Ovarian hyperstimulation syndrome, also referred to as OHSS, is a condition caused by taking certain fertility medications, such as gonadotropins, that stimulate the ovaries to produce eggs. OHSS occurs when medications overstimulate the ovaries, causing the ovaries to swell and leak fluid into the chest or belly. According to the American Society for Reproductive Medicine, the mild form of OHSS occurs in 10 percent to 20 percent of gonadotropin treatment cycles and the severe form of OHSS occurs in 1 percent of gonadotropin treatment cycles.
Signs and Symptoms
According to the Mayo Clinic, symptoms of OHSS can occur between three to 10 days after you begin fertility treatments. Symptoms of a mild case of OHSS include bloating, mild nausea, vomiting, diarrhea, tenderness in the area of the ovaries and mild to moderate belly pain that comes and goes. Symptoms of a more-severe case of OHSS include severe belly pain, decreased urinary frequency, dark urine, shortness of breath, enlarged belly, dizziness, rapid weight gain and severe, persistent nausea and vomiting.
Risk Factors
Risk factors for developing OHSS include using certain fertility medications such as gonadotropins, developing a large number of follicles while undergoing fertility treatment, age younger than 35 years, high estradiol levels during fertility treatments, low body weight and a history of having OHSS. Women with polycystic ovary syndrome, also referred to as PCOS, are at a higher risk of ovarian hyperstimulation syndrome. Polycystic ovary syndrome is a condition that affects hormone cycles and causes small cysts on the ovaries. Gonadotropins are injectable fertility medications that stimulate the ovaries to develop multiple follicles and induce ovulation. A follicle is a group of cells in the ovary that contain an egg, which it releases during ovulation.
Prevention
Ovarian hyperstimulation syndrome prevention includes using the lowest possible gonadotropin dosage, delaying the gonadotropin injection due to a high estradiol level or a large number of follicles, avoiding the use of HCG, which is used to trigger ovulation, canceling the ovulation induction or in vitro fertilization cycle if OHSS is likely and monitoring your condition with blood tests and ultrasound examinations while you are using fertility medications. Your physician may also suggest follicle aspiration and freezing embryos. Your physician will discuss which prevention strategies are indicated for your situation based on your risk factors and medical history.
