Ovarian Hyperstimulation Syndrome (OHSS): Causes, Symptoms, and Risks Explained
What is Ovarian Hyperstimulation Syndrome (OHSS)?
Ovarian Hyperstimulation Syndrome (OHSS) is a condition where ovaries get swollen and painful due to an excessive response to the stimulation medications. It is common in women who are trying to get pregnant with fertility treatments.
What Causes OHSS?
OHSS is a side effect often associated with fertility medication that stimulates the ovaries to produce multiple eggs.
- Human Chorionic Gonadotropin (hCG) Trigger: The hCG leads to the production of high levels of ovarian hormones (like estrogen) and substances called vascular endothelial growth factors (VEGF). This can cause fluid to leak out of blood vessels into the abdominal cavity, leading to swelling and fluid accumulation.
- Gonadotropins (FSH or LH): Used to stimulate the growth of multiple follicles. When the response to these medications is too strong, it can lead to OHSS.
What factors are known to increase your risk of OHSS?
The factors that can increase the likelihood of developing OHSS are:
- Women with PCOS are more likely to have OHSS.
- Younger women under 35 are at higher risk.
- A large number of follicles develop in the ovaries.
- Women who have experienced OHSS in a previous cycle are at higher risk.
- Women with lower body weight.
Symptoms of OHSS
Symptoms of OHSS can vary from mild to severe. They appear within a week after the trigger injection of hCG, but can also occur later.
Mild to Moderate OHSS Symptoms
- Abdominal bloating and discomfort
- Mild to moderate abdominal pain or cramping
- Nausea and vomiting
- Diarrhea
- Suddenly gaining a lot of weight, like more than 2-3 pounds in a single day.
Severe OHSS Symptoms
- Severe abdominal pain and bloating
- Persistent nausea and vomiting, leading to dehydration
- Shortness of breath or difficulty breathing due to fluid accumulation around the lungs (pleural effusion)
- Rapid weight gain (more than 10 pounds within a week)
- Decreased urination or dark-colored urine (signs of dehydration or kidney dysfunction)
- Blood clots (due to increased blood viscosity from fluid loss)
- Enlarged, painful ovaries
How long does OHSS last?
The duration of OHSS can vary depending on its severity.
- Mild cases: Symptoms resolve within 7-10 days.
- Moderate to severe cases: If pregnancy does not result, symptoms may last longer, up to a few weeks.
- Pregnancy: If a pregnancy occurs, OHSS may worsen and last for several weeks or even longer.
How is hyperstimulation diagnosed?
OHSS is diagnosed based on symptoms, physical examination, and specific tests to assess the severity:
- Physical Examination: The doctor will check for signs of abdominal bloating, tenderness, or fluid accumulation.
- Ultrasound: To measure the size of the ovaries and the presence of fluid in the abdomen (ascites).
- Blood Tests: To check for elevated levels of estradiol, hematocrit (indicating concentration of blood), and electrolyte imbalances. These tests help assess the severity of OHSS and any impact on kidney or liver function.
A Note From Sishu Fertility Clinic
OHSS is a potentially serious complication of ovarian stimulation during fertility treatments, but with careful monitoring, proper medication adjustments, and preventive measures, its risks can be minimized. If you suspect you have symptoms of OHSS, it is essential to contact your fertility specialist promptly for evaluation and appropriate management.
Sishu Fertility Clinic is best fertility clinic in Nepal aim to provide infertility treatment solution for couples with help of excellent team of Doctors, Gynecologist and Fertility experts.