During your IVF cycle, you may feel clogged and bloated. Ovarian hyperstimulation syndrome (OHSS) occurs as an overreaction to taking medication used to grow eggs during an IVF cycle.
What is OHSS?
Ovarian hyperstimulation syndrome can occur when too many follicles (the sacs containing the eggs) grow as a result of hormone injections used in fertility treatments. High estradiol levels are linked to the enormous number of developing follicles found in the ovaries of women with OHSS. This might result in fluid leakage into the belly, which would make you feel bloated, queasy, and distended. (1)
What are OHSS symptoms?
Women with mild to moderate OHSS have the following symptoms:
- Mild swelling
- Nausea
- Weight gain due to fluid
Women with severe OHSS often have:
- Vomiting and incontinence
- Significant discomfort from abdominal swelling
- May develop shortness of breath
Mild OHSS symptoms are frequently experienced during stimulation. However, six to eight days following the conclusion of treatment, moderate to severe symptoms typically reach their climax. (2)
How common is OHSS?
Because of research that has enhanced our knowledge of the condition, and specific methods to avoid or lessen its likelihood of occurring, OHSS is far less common than it was ten years ago.
Most people receive a light version that settles after a few days. 3-8% can acquire a moderate shape in some individuals. Fewer than 2% need to be hospitalized. It typically occurs in IVF patients; however, it can also occur following ovulation induction therapy.
It is crucial to understand that each woman who utilizes reproductive medications runs the risk of developing OHSS. Approximately a week after your embryo is transferred, when the pregnancy begins and the pregnancy hormone is produced, OHSS can occasionally go unnoticed. (3)
How long does OHSS last?
Most OHSS symptoms resolve spontaneously 7-10 days after fertility treatment. If your fertility treatment is successful and you become pregnant, your symptoms may last for up to several weeks. (4)
How is OHSS prevented?
Reduced activity, drinking electrolyte-rich fluids, draining abdomen fluid, using painkillers and nausea drugs, and careful ultrasound monitoring of the ovaries are how OHSS is typically treated. All eggs and/or embryos from those at risk or experiencing symptoms will be frozen for a future transfer because pregnancy can make OHSS worse or last longer.
This enables OHSS to resolve more quickly and can stop symptoms from later getting worse. Patients must be aware of the symptoms of OHSS and the physical changes that occur during the IVF cycle. All patients must immediately get in touch with their doctor or nurse if any of these symptoms appear so that the proper treatment and preventive measures can be taken. (5)
Why are OHSS diagnosis and treatment crucial?
OHSS can result in major problems if it is severe or if it is not treated promptly. The fluid that typically moves blood cells through arteries and veins might leak out and pool in the abdomen around the ovaries, intestines, and kidneys due to alterations in the body’s chemistry.
The swelling may be uncomfortable and may surround the heart, lungs, liver, and diaphragm. Breathing difficulties and shortness of breath may result from this. There is a chance that the kidneys will stop producing enough urine. Blood clots are more prone to form as a result of the increased blood concentration.
Treatments for OHSS
In addressing OHSS following IVF, the approach is tailored based on symptom severity. For individuals experiencing mild symptoms, several non-invasive strategies are advocated. Initially, healthcare professionals suggest rest as a crucial step for bodily recuperation. Additionally, discomfort associated with OHSS may be alleviated through the use of over-the-counter pain relievers, such as acetaminophen. Dehydration poses a significant risk; therefore, consuming ample fluids is strongly recommended to mitigate this concern. Furthermore, to counteract potential electrolyte imbalances, oral or intravenous electrolyte solutions may be prescribed.
- Rest facilitates the body’s natural recovery process.
- Over-the-counter pain relievers, like acetaminophen, are effective for managing discomfort.
- Adequate fluid intake is essential to prevent dehydration.
- Electrolyte replacement through oral or intravenous solutions addresses imbalances.
In contrast, severe OHSS cases necessitate more intensive interventions, potentially including hospitalization. Treatment in these instances may encompass intravenous hydration to correct dehydration and electrolyte disparities. Abdominal paracentesis, a procedure involving the drainage of excess abdominal fluid through needle aspiration, is another therapeutic option. Moreover, certain medications are available that aim to reduce ovarian swelling and fluid accumulation, thereby alleviating the condition’s more acute manifestations. Through these measures, the goal is to stabilize the patient’s condition and promote recovery.
Source:
Alper, M. M., Smith, L. P., & Sills, E. S. (2009). Ovarian hyperstimulation syndrome: current views on pathophysiology, risk factors, prevention, and management. Journal of experimental & clinical assisted reproduction, 6.
