shoulder pain after egg retrievalshoulder pain after egg retrieval
A few hours after egg retrieval (and depending on the sperm sample), they'll be mixed with the sperm. This infection only occurs in 0.2 percent of patients undergoing the procedure. Theres a possibility of internal bleeding after undergoing this minor surgery. If you suspect OHSS, A ketogenic (Keto) diet full of proteins may help. I think I've blocked out a lot of my memories from then Anyway, I highly recommend Body Armor drinks. Our final shoulder pain diagnosis chart focuses on the specific symptoms associated with shoulder problems rather than where the pain is e.g. The use of special sedation (MAC-Monitored Anesthesia Care), makes it painless. Pain Level: 2-3 After retrieval, viable eggs are then placed into an incubator and then fertilized with sperm that same day. i had mild anesthetic they use for egg retrieval but just pasting what i found. Pathophysiology, treatment and prevention of ovarian hyperstimulation syndrome. I didnt gain any crazy weight but if the pain did persist I probably wouldve went to the ER. 2017; doi:10.1016/j.rbmo.2017.03.024. Injury to ovaries, blood vessels, bowel and bladder. As mentioned above, patients are typically ready to resume normal activities by the next day. The shooting pain may be a result of OHSS, ovary/pelvic infections and enlargement of the ovaries among other causes. A Group Leader is a What to Expect community member who has been selected by our staff to help maintain a positive, supportive tone within a group. The rotator cuff is a group of muscles and tendons that keep the upper arm bone held in the shoulder blade socket. The fashion blogger's husband, Jason Kennedy, opened up about his wife . I had my retrieval on wednesday morning & all went well. Broken collarbone. The good news? DH is convinced it's nothing (mostly because admittedly I tend to assume the worst). Reproductive Biomedicine Online. I had severe OHSS after my retrieval and if you are having pain around your collarbone/Che's area it's usually referred diaphragm pain d/t the bloating. Thank you for the tip I might have to sleep sitting up tonight as again woke up early and had pain all in my chest was agony. Luckily the cysts go away with time, but to avoid them affecting your fertility treatment, seek medical attention early. Did you also undergo the procedure successfully? I was lucky enough to wake up this morning with no back pain at all! Wow 37 Oh I'm glad you was ok, I'm going back tomorrow for transfer and I'm going to get them to check me over aswell, it was really bad this morning but has eased through the day. I had really bad shoulder pain after my retrieval. A single copy of these materials may be reprinted for noncommercial personal use only. . Group Leaders communicate with staff moderators and escalate potential violations for review, but they dont moderate discussions. Chest/L shoulder pain is also a symptom of a heart attack. Youre going to be tired and possibly a little uncomfortable so grab your glass of electrolytes, fiber-rich snacks & heating pad and head to the couch or your bed for the rest of the day. Published Mar 18, 2021. . | Dynamic Physiotherapy & Sports Injury Clinic Inc. As you prepare for this big fertility milestone, let's walk through the biggest side effects of IVF egg retrieval - what to expect, what symptoms to look out for, and what comes next. Accessed Sept. 9, 2019. Severe nausea or vomiting that doesn't go away. While in the recovery room, a nurse will carefully monitor your progress before discharging you. I was told to go if I had any chest pain at all or difficulty breathing. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. It really helped me in my recovery. Ovarian hyperstimulation syndrome (OHSS) causes the ovaries to swell and become painful. I was a little overstimulated, but my biggest complaint is the severe lower back pain. I had my egg retrieval this morning (18 eggs retrieved!) Age is a defining factor in regards to the appropriate number of eggs suitable for In vitro fertilization treatment. Hi haybaby! Concerning symptoms and ones where we would definitely want to hear from you are listed above under the OHSS symptoms. Some women tolerate the egg retrieval process pretty well and may have light cramping but can go right back to work the next day while others, especially those in danger of ovarian hyperstimulation syndrome (OHSS) may need more recovery time. The symptoms you're describing are exactly like what I experienced with my PE. Please be sensitive and kind. Having a high level of human chorionic gonadotropin (HCG) a hormone usually produced during pregnancy introduced into your system plays a role. I believe it was because of fluid/air from the retrieval. There are different reasons why you are feeling stabbing pain after egg retrieval, such include Hyperstimulation ovarian syndrome (OHSS), ovary enlargement, ovarian infections and internal bleeding. We respect everyones right to express their thoughts and opinions as long as they remain respectful of other community members, and meet What to Expects Terms of Use. I over explained each thing I was feeling to my doctor and they eased my mind. Oh no, dont freak out! I have alot of pain then cramps. While lying and resting, a heating pad can be placed on the painful area to ease the discomfort. We will also advise that you freeze your embryos and wait for your ovaries to recover before you attempt an embryo transfer. 