Ovarian Hyperstimulation Syndrome (OHSS): What You Need to Know
Ovarian hyperstimulation syndrome (OHSS) is a condition that can affect some women who undergo fertility treatments that involve stimulating the ovaries to produce multiple eggs. OHSS causes the ovaries to swell and become painful, and can also lead to fluid accumulation in the abdomen and chest. In some cases, OHSS can cause serious complications such as blood clots, kidney failure, or ovarian torsion.
Symptoms of OHSS
The symptoms of OHSS vary depending on the severity of the condition. Mild to moderate OHSS may cause abdominal bloating, nausea, vomiting, diarrhoea, or tenderness in the ovaries. Severe OHSS may cause rapid weight gain, severe abdominal pain, shortness of breath, decreased urination, or blood clots in the legs or lungs.
Risk Factors for Developing OHSS
The risk factors for developing OHSS include having polycystic ovary syndrome (PCOS), being younger than 35 years old, having a low body weight, having a high number of follicles or eggs retrieved, or having a high level of human chorionic gonadotropin (hCG) in the blood. hCG is a hormone that is produced during pregnancy and is often used to trigger ovulation or support implantation in fertility treatments.
Diagnosis of OHSS
The diagnosis of OHSS is based on a physical exam, an ultrasound of the ovaries, and blood tests to check for hormonal levels, electrolyte imbalance, dehydration, and kidney function. The treatment of OHSS depends on the severity of the symptoms and whether pregnancy occurs. Mild to moderate OHSS usually resolves on its own within a week or two, but may last longer if pregnancy occurs.
Treatment of OHSS
Treatment of OHSS may involve increasing fluid intake, taking painkillers, avoiding strenuous activity, and monitoring weight and urine output.
Severe OHSS may require hospitalisation and aggressive treatment with intravenous fluids, medications to suppress ovarian activity or prevent blood clots, and drainage of excess fluid from the abdomen or chest. In rare cases, surgery may be needed to remove a ruptured ovarian cyst or to untwist a twisted ovary.
Prevention of OHSS
The prevention of OHSS involves careful monitoring of ovarian stimulation and adjusting the dose of medications accordingly. Some strategies that may reduce the risk of OHSS include using a lower dose of hCG or an alternative medication to trigger ovulation, freezing all embryos for future transfer instead of transferring them in the same cycle, or using a GnRH antagonist protocol that allows more control over ovarian stimulation.
OHSS is a potential complication of fertility treatments that can cause significant discomfort and distress for women who experience it. However, with proper diagnosis, treatment, and prevention, most cases of OHSS can be managed successfully and do not affect the chances of achieving pregnancy.
Sources
- Debbo Africa: https://debbo.africa
- Mayo Clinic. (2021). Ovarian hyperstimulation syndrome - Diagnosis & treatment: https://www.mayoclinic.org/diseases-conditions/ovarian-hyperstimulation-syndrome-ohss/diagnosis-treatment/drc-20354703
- Healthline. (2020). All About OHSS (Ovarian Hyperstimulation Syndrome): https://www.healthline.com/health/infertility/ohss
- Cleveland Clinic. (n.d.). Ovarian Hyperstimulation Syndrome (OHSS): Symptoms: https://my.clevelandclinic.org/health/diseases/17972-ovarian-hyperstimulation-syndrome-ohss