What is OHSS?
Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of a fertility treatment. The medication (gonadotrophin) used to stimulate the ovaries to produce multiple follicles during an IVF or IUI treatment improves the chances of pregnancy. However, when too many ovarian follicles have developed in response to the usual dose of medication, it may lead to OHSS.
OHSS occurs when over-stimulated ovaries enlarge and leak fluid into the body. Fluid leaks into the abdomen and in severe cases, into the space around the heart and lungs. OHSS is usually mild and causes no more than a slight lower abdominal discomfort in most cases. Although uncommon, medical attention is required as it can be potentially life threatening if left untreated.
Potential Complications of OHSS (Rare)
- Organ failure involving kidneys, liver and lungs.
- A serious but rare complication such as blood clot (thrombosis) can cause stroke or respiratory problems.
When detected early and managed appropriately, the condition can be controlled. There is currently no evidence of problems in the baby as a result of OHSS.
Occurrence of OHSS
As many as one in three (33%) develop mild OHSS. The severe form will affect less than one percent (1%) of patients that may require hospital admission and treatment.
Symptoms
You may be developing OHSS if you experience some or all of the following symptoms:
- Persistent lower abdominal discomfort
- Nausea and vomiting
- Bloated-ness or swelling of the abdomen and genital area
- Shortness of breath
- Dehydration
- Reduction of urine volume
- Abdominal pain
Medical Attention
OHSS is usually self-limiting and can be treated at home with rest.
- Make sure you drink clear fluids at regular intervals.
- Make sure you do not drink in excess.
- If you have pain, take ordinary paracetamol. You should avoid anti-inflammatory drugs (aspirin or aspirin-like drugs such as ibuprofen), which can affect kidney function.
- Even if you feel tired, make sure you continue to move your legs.
Immediate medical attention is required should the symptoms persist or worsen. They include:
- Vomiting
- Urinary problems
- Chest pain or any difficulty in breathing
In this instance, admission to hospital for treatment and close monitoring are required. Most of the time, the symptoms will subside in 5 to 15 days. You should report any of your concerns to us at Alpha IVF Centre at any time.
Management of OHSS
Some women are more likely to develop OHSS, especially those with polycystic ovaries, those who are thin and those who responded with many follicles or experienced OHSS in the past.
If you are already undergoing an IVF/ICSI programme and your risk of OHSS is high, your fertility specialist will opt for a GnRH agonist trigger for final oocyte maturation instead. Also, you are advised to defer fresh embryo transfer. The resulting good quality blastocysts will be frozen for later use.
Please take note that severe OHSS requires you to be admitted to the hospital for monitoring and treatment.
