Ovarian Hyperstimulation Syndrome

Too Much Stimulation

While undergoing treatment with certain medications that stimulate egg production, a woman may be at risk of developing the condition known as ovarian hyperstimulation syndrome (OHSS). It's normal for a woman to produce one egg every month, but some women who are having trouble conceiving may be treated with drugs to help them achieve normal ovulation or to increase the number of eggs they produce in a cycle. If the drugs cause too much stimulation of the ovaries, they can become swollen and painful and fluid may leak into the abdomen and chest. This is the definition of OHSS, which can occur only after the eggs are released from the ovary (ovulation).

Increased Risk

If your doctor treats you with an injection of the hormone that is called human chorionic gonadotropin (hCG) to stimulate ovulation, this increases your risk for OHSS and this risk increases if you receive one or two doses after you have already ovulated. The risk of OHSS is much less in women taking oral fertility drugs, such as Clomid, since doctors try to give the least dose possible.

OHSS hits some 10% of women who undergo in vitro fertilization. Most of the time, the condition is mild, but more severe cases of the condition can endanger a woman's health. OHSS tends to occur in women under the age of 35. Other risk factors include very high levels of estrogen during fertility treatments and the existence of the condition known as polycystic ovarian syndrome (PCOS).

The milder symptoms of OHSS include bloating, mild abdominal pain, and weight gain. In more severe cases, the symptoms include significant weight gain, for instance more than 10 pounds in a matter of days, intense pain or swelling in the abdomen, a decrease in urination, and shortness of breath. Depending upon the severity of your condition, hospitalization may be required.

Your doctor will want to administer certain medical tests in order to assess and monitor your condition. In milder cases, the treatment for OHSS includes:

Lots of rest with your legs elevated to help you release the excess fluid from your body.

Lots of fluids—10-12 glasses a day—including drinks that contain electrolytes.

No caffeine or alcohol.

No strenuous exercise and no sexual intercourse. These may cause your ovarian cysts to leak or rupture.

Over-the-counter pain killers like Tylenol.

Milder cases of OHSS go away after you begin menstruation, but severe cases may take several days to resolve. Pregnancy may worsen your symptoms and cause them to persist for weeks.

Much less often, OHSS has life-threatening complications including:

Severe build-up of fluids in the abdomen and chest

Severe electrolyte imbalance

Kidney failure

Blood clots