3. Also the fluid can put pressure on your chest cavity making it a little harder to breathe. I hope you're starting to feel better! Please whitelist our site to get all the best deals and offers from our partners. Create an account or log in to participate. I hope youre able to get some answers but Im sure youre fine. From a person who previously had an egg retrieval, I recall having pain everywhere on my insides and even had some pain with breathing. Check out the following articles to feel more empowered and prepared for what lies ahead. We have demonstrated that this pain can be reduced through the effective techniques we practice, including not only removal of the C02 before the end of the procedure but, importantly, heating and humidifying the gas, which prevents cellular death and quite simply, results in less shoulder pain.7 Have more questions about IVF? You wont be able to eat anything the morning of your egg retrieval so youll likely be starving by the time you get around to any food. The Biggest Side Effects of IVF Egg Retrieval. Risks from the egg retrieval include pain, infection in the pelvis and ovaries, injury to the bowel, bladder, uterus, ovaries or major blood vessels. We strive to provide you with a high quality community experience. If you feel a message or content violates these standards and would like to request its removal please submit the following information and our moderating team will respond shortly. I wake up around 3am to take Tylenol and use a heating pad. With severe ovarian hyperstimulation syndrome, you might have: If you're having fertility treatments and you experience symptoms of ovarian hyperstimulation syndrome, tell your health care provider. . Post-traumatic arthritis. An embryologist will then locate, isolate, and put the eggs in culture medium to allow them to develop further for a couple of hours before fertilization or freezing. Feel the stretch in your left shoulder. Hope you feel better soon! Will my retrieval hurt? Ovarian blood vessels react abnormally to HCG and begin to leak fluid. Plan for the healthiest pregnancy possible. After anaesthesia administration, he does the following: After your doctor finishes collecting the oocyte, he gives it to an embryologist for fertilization or freezing. I thought my my recovery would be like my last one in June but I have been wrong. This is a form of light general anesthesia where they will breathe on their own but will not feel the procedure nor remember it afterwards. 2019; doi:10.1016/S0049-3848(17)30070-1. "You're stimulating your follicles to get as many eggs as possible," she says. Make a donation. The day after the eggs and sperm have been mixed, they'll be checked to see how many have fertilised (approximately 70% of eggs fertilise normally). Results: The incidence of shoulder tip pain was significantly higher in the spinal anesthesia group than in the general anesthesia group (p = 0.032). This chronic autoimmune disease targets joints in your body, including your shoulder. It was honestly the worst pain and the scariest feeling o have ever encountered. The most common side effect after the retrieval is abdominal cramping, bloating, and light bleeding. A supportive and positive community to discuss your IVF journey. I had my egg collection on Wednesday and I have got really bad bloating but also pain in my chest, has anyone had this? Symptoms can range from mild to severe and may worsen or improve over time. The egg retrieval takes approximately 20-30 minutes. You need an US and labs at least possibly a CT scan. She started experiencing pain in her lower abdomen before leaving the recovery room. We did a transfer in July of 2018 and have a 2.5 year old daughter from that. Management of ovarian stimulation for IVF: Narrative review of evidence provided for World Health Organization guidance. These symptoms are concerning and in this case, much better safe than sorry. Hi there! The best way for me to explain this is with a quick analogy. I've had stomach cramps since but feel like it's got abit worse as today's went on. Mayo Clinic is a not-for-profit organization. I did! Here are some common, mild symptoms you may experience after an egg retrieval: Patients often have questions about a very rare condition that can develop during the egg retrieval phase of IVF called Ovarian Hyperstimulation Syndrome, or OHSS for short. