Danielle’s Story: Embracing Surrender: My Experience With OHSS

1/6 “Unexplained Infertility”

“It was the day before Thanksgiving.

I remember because I took the day as a good omen.

That was the day I went in for my first IVF transfer, where a healthy embryo that was made in the clinic just a few days earlier was implanted back in my uterus. Almost two years after my husband and I first started trying for a baby.

I have what’s known as “unexplained infertility,” which means that neither my husband nor I had any underlying medical conditions that were preventing us from getting pregnant. Every month, we were told how amazing everything looked, even getting the comment that my body was having “textbook” responses to our treatment. After countless blood draws, ultrasounds, self-administered injections, seven rounds of IUI, and tear-filled days and nights filled with hope and despair, we were finally able to do IVF.

When I went to do the transfer, I was filled with hope and nervousness. I was so grateful to see the amazing doctor who had helped us throughout the entire process. Although he does not identify as observant, I was moved that he said a bracha (blessing) during the embryo insertion procedure. It was such a powerful moment, and I said my own silent prayer that this would be it and that this would end my nightmare of infertility.

Afterwards, my husband and I tried to make the rest of the day nice, taking the day off of work, going out for a nice brunch, and relaxing at home. We were having three girls from a gap-year program staying by us that weekend and were excited to have a Thanksgiving-themed Shabbat meal with friends of ours in the community who were also hosting teens from the same program.

We went into that month’s two-week wait just like any other, hopeful but trying to distract ourselves from thinking about our situation too much.

Until that Shabbat morning, when something didn’t feel right.”

(2/6) “OHSS”

“I started feeling nauseous.

I shrugged it off at first, thinking that the hormones I was taking after the transfer to help my body accept the embryo were just having a little fun inside my body. I laid low but tried to stay positive while pushing through the discomfort.

The next morning, I stayed home from work feeling sick and called my fertility specialist’s office. I spoke to the nurse and told her what was going on, and she told me that feeling a bit ill was not uncommon for the first few days after an IVF transfer. She reminded me to drink a lot of water and rest, and to be back in touch if my condition got worse. I took a deep breath, told my boss I would be home sick for the next few days, and settled in for what I thought would be hours of binge-watching Netflix.

Two days later, I called the nurse again.

I told her that in addition to my nausea getting worse, I was having a difficult time turning onto my side while I was sleeping. She told me to come immediately to the doctor’s office to get an ultrasound.

Luckily, my husband was home with me to help me out, so we quickly packed a bag with essentials, and he drove me to our doctor’s office in Tel Aviv. Since my doctor wasn’t in the office that day, we went to a different floor where we could get an ultrasound and see a different doctor afterward.

When I finished the ultrasound, the doctor told me that I had ovarian hyper-stimulation syndrome (OHSS), a medical condition that can sometimes happen during IVF or other fertility treatments.

She said my case was serious and that I needed to go to the hospital immediately…” 

(3/6) “Hospital Stay”

“We ended up driving to the women’s emergency ward at Assuta Ashdod, a hospital that is closer to where we live, where their doctor confirmed the diagnosis. Women’s ovaries are typically three centimeters in diameter, but mine had grown to 10 centimeters in diameter. I was immediately admitted to the women’s emergency ward, hooked up to an IV, and began one of the longest weeks of my life.

Aside from enlarged ovaries, more serious cases of OHSS result in “vascular hyperpermeability,” which means that the local capillaries inside my body could not contain the fluids within them. As a result, these fluids leaked into what’s known as the “third space,” which is the abdominal and pleural cavity. Due to this fluid leak, I gained over 20 pounds of pure water weight in six days that accumulated in my stomach and hips.

Unfortunately, they told me there wasn’t much to do about OHSS; you just need to let it run its course and wait for your body to reabsorb the fluid so you can eliminate it by going to the bathroom. The hospital admitted me to monitor my progress (or lack thereof), control my fluid intake so they could measure my input and output, and get more involved if my symptoms got to a dangerous level. Every day, I was only allowed to drink one liter of liquid (both food and drink), while the nurses administered two liters of fluids through an IV. Then I would need to go to the bathroom into a bucket, which would be measured every morning to tell the doctors how much of the fluid came out of my system. At the worst of it, after consuming three liters of fluid, my day’s output was a third of a liter. The rest of the fluid was in my abdominal cavity, waiting to get reabsorbed.

In addition to the excessive weight gain, I was still experiencing extreme nausea and was heavily reliant on strong anti-nausea medicine to get me through each day. The weight gain also made it difficult to walk, shower, or go to the bathroom without assistance.

I needed to take daily anticoagulation shots, wear compression socks, and push myself to walk as often as possible to prevent any swelling or blood clots from happening in my lower legs. The swelling even escalated to a point where I was having difficulty breathing. If that were to get worse, the doctors would have had to manually drain the liquid from around my lungs (which could refill afterward), but fortunately, it did not escalate to that point.

The worst part of the entire hospital stay was that the entire time, I had no idea whether or not I was pregnant. Every day I would get my blood taken, and when the doctors would do their morning rounds, I would ask the same question: “Am I pregnant?”

They would always answer the same way: they couldn’t say for certain and that they would hopefully have an answer in a few days.

The wait felt like an eternity.” 

