects approximately 1% of patients undergoing reproductive treatment, and is classified as mild, moderate or severe.

Treatment of OHSS can be done on an outpatient basis; however, patients who develop severe OHSS may need to be hospitalized for closer observation.

If you are identified as being at risk of developing OHSS you may be asked to follow a high protein diet during and following your IVF cycle. Your IVF case manager will provide you with a list of high protein foods and recommendations for increased fluid intake, rest and monitoring of urinary output and weight gain.

The development of OHSS can be a very stressful time; symptoms may include bloating, rapid weight gain, decreased urinary output and shortness-of-breath. You may be asked to maintain daily contact with your case manager and IVF provider during this time, with the hope of helping you navigate through this anxious time.

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I have heard that you can take a pregnancy test after the transfer to see if you are pregnant versus waiting for the laboratory test. Is this accurate?

Pregnancy tests sold over the counter can vary in their sensitivity to detect the hormone hCG and if you test too early your body may not have had enough time to create enough hCG hormones to be detected by the test. The test result could then be incorrect and indicate a negative result. To get more accurate results, we have patients do a blood test for pregnancy 2 weeks after the retrieval.

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What are the common symptoms after a transfer and does it mean I am pregnant?

Approximately 20% of women experience some spotting or cramping after a transfer and in early pregnancy. This can be the result of cervical irritation, implantation, or issues including infection or miscarriage. Cramping can occur when the uterus experiences changes as the egg implants and begins to grow. Many of these women continue on to have a normal pregnancy and a healthy baby. In addition, women doing an IVF cycle are on a medication called progesterone and, occasionally, this medication can cause symptoms that are similar to those felt during pregnancy, such as breast enlargement, nipple tenderness, and nausea. It is important to remember that each pregnancy is unique. Some women experience pregnancy symptoms early in the process, while others do not.

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A friend of mine is taking supplements during her cycle. What supplements do you recommend?

We suggest that you stop all herbs and supplements during the IVF cycle so they do not interfere with your fertility treatment. Prescription drugs are evaluated by the FDA whereas natural herbs are not. The strength and the quality of herbal medications can vary between products and their safety or effectiveness can be unreliable. Not all herbs are safe to take during IVF and pregnancy. Some herbs are contraindicated in pregnancy. Studies on herbal medications effects on pregnant women are limited. We do recommend that you take a prenatal vitamin which supplies vitamins and essential minerals. Prenatal vitamins include folic acid, which decreases the risk of neural tube defects.

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