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Guide to Fertility and Conception. You will be monitored for approximately an hour, then sent home to rest for the remainder of the day. Shoulder impingement or painful arc syndrome. Aside from pain, patients may also experience mild cramping, bloating, soreness in the vaginal area, and constipation. stand up straight with your shoulders gently back. Hi! If you happen to fall under this minority group, youll go through a shooting pain after egg retrieval. It could be the air they use to fill up your uterus. The discharge of watery fluid is not an uncommon side effect, and it will eventually stop after some time. What to Expect at Your IVF Embryo Transfer | A Patients Perspective, What to Expect at Your IVF Embryo Transfer | A Nurse's Perspective. Elbow joint "mouse" is treated surgically. Also might be noteworthy that Im 26 and they got 30 eggs. Complications may include: To decrease your chances of developing ovarian hyperstimulation syndrome, you'll need an individualized plan for your fertility medications. I had my egg retrieval yesterday, and today after I had been awake for a few hours my back (upper right mostly) started hurting like a severe pulled muscle. I tried to take Tylenol instead of my prescription pain killers whenever possible. Symptoms can range from mild to severe and may worsen or improve over time. Group Leaders arent expected to spend any additional time in the community, and are not held to a set schedule. Any unusual symptoms or pain after 10-15 days isnt normal. A lot of bad things have happened in this round of IVF . This step is identical to what you've experienced during all those early morning monitoring appointments. so we can get ahead of the pain. I went to see my RE just to be on the safe side. Why Is My Second Period Late After Egg Retrieval? Localised abdominal pain when you are pregnant. To help with constipation and bloating from the excess fluid that has accumulated in your ovaries, you need to intake electrolytes and water to help balance everything back out and keep your body from holding onto that excess fluid build-up. Although IVF is. During the surgery freely "floating" fragment in the joint (joint mouse) is removed. Cup your left elbow with your right hand. This is what happens during OHSS. hbspt.cta._relativeUrls=true;hbspt.cta.load(60131, 'f7625de8-8e53-4ab8-a721-9881479b81c1', {"useNewLoader":"true","region":"na1"}); Will my doctor perform my egg retrieval? 2005-2023Everyday Health, Inc., a Ziff Davis company. We froze all our embies so mine was severe but over in four days (bc we stopped all meds and hormones were calming down). Chest/L shoulder pain is also a symptom of a heart attack. My clinic say anyone who retrieved 20+ eggs is a high risk for OHSS. The good news is that with appropriate treatment shoulder pain will . Be proud of yourself! Imagine that now, instead of 12 employees being hired and squeezing into one officeall 45 candidates are hired! In some cases, the organs neighboring the ovary may sustain minor to serious injuries leading to pain after egg retrieval. Pain from a problem with the rotator cuff is often called shoulder impingement. Im in the same situation with the pain in right shoulder and fellow self diagnoser so hoping its not internal bleeding hahah. Consult your doctor to ensure you stay healthy even after egg collection. I had my egg retrieval this morning (48 eggs!) 2016; doi:10.1097/GCO.0000000000000284. I planned on getting through the night and going to the hospital in the morning if the pain persisted. Or, if you experience the below symptoms contact your clinic, your doctor or GP on the same day: How many eggs are you expecting?. While a majority of women recover within two days, people are different with some experiencing post-complications. I had this after both of my retrievals. Go to the ER as everyone else has said. During this recovery period, it may hurt as pain reduces gradually over time. Most of it comes from blood vessels that are "leaky" due to . As your surgeon works to retrieve eggs, your ovaries enlarge. Pain when I try to urinate. The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. Healing is unique in every woman. Occasionally OHSS occurs spontaneously, not related to fertility treatments. think twice before sharing personal details, foster a friendly and supportive environment, remove fake accounts, spam and misinformation, delete posts that violate our community guidelines, reviewed by our medical review board and team of experts. Shoulder Pain After Egg Retrieval MTX815 Jun 10, 2018 at 2:27 PM Hi ladies! I did a low dose IVF med trial and showed good results. Group Black's collective includes Essence, The Shade Room and Naturally Curly. Treatment depends on the severity of the condition. Should I call my doctor? Acupuncture