Feelings of abdominal heaviness come from temporarily enlarged ovaries. "Ovaries are normally the size of a walnut. But after FSH, they could be the size of plum or even the size of a grapefruit," explains Dr. Frederick Licciardi, reproductive endocrinologist and founding partner of the New York University Program for In Vitro Fertilization, Reproductive Surgery and Infertility. Dr. Williams advises patients to change positions to take pressure off the ligament attached to the abnormally heavy ovary and try Tylenol for mild discomfort. But he cautions women to contact a doctor if they have nausea, vomiting, or pain that doesn't subside with positional changes. These symptoms could indicate a twist in the ligament (ovarian torsion), a serious condition that requires immediate medical attention. Ovarian torsion is rare, though, so most women will find relief with a little rest, an understanding partner, and elastic pants!
Hyperstimulation—Too Much of a Good Thing
FSH will very rarely trigger a condition called ovarian hyperstimulation syndrome (OHSS), where excessive fluid leaks into the abdominal cavity causing extreme bloating, nausea, and shortness of breath. As one of the unlucky 1 or 2 percent of women who have experienced it, I can say that although it was uncomfortable, the signs were pretty easy to recognize. I was only two weeks pregnant but looked five months along, and I had a hard time catching my breath. The cure—draining the excess fluid in the doctor's office under mild sedation (paracentesis)—provided quick relief, and my pregnancy proceeded perfectly.
For mild bloating, women can find relief with soup! "The best home remedy is to keep lots of salt in your body to hold the fluid in your blood stream so it doesn't leak into your abdomen," says Dr. Williams. "Drink salty fluids like Campbell's soup, V8, tomato juice, or Gatorade Endurance."
Progesterone—Grumpy and Lumpy
Once embryos are created and transferred into a woman's uterus, she'll take progesterone for approximately 10 weeks to create a more robust uterine lining for the growing baby. Candace Tan of San Francisco, who conceived her first child via IVF in 2005 and is currently pregnant with her second baby, says, "It became very obvious to me when I was on progesterone and when I wasn't. It made me moody and edgy. I'd gain three pounds of water weight. I'd get headaches. I was miserable."
Dr. Williams confirms that progesterone causes intestinal bloating as well as heartburn. He recommends "lots of fluids and fiber to keep things going through" and antacids to keep the burps at bay.
The other major complaint about progesterone? It's literally a pain in the rear end. That's because it's often mixed with oil and delivered as an intramuscular shot that causes lumps under the skin. Dr. Licciardi jokes, "Progesterone is really a 'sore' subject." An alternative is to use progesterone vaginal suppositories. They're messy, but don't hurt a bit. Dr. Given's practice uses suppositories; Dr. Williams says the injections and suppositories have the same success rate. Another option is to ask for a smaller injection needle. According to Robin Taylor, "Progesterone hurts like hell. It hurt to walk." She says it helped when a nurse swapped her 1.5 inch/22 gauge needles for shorter, thinner 1 inch/23 gauge needles.
The Ultimate Side Effect
If all of this sounds daunting, try to remember that thousands of women undergo fertility treatments each year with no major complaints. "For every patient who tells me she's at her wits' end, I have another who says she feels fine," says Dr. Licciardi. "For every negative extreme, I have an extreme that's fantastic, and everyone else is in the middle." And really, all the moods and extra pounds are undoubtedly forgotten when the best side effect of all shows up—a new baby.