Ovarian Hyperstimulation Syndrome

What is Ovarian Hyperstimulation Syndrome?

Ovarian hyperstimulation syndrome (OHSS) is a condition that can result from IUI, or intrauterine insemination, when the treatment is augmented with fertility drugs. Fertility drugs are medications that aim to stimulate a woman's ovaries to produce eggs for fertilization.

In the case of OHSS, however, the ovaries are over-stimulated and they become swollen and full of fluid. Up to 10% of women who take fertility drugs are affected by OHSS, and women are more likely to develop OHSS if they are injected with the drug called "human chorionic gonadotropin" (hcG) to stimulate ovulation.

OHSS Risk Factors and Symptoms

Women who are younger than 35 years old and whose estrogen levels are very high during fertility treatments are at greater risk of developing OHSS. Another risk factor for OHSS is polycystic ovarian syndrome. Women who become pregnant while they have OHSS may have much more severe symptoms.

While most cases of OHSS are mild, OHSS symptoms can range from mild to moderate to severe. Severe cases of OHSS are dangerous.

Mild Symptoms: feeling of fullness, bloated abdomen, diarrhea, nausea, and slight weight gain.

Moderate Symptoms: extended abdomen, vomiting, diarrhea, greater weight gain (more than two pounds a day), dark and minimal amount of urine, very thirsty, dry skin and dry hair.

Severe Symptoms: bloating spreads to above the waist, distinct abdominal distention, very dark urine and in tiny amounts, shortness of breath, abdominal, chest, and calf pains.

In rare instances, women may experience critical complications as a result of OHSS, such as kidney failure, blood clots, and electrolyte imbalance.

OHSS Treatment

Mild cases of OHSS generally go away on their own once menstruation begins. To ease the discomfort of mild OHSS symptoms, women should:

  • Avoid caffeine and alcohol consumption
  • Abstain from sex and from intense exercise so as not to rupture the bloated ovaries, cause them to leak, or cause them to twist and cut off blood flow
  • Rest with legs elevated
  • Drink at least ten 8-oz. glasses of fluid daily
  • Monitor their weight to make sure it is not going up daily
  • Take over-the-counter pain relievers if needed

Treatment of severe OHSS cases often requires hospitalization, where collected fluids are released from the body, where women are given intravenous fluids, and where women are carefully monitored.

Preventing OHSS

OHSS can be prevented by taking lower doses of fertility drugs, by careful monitoring of women's estrogen levels during infertility treatments, and by periodic pelvic ultrasounds to make sure the ovaries are not being over-stimulated. Some doctors recommend a protein solution called albumin to reduce women's chances of developing OHSS.

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