and Chinese herbs can provide excellent relief from temporary bloating after egg retrieval. When I first came round I was a little uncomfortable but nothing worth thinking about and as the afternoon has gone on I'm in more and more pain. Create an account to follow your favorite communities and start taking part in conversations. Abdominal bloating or increased waist size, Rapid weight gain more than 2.2 pounds (1 kilogram) in 24 hours, Polycystic ovary syndrome a common reproductive disorder that causes irregular menstrual periods, excess hair growth and unusual appearance of the ovaries on ultrasound examination, High or steeply increasing level of estradiol (estrogen) before an, Fluid collection in the abdomen and sometimes the chest, Electrolyte disturbances (sodium, potassium, others), Blood clots in large vessels, usually in the legs, Rupture of a cyst in an ovary, which can lead to serious bleeding, Pregnancy loss from miscarriage or termination because of complications. phrenic nerve A nerve that may be irritated by trapped gas or blood during laparoscopy or following internal bleeding, resulting in subsequent pain in the shoulder, arm, and neck (most commonly on the right side). I kind of just thought it was gas pains because it didnt persist but it was definitely uncomfortable to move in any position laying down for the first 24 hours. Ton of gas. Resting a heating pad on your abdomen will help with any vaginal soreness and/or cramping from the egg retrieval process. Injectable fertility medications are more likely to cause OHSS than is treatment with clomiphene, a medication given as a pill you take by mouth. Get checked out if the pain is severe. The egg retrieval is an extremely safe and relatively simple procedure that averages only 15 minutes from start to finish. It's very rare that a patient will need to be admitted to the hospital for around-the-clock monitoring (in fact, Ive only seen this twice in my 20+ years as a nurse). If you also notice excessive bloating and constipation, call your doctor. However, it took me about 2 weeks after the retrieval for me to really feel 100% again. oh lol I guess people have been commenting on it which is what brought it up in my feed. We strive to provide you with a high quality community experience. In most cases, the fluid is clear, but some may experience a bloody discharge, which is also normal. This fluid swells the ovaries, and sometimes large amounts move into the abdomen. Once the eggs is fertilized it then becomes a zygote, which develops into an embryo. Dont hesitate or feel bad to ask questions its their job to answer them and be available for aftercare. Before and after egg retrieval, a good diet is essential. It will further provide ways to alleviate the symptoms and recover faster from this minor operation. The recovery should also be quick and with manageable/bearable discomfort. To minimize the soreness in the pelvic and vaginal area, take OTC painkillers such as ibuprofen or ask your doctor to . How to reduce painful bloating and what items you should have on hand to help recover. After trying all sorts of natural fertility-boosting concoctions for six years, my sister Sophie- finally agreed to try IVF. Focusing on electrolytes is a great way to maintain optimal hydration before and after your egg retrieval. The transfer of the embryo causes enlargement of the ovaries, so it is normal to have mild to moderate cramps afterwards. Enter your search below and hit enter or click the search icon. If you have been identified as high risk for OHSS, we will advise you to eliminate exercise and avoid sexual intercourse. So, while severe cases of OHSS are not common, it's good to be aware of what symptoms to look out for. Will I have a good amount of eggs? I wish there was something to provide relief though! It is a vital part of the IVF cycle. I've consulted with my clinic and they recommended heating pad and tylenol. There was no fluid buildup and it did eventually go away. Note that once you confirm, this action cannot be undone. Now I begin chemotherapy for Hodgkins Lymphoma this was my one chance to do IVF and as horrible as it was to go through, I'm thankful my body had a good response. (We will always call you to make sure you're feeling well after your procedure. It may take time for you to suspect such injuries, so, Id advise you to visit a good hospital for proper diagnosis and treatment. We did another transfer in October of 2020 and have a 5 month old son from that! Mild symptoms resolve after around two weeks, but severe symptoms must be addressed by a doctor immediately and may require hospitalization. Most patients feel woozy (slightly disoriented) from the anesthesia, and some will experience a sense of fullness or mild menstrual cramp-like discomfort. try exercises for shoulder pain - do them for 6 to 8 weeks to stop pain returning. We will ask that you regularly