Concerns About Pregnancy After IVF: Is Abdominal Distension Normal?

Pregnancy issues

I have a question: After artificial insemination, I became pregnant, but there’s a problem (with my second pregnancy).
My last menstrual period was on December 26, I underwent artificial insemination on January 8, and I tested positive for pregnancy on January 23.
Now my abdomen and stomach are very swollen, looking like a 3-4 month pregnant woman, especially my stomach, which is larger than my abdomen.
I am still using progesterone.
I consulted with a nurse, and she said it’s normal; it might be due to a higher dosage causing a more significant ovarian response.
(My primary physician is out of the country during the New Year, so I can't have a follow-up appointment.) I would like to know if this situation is truly normal.
Should I go to a large hospital for an examination? My first pregnancy was also through artificial insemination, but I didn’t experience this issue then, and I’m quite worried.

Baobao, 30~39 year old female. Ask Date: 2012/01/25

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the symptoms you are experiencing may be due to early pregnancy nausea combined with the side effects of progesterone.
It is advisable to consult a physician for an ultrasound examination and consider medication to manage the symptoms.
Eating smaller, more frequent meals and incorporating walking to aid digestion can be helpful.
Additionally, consuming foods with stronger flavors (such as alkaline, sour, or spicy) and changing positions may alleviate discomfort.
Typically, these symptoms resolve within 3 to 4 months.
Whether you should visit a larger hospital depends on the severity and urgency of your condition; if necessary, it is important to take the time to address the issue.
Wishing you safety and health.
Dr.
Zhang

Reply Date: 2012/01/25

More Info

After undergoing in vitro fertilization (IVF), it is common for patients to experience various symptoms, including abdominal distension. Your situation, where you are experiencing significant abdominal and gastric swelling, can be concerning, especially since this is your second pregnancy following IVF.
Firstly, it is important to understand that abdominal distension can occur for several reasons during early pregnancy, particularly after IVF. One of the primary causes is ovarian hyperstimulation syndrome (OHSS), which can happen when the ovaries are stimulated to produce multiple eggs. This condition can lead to swollen ovaries and fluid accumulation in the abdomen, causing a feeling of fullness or bloating. The fact that you are still taking progesterone (like the natural progesterone you mentioned) can also contribute to bloating and gastrointestinal discomfort, as hormonal changes can affect digestion and fluid retention.

In your case, the significant distension you describe, where your abdomen appears similar to that of a 3-4 month pregnant woman, is unusual, especially if this did not occur during your first IVF pregnancy. While some degree of bloating is normal, especially in the early stages of pregnancy, excessive swelling may warrant further investigation. It is essential to consider the following factors:
1. Ovarian Response: If you had a stronger ovarian response during this cycle compared to your first IVF, it could lead to increased fluid retention and distension. This is particularly true if you were on a higher dose of fertility medications.

2. Fluid Accumulation: In cases of OHSS, fluid can accumulate in the abdominal cavity, leading to significant swelling. Symptoms may include abdominal pain, nausea, vomiting, and shortness of breath in severe cases.

3. Pregnancy Progression: As your pregnancy progresses, the uterus expands, which can also contribute to abdominal distension. However, this typically does not occur until later in the first trimester.

4. Gastrointestinal Changes: Pregnancy hormones can slow down gastrointestinal motility, leading to bloating and discomfort. This can be exacerbated by the medications used during IVF.

Given your concerns and the unusual nature of your symptoms, it would be prudent to seek further evaluation. While your nurse mentioned that this could be normal, it is always better to err on the side of caution, especially when it comes to your health and the health of your developing baby. A visit to a larger medical facility or a specialist in maternal-fetal medicine could provide you with more comprehensive care and reassurance.

During your appointment, be sure to discuss all your symptoms in detail, including the degree of distension, any pain or discomfort, and your medication regimen. Your healthcare provider may recommend an ultrasound to assess the status of your ovaries and the pregnancy, ensuring that everything is progressing normally and ruling out any complications such as OHSS.

In summary, while some abdominal distension can be normal after IVF and during early pregnancy, the extent of your symptoms suggests that further evaluation is warranted. It is essential to prioritize your health and peace of mind, so do not hesitate to seek medical advice.

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