Ovarian hyperstimulation syndrome (OHSS) is one potential side effect of treatment with injectable gonadotropins, which are commonly used to stimulate the ovaries to produce more egg follicles. Treatment for this condition depends heavily on how severe it is, and on whether or not any complications develop.
Ovarian hyperstimulation syndrome occurs when the ovaries are very sensitive to the hormones given to the the patient, many eggs can develop causing the ovaries to become large. In most cases, the condition is relatively mild and does not require intensive
treatment; however, it can become severe.
OHSS is by far most likely to develop as a result of treatment with injectable gonadotropins. However, in some cases patients develop OHSS when being treated with Clomid. Rarely, women develop the condition when they are not receiving any fertility medications at all.
Symptoms of OHSS
Mild to moderate OHSS may cause symptoms such as:
- Abdominal bloating
- Mild to moderate abdominal pain
- Nausea or mild to moderate vomiting
- Tenderness around the ovaries
Severe OHSS can cause symptoms such as:
- Weight gain of 5 pounds or more in one day
- Severe abdominal pain
- Severe or persistent vomiting
- Dark urine
- Decreased urination
- Shortness of breath
If you have symptoms of OHSS, it is important to contact your physician as soon as possible. Additionally, if you have symptoms of severe OHSS, you should go to the hospital.
Mild to moderate OHSS will usually resolve quickly once the medication is no longer being used. However, symptoms can persist for several days to several weeks if the woman becomes pregnant, because of the hormonal changes that occur in pregnancy.
Prevention of OHSS
Your doctor will use blood tests such as AMH levels and ultrasound to view the ovaries before starting you on fertility medications. The doctor will use this information to modify the dose of medication you receive and how often you are monitored. You may even have your treatment protocol changed to reduce the risk of OHSS. If you are being treated with IVF, the doctor may recommend freezing of your embryos to delay pregnancy.
How Mild Ovarian Hyperstimulation Syndrome is Treated
Often, mild OHSS will resolve on its own once the medication therapy is finished, and there is no need to treat it.
Moderate ovarian hyperstimulation syndrome treatment may include:
- Anti-nausea medication
- Prescription painkillers
- Not drinking to much fluid (especially the salty kind)
- Taking medication to prevent blood clots
One of the primary goals of treating moderate OHSS is to prevent the condition from worsening into severe OHSS, and to catch it as soon as possible if it does. To this end, the doctor may recommend daily weigh-ins
and waist measurements, blood tests,measuring urine output, and frequently performing ultrasounds.
Treatment for Severe OHSS
Rarely, women with severe OHSS need to be admitted to the hospital for ovarian hyperstimulation syndrome treatment. This may include:
- Careful monitoring of the condition
- IV pain and nausea medication
- Anticoagulent medications to prevent blood clots
- Surgery to treat ruptured ovarian cysts or twisted ovaries
- Treatment of lung or liver complications
Approach to Future Fertility Treatment Cycles
Preventing future episodes of OHSS is a key goal of ovarian hyperstimulation syndrome treatment. Developing OHSS is a sign that the initial dose of fertility medication was too high for the patient to tolerate. If you choose to go through further fertility treatment cycles, the doctor will prescribe a lower, more gentle dose of medication. In addition, you will be carefully monitored for the recurrence of OHSS.
Weighing the Risks and Benefits of Fertility Treatment
The majority of women who receive injectable fertility medications never require ovarian hyperstimulation syndrome treatment. However, there is always a chance that the condition will develop. Only you can decide whether or not you believe that the risk of OHSS and other side effects is worth the benefit of potentially getting pregnant.
Before receiving fertility treatment, your physician will go over the possible side effects in detail to ensure that you are fully informed at the outset of treatment. To learn more about whether fertility treatment is right for you, please click below and enter your information or call Dr. Randy Morris at (630) 357-6540.