Overview
Ovarian hyperstimulation syndrome (OHSS) is a condition that occurs as a result of an exaggerated response to excess hormones, usually in women taking injectable hormone medications to stimulate the development of eggs in the ovaries. It causes the ovaries to swell and become painful. OHSS may occur during fertility treatments using injectable medications, such as during in vitro fertilization (IVF) or ovulation induction. Symptoms can range from mild to severe and may include abdominal swelling, pain, weight gain, and breathing difficulties. Treatment for OHSS depends on the severity of the condition and may involve hospitalization and additional medical intervention.
Understanding the disease
Symptoms
The symptoms of ovarian hyperstimulation syndrome (OHSS) can range from mild to severe and may include:
- Mild to moderate OHSS: Symptoms may include abdominal pain, bloating, nausea, vomiting, diarrhea, tenderness in the ovarian area, and a large number of follicles.
- Severe OHSS: In severe cases, symptoms can be more extreme, including rapid weight gain of more than 2.2 pounds in 24 hours, severe abdominal pain, persistent nausea and vomiting, blood clots, decreased urination, shortness of breath, tight or enlarged abdomen, and other complications. It's important to note that OHSS can be a complication of fertility treatments using injectable medications, and in some cases, it may lead to more serious health issues. If you suspect you are experiencing OHSS, it's essential to consult with a healthcare professional for proper evaluation and treatment.
Risk Factors
Risk factors for developing ovarian hyperstimulation syndrome (OHSS) include:
- Undergoing fertility treatments, especially when using injectable fertility medications.
- High or steeply increasing level of estradiol (estrogen) before an HCG trigger shot.
- Previous episodes of OHSS.
- Age under 35.
- Low body weight.
- Polycystic ovary syndrome (PCOS), a common reproductive disorder that causes irregular menstrual periods, excess hair growth, and unusual appearance of the ovaries on ultrasound examination. It is important to note that sometimes OHSS occurs spontaneously, without any known risk factors.
Development
Ovarian hyperstimulation syndrome (OHSS) develops as an exaggerated response to excess hormones. It usually occurs in women taking injectable hormone medications to stimulate the development of eggs in the ovaries. The condition causes the ovaries to swell and become painful. OHSS may occur during fertility treatments using injectable medications to stimulate ovulation, such as during in vitro fertilization (IVF) or ovulation induction. In some cases, it can also occur during fertility treatments using oral medications like clomiphene. OHSS can range from mild to severe and may require hospitalization and additional treatment in severe cases.
Assessment and Diagnosis
Triage
You should see a doctor if you experience symptoms of ovarian hyperstimulation syndrome (OHSS) while undergoing fertility treatments. Even if you have a mild case of OHSS, your health care provider will want to observe you for sudden weight gain or worsening symptoms. Contact your provider right away if you develop breathing problems or pain in your legs during your fertility treatment, as these may indicate an urgent situation requiring prompt medical attention.
Diagnosis
Diagnosis of ovarian hyperstimulation syndrome (OHSS) may be based on a physical exam, ultrasound, and blood tests. A healthcare provider will check for weight gain, abdominal pain, and enlarged ovaries with fluid-filled cysts, which may be visible through an ultrasound. Blood tests can help assess kidney function and check for abnormalities in blood, such as dehydration or electrolyte imbalance.
Management and Treatment
Complications
Potential complications of ovarian hyperstimulation syndrome (OHSS) include fluid collection in the abdomen and chest, electrolyte disturbances, blood clots in large vessels, kidney failure, twisting of the ovary (ovarian torsion), rupture of a cyst in the ovary leading to serious bleeding, breathing problems, pregnancy loss from miscarriage or termination due to complications, and rarely, death.
Prevention
There are strategies to help prevent Ovarian Hyperstimulation Syndrome (OHSS). Your health care provider will create an individualized plan for your fertility medications, which may include adjusting the medication dosage, adding medications like low-dose aspirin or metformin, coasting (stopping injectable medications for a few days before triggering ovulation), and closely monitoring follicle development and hormone levels through ultrasounds and blood tests. Following these strategies can decrease your chances of developing OHSS.
Home Remedies
There are no specific home remedies provided for the treatment or management of ovarian hyperstimulation syndrome (OHSS). It is important to consult with a healthcare provider for proper evaluation and treatment of OHSS. They will determine the appropriate course of action, which may include adjusting medication, hospitalization, or additional treatments as needed.
Treatment
Treatment for ovarian hyperstimulation syndrome (OHSS) depends on the severity of the condition. For mild to moderate cases, treatments may include adjusting medication, adding medication, or coasting. In severe cases, hospitalization and additional treatment may be required. Medications like low-dose aspirin, dopamine agonists, calcium infusions, or metformin may be used to reduce the risk of OHSS. If you are experiencing symptoms of OHSS, it is essential to contact your health care provider for proper evaluation and management.
Preparing for medical consultation
To prepare for an appointment for ovarian hyperstimulation syndrome (OHSS), follow these steps:
- Make a list of your symptoms: Write down all the symptoms you're experiencing, even if you don't think they're related. This will help you to discuss them with your healthcare provider.
- Prepare a list of your medications and supplements: Include doses and how often you take them. This information will be useful for your provider to understand your overall health and potential interactions with OHSS.
- Bring a family member or friend: Having someone accompany you can be helpful in retaining the information provided during the appointment.
- Bring a notebook or notepad: Take notes during the appointment to help you remember important details and questions.
- Prepare a list of questions: Create a list of questions to ask your healthcare provider, including:
- What's the most likely cause of my symptoms?
- What kind of tests do I need?
- Does ovarian hyperstimulation syndrome usually go away on its own, or will I need treatment?
- Can you provide me with printed materials or brochures? Do you have any recommendations for websites?
- Gather your health history and medical records: Collect any relevant information about your reproductive history, past surgeries, and exposure to chemicals or radiation. This information will help your provider understand your overall health and potential risk factors for OHSS. Remember to be open and honest with your healthcare provider about your symptoms and concerns. Don't hesitate to ask follow-up questions or ask for clarification if needed.