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Ovarian Hyperstimulation Syndrome

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What is it?

Beyond being yet another thing to test the sanity of the beleaguered and stressed IVF patient, it is a potentially dangerous syndrome which occurs in response to gonadotrophin injections (in IVF and GIFT) to stimulate the ovaries.

Help! What are the symptoms?

It occurs typically in women who have achieved more than thirty eggs and briefly congratulated themselves only to recoil in horror when they experience severe abdominal bloating, fluid retention and decreased urination.

Regardless, if suspected it must be reported to the clinic right away.

Why?

The development of OHSS can lead to exaggerated enlargement of the ovaries, fluid shift from circulation into the abdominal cavity and decreased red blood cell concentration that may lead to thrombosis. In severe cases there is leakage into the chest cavity causing shortness of breath.

What is the treatment?

In mild cases pain relief but in more severe cases hospital admission and very severe cases intensive medical care is required.

Intravenous drip to correct fluid imbalance, injections of pethidine to assist pain and injections of heparin to counter any tendency of blood to clot abnormally, are some of the medical delights which may await the OHSS patient if admitted.

How and when will it all end?

It is usually self-limiting and will disappear after e few days up until the onset of the next period.

And here is the irony - if pregnancy is achieved it can go on for weeks.  

How likely is it to occur?

In up to one percent of patients however in the case of pre-diagnosed polycystic ovarian syndrome the chances are higher as PCOS women are more likely to over or under respond to stimulation.