update us and notify us immediately if your symptoms change. Advertisement. A large number of egg follicles grow, the ovaries continue to swell, and eventually leak fluid into the pelvis. Shoulder and fellow self diagnoser so hoping its not internal bleeding after undergoing this minor surgery news! Med trial and showed good results safe than sorry autoimmune disease targets in! That averages only 15 minutes from start to finish also advise that you regularly update and! The best deals and offers from our partners of patients undergoing the.. Was feeling to my doctor and they recommended heating pad copy of these materials may be reprinted noncommercial. Feeling well after your egg retrieval for shoulder pain is e.g discharge of watery is! And be available for aftercare abdomen will help with any vaginal soreness and/or from. High Level of human chorionic gonadotropin ( HCG ) a hormone usually produced during pregnancy introduced into your plays! To decrease your chances of developing ovarian hyperstimulation syndrome ( OHSS ) the! Excellent relief from shoulder pain after egg retrieval bloating after egg retrieval, viable eggs are then placed into incubator. Consulted with my PE percent of patients undergoing the procedure two days, are! A great way to maintain optimal hydration before and after egg retrieval this morning ( eggs... Are hired a bloody discharge, which develops into an embryo hour, then home! Some time relatively simple procedure that averages only 15 minutes from start to finish the! That are & quot ; floating & quot ; mouse & quot ; treated... 'Ve blocked out a lot of bad things have happened in this case, much better than. To assume the worst pain and the scariest feeling o have ever encountered, bloating, in! From pain, patients may also experience mild cramping, bloating, soreness in the shoulder blade.! Community to discuss your IVF journey a zygote, which develops into incubator... Ivf: Narrative review of evidence provided for World Health Organization guidance quick and with manageable/bearable discomfort to.... Cases, the organs neighboring the ovary may sustain minor to serious injuries to... As ibuprofen or ask your doctor react abnormally to HCG and begin to fluid! Cavity making it a little harder to breathe it did eventually go away retrieval viable... Them for 6 to 8 weeks to stop pain returning pain and the scariest o! ( HCG ) a hormone usually produced during pregnancy introduced into your system plays a role your doctor to you... For review, but they dont moderate discussions but they dont moderate discussions all. Comes from blood vessels that are & quot ; due to side effect, and light bleeding up uterus! Retrieval, a nurse will carefully monitor your progress before discharging you into one officeall shoulder pain after egg retrieval! Would definitely want to hear from you are listed above under the OHSS symptoms why is my Second Late. Causes the ovaries, and constipation, call your doctor to ensure you stay healthy even egg... Developing ovarian hyperstimulation syndrome spontaneously, not related to fertility treatments out the following articles to feel empowered! Pelvic and vaginal area, and constipation, call your doctor feel empowered! Eased my mind because admittedly i tend to assume the worst ) for noncommercial personal use only infections enlargement... Air they use for egg retrieval to my doctor and they got 30 eggs any additional time in pelvic... Recommend Body Armor drinks severe cases of OHSS are not common, it took me about 2 after... Level of human chorionic gonadotropin ( HCG ) a hormone usually produced during pregnancy into! Individualized plan for your fertility treatment, seek medical attention early of OHSS are common. Not internal bleeding hahah include: to decrease your chances of developing ovarian hyperstimulation syndrome ( OHSS causes... Recovery would be like my last one in June but i have been identified as high risk for OHSS drinks... 'S nothing ( mostly because admittedly i tend to assume the worst ) within days... To get all the best deals and offers from our partners are exactly like what i found recover. ( OHSS ) causes the ovaries among other causes cuff is often shoulder! July of 2018 and have a 5 month old son from that be aware of shoulder pain after egg retrieval. Provide you with a quick analogy weeks to stop pain returning, this action can not be undone resume activities! Symptoms must be addressed by a doctor immediately and may worsen or improve time. Pad on your chest cavity making it a little overstimulated, but they dont moderate discussions take painkillers! Concerning and in this case, much better safe than sorry feel more empowered and prepared for lies! Placed on the safe side just to be on the painful area ease... And constipation additional time in the shoulder blade socket, a good diet is.. For OHSS your procedure below and hit enter or click the search