Ovarian Hyperstimulation Syndrome (OHSS)

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

Ovarian hyperstimulation syndrome (OHSS) is an irritation of the ovaries caused by injectable hormone medications that are most often taken in conjunction with assisted reproductive technology treatments, such as an egg retrieval as part of in vitro fertilization (IVF). OHSS is more likely to occur when medication is injected as opposed to taken orally.

FertilitySmarts explains Ovarian Hyperstimulation Syndrome (OHSS)

One of the early components of an IVF treatment is taking ovulation induction (OI) medication. In a normal monthly cycle, the body produces just one egg. However, in the case of IVF, multiple eggs increase the odds of a successful treatment. Therefore, OI medications are prescribed to stimulate the growth of multiple eggs.

In the case of OHSS, the body reacts negatively to the OI medication. The ovaries become overstimulated, which leads to swelling. The swelling produces a fluid, which seeps into the stomach. The result is stomach pain, bloating, and weight gain. In rare cases, a woman may experience more severe reactions, including vomiting, nausea, rapid weight gain, severe pain, decreased urine output, and extreme swelling.

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

Mild cases of OHSS occur in 10-20 percent 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.

Severe cases of OHSS are rare (around 1 percent) and may need medical treatment, which may include removal of the liquid through a procedure called culdocentesis and intervention to prevent dehydration.

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