(4/6) “The Pain of Infertility”

“The majority of the women’s emergency ward was filled with women with high-risk pregnancies, and since they were there for a long time, many of these women got to know each other well. Two women were especially sweet and befriended me while they saw me struggling to walk around the ward. During our conversation, they asked how far along I was. While in any other circumstance I would have been offended, it was a fair question; the weight gain I had from the OHSS made me look six months pregnant. They were shocked when I told them I didn’t even know if I was pregnant or not.

Yet throughout the entire experience, I felt a strange sense of calm. I went through each day with patience, resolve, and a deep sense of surrender. Over the previous two years, I was often on the brink of tears after learning that I would go another month without being pregnant. I fell into a deep depression, and withdrew myself from many social situations. I was constantly in fear of well-meaning but deeply insensitive and hurtful comments, and was exhausted from feeling a need to plaster a fake smile on my face when I was hurting so deeply inside.

I owe much of my sanity during my fertility journey to my social worker, Osnat, who I met with on a weekly basis for over six months after trying two other social workers before her. In a mix of Hebrew and English, she would listen to me cry and help me work on different ways to cope with a difficult situation that didn’t have an end date in sight. The metaphor I remember most from my time with her is that she referred to my fertility journey as a “pool of pain.”

One of the ways to get myself out of this “pool” was to let go of the things that were trapping me inside. The fear of social situations, my defensiveness, my feelings of bitterness when I would see others’ pregnancy announcements. Week in and week out, we worked on different ways to let that all go. I understood the need to do this, but on my more cynical days I would find this much easier said than done.

When I was in the hospital, I felt like all the coping skills I worked on with Osnat were put to the test. I was in a situation where I was completely out of control. I had no idea how long I would be in the hospital, how long it would take for the effects of the OHSS to go away, and whether I would need to end this hospital stay with another negative result and brace myself for another round of IVF.

Yet while I was there, I miraculously felt unfazed by all the unknowns. Even when some of my friends and family members would lament how this was happening to me after going through such a difficult fertility journey, I would respond to them with a shrug. I didn’t have time to dwell on why this was happening to me; I needed to dedicate all of my energy to getting better and try to make the experience as bearable as possible.

I needed to surrender to the situation at hand and just let it run its course.”

(5/6) “Blessing On Its Way”

“Ultimately, we made the best of a painful experience. 

Family and friends living in Israel came to visit, offering food, comforting words, and company. In hindsight, I feel so blessed that I was hospitalized before the onset of COVID-19, so that hospital visits were even possible. My mom was able to fly to Israel from America to keep me company in the hospital and help me with my recovery after I was eventually discharged, another thing to not take for granted these days. I got to experience a beautiful Shabbat in the hospital and was grateful for the Chabad volunteers who made Shabbat at Assuta Ashdod so restful amid a difficult situation. I even laughed at points with the other patients, doctors, and nurses on staff, stories that I remember with fondness today. 

Two days before I was discharged, the doctors on call that day came into my room with their residents to do their hospital rounds, as usual. I had already had my blood taken that morning, so the doctor saw my results and was reporting on my progress when he said something in the most Israeli way:

“Oh, and you know you’re pregnant, right?”

I was shocked. I obviously told him no and asked him if I really was pregnant. When he confirmed that I was about two weeks along, I burst out into tears. Tears of relief, joy, overwhelming happiness after feeling like I was holding my breath for so long. All of the craziness I had experienced over the previous week in the hospital finally came to a head, and I felt relieved and rejuvenated. 

While OHSS typically resolves itself in one to two weeks, pregnancy makes the recovery take longer. Even though I was discharged after a week in the hospital, I was on sick leave from work for almost a month and my symptoms didn’t fully resolve themselves until the end of my first trimester. 

But I got to go home. I was finally well on my way to having a baby of my own. 

It was all so hard, but there was so much blessing on its way.”

(6/6)  “Perspectives and Miracles” 

“I choose to view my experience with OHSS as a positive one. My husband and I got much more comfortable navigating an Israeli hospital and working together when it came to medical issues. This made my birth experience at the same hospital nine months later that much easier. I was able to spend a lot of amazing, one-on-one quality time with my mom. Thank G-d, the rest of my pregnancy went very smoothly from a medical standpoint. 

The most important lesson that I learned from OHSS, however, was that feeling of surrender. After hitting my second trimester, COVID-19 hit and the world was plunged into chaos. I barely left my house during my second and third trimester, went to doctor’s appointments without my husband (donned in a mask and gloves), and didn’t see any family until my parents were miraculously allowed into the country to celebrate the birth. I didn’t know if I could have a doula accompany me and my husband in the delivery room until a week before I gave birth, and I had to navigate buying everything I needed for the baby during a time of on-again, off-again lockdowns. 

While these obviously added some stress to the pregnancy, my OHSS helped me gain perspective and navigate these challenges in a calm, level-headed way. Even with the difficulties of early motherhood that followed, it took me less time to feel that sense of surrender and focus my energy on finding practical ways to navigate those struggles. 

Thank G-d, today my daughter is nine months old, and she is my miracle baby. I see her face every day and I am so grateful to get to this stage in my journey. 

For other women and men struggling to start or expand your families, I see you and pray that you find blessings along the way. 

You are not alone.”