Ovarian hyperstimulation syndrome (OHSS) is a condition that may develop as a result of treatment with injectable gonadotropins, or less commonly as a result of other medications or conditions. Below, we will take a look at how this condition develops, as well as how it may be treated.
Superovulation and Ovulation Induction with Gonadotropins
Injectable gonadotropins include luteinizing hormone (LH) and follicle stimulating hormone (FSH), which are used to produce or increase ovulation in women undergoing IVF, IUI, or other fertility treatments. The goal of treatment with gonadotropins is to stimulate the ovaries to produce one or more egg follicles. Then, the patient can either be inseminated through timed sex or IUI, or the mature follicles can be collected for use in IVF. Gonadotropins may also be used for women who would like to freeze their eggs.
What is Ovarian Hyperstimulation Syndrome?
During ovarian hyperstimulation syndrome, the ovaries become “overstimulated,” filling with fluid and swelling as a result of the response of the ovaries to gonadotropins in the body. In most cases, the symptoms of OHSS are relatively mild, but in some cases the condition can lead to more severe problems.
Injectable fertility treatments are by far the most common cause of OHSS. Less commonly, some women taking oral Clomid may develop OHSS. Even more rarely, some women may develop the condition spontaneously, without taking any hormonal medications.
Symptoms of OHSS
The symptoms of mild to moderate OHSS include:
- Mild to moderate abdominal pain
- Abdominal bloating
- Tenderness in the pelvic area, where the ovaries are located
Rarely, women develop severe OHSS, which requires more aggressive intervention. Symptoms of severe OHSS include rapidly gaining weight, severe abdominal pain, severe vomiting, shortness of breath, dark urine or decreased urine, and dizziness. Severe OHSS can lead to extremely serious side effects like ovarian cyst rupture, lung problems, or liver problems.
By being aware of the symptoms of OHSS, patients can know what to keep their doctor informed of, as well as what symptoms warrant urgent treatment. If you have symptoms of OHSS, you should contact your doctor.
Treatment for OHSS
The primary treatment for mild to moderate OHSS is to discontinue the treatment. Once the drugs are discontinued, symptoms are usually alleviated quickly. However, if the woman gets pregnant, the changes to hormone levels can cause OHSS to persist for days or even weeks. The doctor may recommend anti-nausea medication or painkillers to help manage symptoms. Additionally, the patient must be closely monitored for a shift to severe OHSS.
Women with severe OHSS may be admitted to the hospital to be closely monitored and receive more aggressive treatment. In some cases, excess fluid may be removed from the abdomen with a needle under ultrasound guidance. If an ovarian cyst ruptures, surgery may be required, though this is rare. Patients with liver or lung complications may need further observation though they will usually resolve without treatment.
Future Fertility Treatment
When a woman has had ovarian hyperstimulation syndrome once, she is more likely to develop the condition again if she is treated with the same medication protocol in the future. Depending on the severity of the reaction, future cycles may need to be done using a gentler protocol that uses lower doses of medication. In addition, the physician will be extremely vigilant in monitoring for signs of side effects during future cycles.
If you are interested in treatment for your infertility, your doctor will go over the possible side effects associated with treatment in detail. To schedule your consultation today, please click below and enter your information or call Dr. Randy Morris at (630) 357-6540.