What Is Ovarian Hyperstimulation Syndrome?

Dr Bhakti Tadekar
What Is Ovarian Hyperstimulation Syndrome?

If you have been trying to learn about the signs  of ovarian hyperstimulation syndrome and its treatment, you first need to know exactly what it involves.

What is Ovarian Hyperstimulation Syndrome (OHSS)?

Ovarian Hyperstimulation Syndrome is a rare, potentially serious complication of assisted reproduction technology, which means fertility treatments where injectable hormone medications are used for stimulating development of eggs in the ovaries. These include in vitro fertilization (IVF), ovulation induction and intrauterine insemination. OHSS causes the ovaries to become enlarged and painful.

 

Symptoms and signs of ovarian hyperstimulation syndrome

Symptoms and signs of OHSS can range from mild to severe.


Mild: Mild abdominal pain and swelling, nausea, discomfort


Moderate: Symptoms similar to mild form but swelling is worse, accompanied by increased pain, vomiting and diarrhea.


Severe: All symptoms of moderate form along with extreme thirst and dehydration, rapid weight gain which is due to fluid build-up, decreased urine production, difficulty breathing, tightness in abdomen and chest, or blood clots in legs.


The symptoms should resolve in 7-10 days. If you do not get pregnant in that cycle, the symptoms get better before the start of next periods.


Causes of OHSS

Injectable fertility treatment medications like gonadotropins, types of hormones, stimulate the ovaries to mature and release eggs. Sometimes the ovaries react abnormally to this stimulation, which causes them to release excessive fluid. This causes the ovaries to swell and this fluid may also move into the abdomen and surrounding parts causing other complications.


If you get pregnant during this cycle, the OHSS may worsen.


Risk factors for OHSS

The risk of developing OHSS is higher in women who:


Diagnosis of OHSS

A physician can diagnose OHSS with the help of physical examination, ultrasound and blood tests.


Physical examination might reveal abdominal tenderness, and includes measurement of waistline and weight to see whether fluid has or is building up.


An ultrasound exam will help the physician to see whether the ovaries have swollen and if there is build up of fluid.


Certain blood tests will help determine the extent of dehydration, hormone levels and also assess kidney function, as kidneys may be affected as a complication.


Ovarian Hyperstimulation syndrome treatment

Usually, OHSS resolves on its own within a week or two. Symptoms may last much longer if you get pregnant. There is no specific treatment to reverse OHSS. Ovarian hyperstimulation syndrome treatment is usually on an outpatient basis and is aimed at providing symptomatic relief and preventing complications. It may include:

  • Medications to relieve pain like paracetamol
  • Anti-nausea/vomiting medications
  • IV drips to compensate for fluid loss and prevent dehydration
  • Support stockings to prevent clotting of blood.
  • Medications like heparin to thin the blood and prevent it from causing clots
  • Paracentesis – If there is excessive fluid build-up in the abdomen, a small and a simple procedure called paracentesis will be performed where a small needle or tube will be inserted into your abdomen to drain excess fluid.


In case of severe OHSS, hospitalization may be required to monitor the patient closely and provide prompt treatment. Surgery may be required in case of rare complications like ovarian torsion (twisting of ovaries) or hemorrhage (excessive bleeding) due to rupture of a cyst in the ovary.
Talk to your doctor about OHSS if you are suspecting it.

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