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What is ovarian hyperstimulation syndrome (OHSS)?
Undergoing fertility treatment can feel overwhelming and it’s natural to worry about possible complications that may occur during the process.
One rare complication is ovarian hyperstimulation syndrome (OHSS). This condition can occur during fertility treatments, particularly in vitro fertilisation (IVF), when the ovaries are overstimulated. OHSS can lead to enlarged ovaries, bloating and pain. In severe cases, it may even affect respiratory function.
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What are the causes of OHSS?
IVF treatment requires hormonal medication, such as follicle stimulating hormone (FSH) and/or luteinising hormone (LH) to stimulate the ovaries. This helps to increase the number of eggs produced and collected.
Generally, these medications are given through daily injections to enhance the chances of a successful pregnancy. However, some individuals may experience adverse reactions to the medication, leading to OHSS. This reaction can occur due to high levels of oestrogen, progesterone and the pregnancy hormone (HCG), which can impact fluid distribution throughout the body.
Risk factors of OHSS
Various factors can contribute to the development of OHSS. One factor includes age. If you are over 30 years old, you may be at a higher risk. Additionally, individuals with polycystic ovary syndrome (PCOS) are also at risk as they tend to be more sensitive to hormonal medication.
Furthermore, those who have experienced OHSS in the past may have a higher likelihood of developing it again.
Rest assured, our medical team will discuss this in detail during your consultation.
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What are the symptoms of OHSS?
OHSS symptoms can range from mild to severe and may include abdominal swelling and nausea.
Mild OHSS – Symptoms include mild abdominal swelling, bloating, discomfort in the abdominal area and nausea.
Moderate OHSS – In addition to mild symptoms, you may experience increased discomfort in the abdominal area along with more pronounced swelling and bloating due to fluid buildup. You might also notice slight weight gain, experience pain and feel nauseous.
Severe OHSS – Although it’s rare, severe symptoms can include dehydration, reduced urine output, difficulty breathing, redness and tenderness in legs and chest pains.
If you experience any of these symptoms contact your doctor or fertility clinic immediately.
How is OHSS diagnosed?
OHSS is diagnosed through a clinical evaluation which includes assessing your symptoms and conducting an ultrasound. Your doctor will look for signs such as abdominal swelling and check for any fluid buildup.
An ultrasound can measure the size of the ovaries and detect any fluid. Additionally, blood tests may be conducted to help assess kidney function and measure hormone levels.
Based on these results, your doctor or fertility clinic will determine the most effective treatment plan to help manage your symptoms.
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How is OHSS treated?
There's no cure for OHSS, but mild to moderate symptoms can be managed at home. More severe cases may require hospital care and the recovery time can vary from a few days to a few weeks, depending on the severity of the condition. Here are some steps to help manage OHSS:
Pain relief – Take regular painkillers such as paracetamol or codeine to help alleviate pain. Avoid using ibuprofen or Nurofen as these can cause lead to additional complications.
Rest – Avoid strenuous exercise and sexual activity. Make sure you get plenty of rest until your symptoms improve.
Stay hydrated – Drink plenty of fluids and monitor how often you are passing urine. It is best to avoid or limit caffeine and alcohol intake as they can contribute to dehydration.
Progesterone support – Some patients may receive progesterone support through their fertility clinic to help manage or prevent OHSS. This treatment will depend on individual circumstances.
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