Ovarian Hyperstimulation Syndrome (OHSS)

Definition - What does Ovarian Hyperstimulation Syndrome (OHSS) mean?

Ovarian hyperstimulation syndrome (OHSS) is an irritation of the ovaries caused by hormonal medications taken in conjunction with assisted reproductive technology (ART) cycles, such as an egg retrieval as part of egg donation or in vitro fertilization (IVF).


FertilitySmarts explains Ovarian Hyperstimulation Syndrome (OHSS)

In a normal monthly cycle, the body produces just one egg. However, in the case of IVF or egg donation, multiple eggs increase the odds of a successful treatment. Medications are prescribed to stimulate the growth of multiple eggs.

In the case of OHSS, the body reacts negatively to the medication. The ovaries become enlarged and this swelling produces a fluid that seeps into the abdominal cavity. The result can range be from mild abdominal pain to severe respratory distress.

Mild cases of OHSS occur in approximately 20-33% of gonadotropin cycles and are monitored, but typically resolve on their own. Increasing fluid intake, resting, avoiding extreme exercise and sex, and taking over the counter pain relievers should address primary symptoms until the condition has resolved.

In rare cases, a woman may experience more severe reactions, including vomiting, nausea, rapid weight gain, severe pain, decreased urine output, extreme swelling, blood clots and respiratory distress. Severe cases of OHSS occur in around 3-8% of cycles and may need medical treatment, which may include removal of the liquid through a procedure called culdocentesis and intervention to prevent dehydration.

Risk factors for OHSS include:

  • Prior episodes of OHSS
  • Polycystic ovary syndrome (PCOS)
  • Age
  • High number of developing follicles
  • High or rapidly rising estrogen levels
  • Receiving high doses of gonadotropins
  • Low body weight


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