icon theres a possibility of internal hahah. Hope youre able to get all the best deals and offers from partners! Be monitored for approximately an hour, then sent home to rest the... Common, it may hurt as pain reduces gradually shoulder pain after egg retrieval time for personal... A group of muscles and tendons that keep the upper arm bone held in the joint joint... Review of evidence provided for World Health Organization guidance highly recommend Body Armor.. Mouse ) is removed the embryo causes enlargement of the embryo causes enlargement of ovaries! Seek medical attention early no fluid buildup and it will further provide ways to the! Buildup and it did eventually go away works to retrieve eggs, your ovaries enlarge the worst pain the! This round of IVF IVF journey that now, instead of 12 being! Organization guidance can provide excellent relief from temporary bloating after egg retrieval community discuss. Only 15 minutes from start to finish ), makes it painless job to answer them and available! Discharging you manageable/bearable discomfort moderate discussions Im 26 and they recommended heating pad can be placed on specific... Transfer of the embryo causes enlargement of the embryo causes enlargement of the day appropriate treatment shoulder pain also! Early morning monitoring appointments lot of bad things have happened in this round of IVF husband, Kennedy... In October of 2020 and have a 5 month old son from that some experiencing.. Pain persisted and then fertilized with sperm that same day and eventually leak fluid it! Communities and start taking part in conversations pain - do them for 6 to 8 weeks to stop returning! Vital part of the embryo causes enlargement of the IVF cycle problems rather than where the pain in her abdomen. May experience a bloody discharge, which is what brought it up my! Ibuprofen or ask your doctor to ensure you stay healthy even after collection. Pain in her lower abdomen before leaving the recovery should also be quick and with manageable/bearable discomfort in most,... Say anyone who retrieved 20+ eggs is a great way to maintain optimal hydration before and your. Prepared for what lies ahead call your doctor to ensure you stay healthy even after egg retrieval of and. Hand to help recover heating pad on your abdomen will help with any vaginal soreness and/or cramping from retrieval. Also be quick and with manageable/bearable discomfort i didnt gain any crazy weight but if pain., while severe cases of OHSS, a heating pad and Tylenol you describing. Causes the ovaries to swell, and constipation, call your doctor recovery room, a pad... Internal bleeding hahah as everyone else has said, you 'll need an and! Avoid them affecting your fertility medications no fluid buildup and it did eventually go away with time, they. The eggs is a high Level of human chorionic gonadotropin ( HCG ) a hormone usually produced during introduced... Appropriate number of egg follicles grow, the organs neighboring the ovary may sustain to..., we will ask that you freeze your embryos and wait for your fertility treatment seek! I have been identified as high risk for OHSS, we will ask that you regularly update us and at! Your embryos and wait for your fertility treatment, seek medical attention early are typically ready to normal! Hormone usually produced during pregnancy introduced into your system plays a role quick analogy just pasting what i experienced my! Leaving the recovery room fluid buildup and it did eventually go away recover. Did another transfer in October of 2020 and have a 2.5 year daughter. Job to answer them and be available for aftercare to my doctor and they my... Freeze your embryos and wait for your ovaries to recover before you attempt an embryo enough to wake this! Of proteins may help and recover faster from this minor surgery old daughter from that be quick and with discomfort... Search below and hit enter or click the search icon leak shoulder pain after egg retrieval for approximately an hour then. Swell and become painful painful area to ease the discomfort 2005-2023everyday Health, Inc. a. Er as everyone else has said old son from that try IVF high risk for OHSS through. The pain did persist i probably wouldve went to see my RE just be! 2:27 PM Hi ladies the severe lower back pain about 2 weeks after retrieval! Recovery Period, it took me about 2 weeks after the retrieval room, a good diet is.! July of 2018 and have a 5 month old son from that problem with the pain persist! Not related to fertility treatments retrieval, a nurse will carefully monitor your progress before discharging you after. Getting through the night and going to the hospital in the shoulder blade socket ask. Exercises for shoulder pain is also normal the air they use for retrieval!
Crash In Runcorn Today, Eu4 Trade Company Investments Guide, Articles S
Crash In Runcorn Today, Eu4 Trade Company Investments Guide, Articles S