Bloating can be a common (and uncomfortable) side effect of egg retrieval. In a traditional menstrual cycle, only one egg is ovulated per cycle. At the start of the cycle a cohort of follicles are recruited to grow, but typically only one dominant follicle will grow large enough to become that cycle’s ovulated egg. When you go through IVF, the goal is to produce multiple mature eggs in that cycle to be able to retrieve more. This improves the chances of producing one or more healthy embryos, in the hopes that at least one will successfully implant. But the actual bloating is something you'll likely want to decrease as soon as possible post-retrieval. Read on to discover five tips to help make post-egg-retrieval bloating subside quickly.
Why does bloating happen after egg retrieval?
1. Ovarian stimulation causes the ovaries to get bigger
While a normal ovary, growing and maturing just one egg per cycle, is almond- or grape-sized, the goal of ovulation stimulation for an egg retrieval is to grow as many mature eggs as possible, with each one ideally reaching 17 to 24 mm in diameter. This means the ovaries get bigger, ranging from walnut- to peach-sized.
2. Stimulation medications can upset fluid balance
Almost all egg freezing and IVF cycles include a treatment called controlled ovarian stimulation (COS). Your doctor prescribes injectable medications, like gonadotropins, to help make those follicles grow. These are the same types of hormones your body naturally makes, like follicle-stimulating hormone (FSH), but in higher levels. In your IVF cycle, each growing follicle produces estrogen, which helps the eggs grow and mature, and more follicles mean more estrogen.
Having high estrogen levels can interfere with the body’s natural water-balancing regulation and stimulate water retention, leading to discomfort after egg retrieval and bloating
3. Ovarian hyperstimulation syndrome can happen
While estrogen is a necessary and important hormone for protecting our bones and cardiovascular health (and so much more!), ovarian stimulation with gonadotropin medications lead to high estrogen, affecting water balance and shifting fluids in the body. Though the vessels return to normal as the stimulation hormones subside, while they are high you can expect bloating and water retention, and, in extreme cases, ovarian hyperstimulation syndrome.
OHSS after egg retrieval: Mild vs. severe symptoms
Mild cases of OHSS occur in 20 to 33 percent of IVF cycles and typically include feelings of bloating, discomfort, and nausea. Severe cases can be life-threatening, affecting blood pressure, and the function of key organ systems like the kidneys, liver and lungs, though this is rare and only happens in less than one to five percent of IVF cycles.
Your doctor will modify your protocol if you are at high risk, including lowering medication doses and opting to freeze the embryos (instead of doing a fresh embryo transfer—a successful implantation will result in the release of B-hCG (beta-human chorionic gonadotropin), which makes OHSS even worse). Generally, OHSS symptoms worsen to a peak within a few days after retrieval and then subside over the course of a few days to two weeks, but you should always contact your doctor if you notice severe OHSS symptoms during your recovery after egg retrieval.
Severe OHSS symptoms include:
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Excessive weight gain
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Severe abdominal pain
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Severe abdominal swelling
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Severe nausea and vomiting
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Difficulty breathing
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Decreased urination
4. The hormones at play during fertility treatments can lead to water retention and leaky blood vessels
Fluid in the pelvis, due to higher hormones, can lead to leaky blood vessels. Though the vessels return to normal as the ovarian stimulation hormones subside, while they are high the result can be bloating and water retention.
Almost all IVF cycles include a treatment called controlled ovarian stimulation (COS). This is when your doctor prescribes certain injectable medications to help make those follicles grow. These are the same types of hormones your body naturally makes, like follicle-stimulating hormone (FSH), to help follicles grow, but in higher levels than your ovaries typically see. In your IVF cycle, when more eggs are stimulated to grow, they all start producing estrogen. The high estrogen levels interact with the water-balancing mechanism in the kidneys and stimulates water retention.
How long does bloating last post egg retrieval?
Not everyone experiences bloating, and it likely depends on the amount of stimulation and your body’s response to the medications, but bloating can last a few days and up to a week after your retrieval.
What makes bloating worse?
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Dehydration. Not drinking enough water can cause many issues. First, lack of hydration makes your muscles stiff, crunchy and uncomfortable, and can make you feel crampy (don’t forget that your uterus is a muscle too). Secondly, without water to flush things out of your system, it’s going to take longer to get rid of the excess hormones, prolonging your discomfort.
- Constipation. You’re already filled up—you don’t need a backlog of fecal matter in there too. Constipation enhances the feeling of fullness and pressure. Ensure adequate water and fiber intake daily to help move things along and enjoy 20 to 30 minutes of gentle to moderate physical activity daily to help with those bowel movements. Need an extra push? Have some yogurt or try a little Magnesium citrate or Magnesium oxide which can act as a natural muscle relaxant and gentle laxative.
What can I do to help make post-retrieval bloating go away?
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Drink plenty of fluids (water). The more water you drink, the better. Aim for two to three litres per day. This might be counter-intuitive since you’re already feeling full but drinking water will flush out the excess estrogen that is causing bloating. (For those experiencing OHSS: It’s important to follow you doctor’s instructions directly as they may include a limit of fluid intake per day.)
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Get your electrolytes. Electrolytes help keep your body hydrated. This is the reason why some clinics will suggest eating salty foods after your retrieval. Some French fries might be your first thought for a salty snack, but there are much healthier and safer ways to get that salt. Ditch the fried foods which can increase cellular stress (and gas) in your body and add an electrolyte powder to your water instead. Alternatively, a cup or can of coconut water is rich in electrolytes, and delicious.
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Consume lots of leafy greens and vegetables. The Brassica family of vegetables includes broccoli, Bok choy, cauliflower, collard greens and cabbage. Brassica vegetables contain a compound that helps the body process and break down estrogens. For more on diet, read more about what to eat before and after egg retrieval.
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Increase fiber intake, aiming for 25 to 50 grams per day. We eliminate excess hormones through our urine and feces and dietary fiber helps ensure regular bowel movements which then helps eliminate hormone metabolites. For more, here's what to eat before and after egg retrieval.
- Take it easy but avoid complete bed rest. Some movement is good, like a 20-minute walk, especially if you’re constipated. Movement also supports your circulation to keep your system pumping fluids and eliminating excess hormones. You’ll want to avoid rigorous activities (like running, jump rope, martial arts) and anything that involves twisting or ab crunching (like twisting yoga poses, or kettlebell workouts). Since the ovaries are still big, there is a risk of them twisting, an emergency called ovarian torsion where the blood supply to the ovaries is stopped and a surgery to untwist is required.
What to avoid after egg retrieval
Discomfort after egg retrieval is normal so, give yourself a few days to rest and recuperate. You don’t need to be on bed rest, but don’t plan any high-intensity workouts, strenuous activities, or heavy lifting. Eat a balanced diet, with plenty of fruits and veggies to help reduce water retention and trapped gas that can contribute to post-retrieval bloating. Your doctor will tell you about any OTC medications you can use for discomfort; so, take those as directed.
