Ovarian Hyperstimulation Syndrome

Ovarian Hyperstimulation Syndrome (OHSS) is a potential side effect of fertility medications used to stimulate the ovaries into producing multiple eggs in an IVF cycle. About 30% of women going through IVF will experience some level of OHSS, with 10% experiencing moderate to severe cases. It is found to be much more common in cases where injectable medications are used, as opposed to Clomid or other drugs taken orally.

If the ovaries become overstimulated during treatment, they can swell, causing a build up of fluid. This fluid can leak into the belly and chest area causing bloating, mild weight gain, mild nausea, mild pain or abdominal discomfort and/or diarrhea. More serious symptoms include: rapid weight gain (more than 10 lbs in 3-5 days), severe bloating, severe abdominal pain, severe nausea, shortness of breath, and accelerated heartbeat.

Prevention and Treatment

OHSS can only occur after ovulation. If a risk is suspected, the doctor may cancel the IVF cycle and freeze any fertilized embryos for a future cycle. They may also decide to try to delay ovulation using a medication such as a GnRH antagonist, or to delay administering the hCG trigger shot. Delaying ovulation by a few days will greatly lower the risk of OHSS, but may decrease the chances of achieving a successful pregnancy.

Close monitoring during the early stages of an IVF cycle through blood tests and ultrasounds is necessary to prevent OHSS. Rapidly increasing estrogen levels or many visible larger follicles are indicators of the condition.

If mild OHSS is suspected, you can most likely alleviate the symptoms at home and avoid a more serious case. Take an over the counter pain reliever, monitor weight gain, avoid overexertion but maintain light activity, avoid sex, alcohol and caffeine, drink plenty of fluids, and put your feet up.

More extensive treatments include IV fluid replacement and removal of fluid from the belly through needle aspiration. These are rare cases, and usually through close monitoring and prevention they can be avoided.