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OHSS: Ovarian Hyperstimulation Syndrome

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With in vitro fertilization (IVF), an occasional side effect that is caused by taking ovarian stimulating fertility drugs is ovarian hyperstimulation syndrome (OHSS). OHSS affects one in 10 women who undergo IVF.

What is Ovarian Hyperstimulation Syndrome?

When a woman develops OHSS, the ovaries become swollen and painful, and fluid can leak into the belly and chest area. The condition occurs because the fertility drugs have stimulated the ovaries too much.

The fertility drugs most often associated with the condition are FSH, LH, hMG and hCG. Your risk may be increased if you take more than one dose of hCG after ovulation and if you become pregnant during the IVF cycle. There is a chance if you develop OHSS that the cycle will be canceled.

Other risk factors for OHSS include:

  • Young age (under 35)
  • Low body weight
  • A large number of follicles, such as women who have polycysstic ovarian syndrome (PCOS)
  • Previous episode of OHSS

Typically, OHSS will occur within the first 10 days of the hCG injection.

Symptoms of Ovarian Hyperstimulation Syndrome

OHSS may be mild, moderate or severe. Symptoms of mild to moderate OHSS include:

  • lower abdominal discomfort that may come and go
  • mild nausea
  • vomiting
  • bloated abdomen

OHSS is considered serious when symptoms persist and worsen. About 1 to 2 percent of women will develop a severe form of OHSS, which has the following symptoms:

  • Severe abdominal pain
  • Rapid weight gain
  • Severe, persisten nausea and vomiting
  • Dark urine
  • Decreased frequency of urination
  • Shortness of breath/respiratory difficulty
  • Ascites (accumulation of fluid in the peritoneal cavity, causing abdominal swelling)
  • Dizziness

Some of the OHSS complications may be life threatening and may increase the risk of pregnancy loss.

Treating Ovarian Hyperstimulation Syndrome

Mild cases of OHSS typically do not need treatment except for increased fluid intake and will go away on their on after menstruation starts, perhaps longer if you are pregnant. If your symptoms worsen rapidly or last longer than a week, call your fertility doctor, so you can be monitored closely.

In the rare case that severe OHSS develops, you will probably need to go to the hospital, where your condition can be monitored, and you can be given fluids intravenously and fluids can be removed that have collected in your body.


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