Infertility/Fertility/Ivf side effects


Just went through my first ivf cycle.  I'm 38. They mentioned bloating as a side effect but not looking pregnant! I have gained about 5 pounds in one week not eating any differently. Was told this isn't excessive for post ivf. Is this correct? No pain anymore but my belly is round firm and huge.  I'm 5'4 and I used to be 110 lbs now I'm 115 lbs and people have asked me if I'm expecting. Can't button my jeans. It's been a week. When can I expect this gross belly to go away. When would it be a concern if it doesn't? Do most women get a big belly after ivf? It's more than bloating. Like I said, I look pregnant.  Why would ivf cause the stomach to puff out so much.  The puff is not just under the belly button, it's my belly,  I'm not vain but I used to have a flat stomach and this looks really weird on me. I assume exercises won't do anything. Again, when would a patient expect this to go away? Also, if I don't get pregnant, how long should I wait if I want to try naturally? Do the meds stay in the system stimulating?  Thanks so much. Any answer hugely appreciated.

Hello Kim from the U.S. (New York),

It is not usual for the stomach to be bulging and feeling excessively bloating.  However, I can't tell you exactly what is going on without more information.  One of the potential risks of IVF is an abnormality called "ovarian hyperstimulation syndrome" or OHSS.  This is when the ovary excessively responds to the stimulation and causes fluid to be pulled into the abdominal cavity.  So, the abdomen fills will fluid and the abdomen gets excessively bloated.  If it progresses, it can progress to the point of interfering with normal bleeding, among other problems.  This usually happens when the follicle count is greater than 20 and the estradiol goes above 4000 at the time of HCG trigger.  Now, there is some continued bloating, similar to the feeling when the ovaries were being stimulated.  That is because after retrieval, the ovaries will re-fill with fluid and become tender again.  Since you have these symptoms, this is something that you should talk to your doctor about so they can make sure you don't have OHSS.

If you get pregnant, it can last for several weeks into the pregnancy.  If you don't get pregnant, it usually will stop shortly thereafter.

In terms of trying naturally, you certainly can start trying as soon as the new cycle begins (after your period).  The stim meds are already out of your system.  They are very short acting and that is why you have to take the injections every day.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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