It usually occurs in women taking injectable hormone medications to stimulate the development of eggs in the ovaries.
Ovarian hyperstimulation syndrome OHSS causes the ovaries to swell and become painful. Less often, OHSS happens during fertility treatments using medications you take by mouth, such as clomiphene. Treatment depends on the severity of the condition. OHSS may improve on its own in mild cases, while severe cases may require hospitalization and additional treatment.
During in vitro fertilization, eggs are removed from mature follicles within an ovary A. An egg is fertilized by injecting a single sperm into the egg or mixing the egg with sperm in a petri dish B. The fertilized egg embryo is transferred into the uterus C.
Symptoms of ovarian hyperstimulation syndrome often begin within a week after using injectable medications to stimulate ovulation, though sometimes it can take two weeks or longer for symptoms to appear.
Symptoms can range from mild to severe and may worsen or improve over time. Some women who use injectable fertility drugs get a mild form of OHSS. This usually goes away after about a week. But, if pregnancy occurs, symptoms of OHSS may worsen and last several days to weeks.
If you're having fertility treatments and you experience symptoms of ovarian hyperstimulation syndrome, tell your health care provider. Even if you have a mild case of OHSS , your provider will want to observe you for sudden weight gain or worsening symptoms. Contact your provider right away if you develop breathing problems or pain in your legs during your fertility treatment.
This may indicate an urgent situation that needs prompt medical attention. The cause of ovarian hyperstimulation syndrome isn't fully understood. Having a high level of human chorionic gonadotropin HCG — a hormone usually produced during pregnancy — introduced into your system plays a role. Ovarian blood vessels react abnormally to HCG and begin to leak fluid. This fluid swells the ovaries, and sometimes large amounts move into the abdomen.
During fertility treatments, HCG may be given as a "trigger" so that a mature follicle will release its egg. If you become pregnant during a treatment cycle, OHSS may worsen as your body begins producing its own HCG in response to the pregnancy. Injectable fertility medications are more likely to cause OHSS than is treatment with clomiphene, a medication given as a pill you take by mouth.
Some women who use injectable fertility drugs get a mild form of OHSS. This usually goes away after about a week. But, if pregnancy occurs, symptoms of OHSS may worsen and last several days to weeks. If you're having fertility treatments and you experience symptoms of ovarian hyperstimulation syndrome, tell your health care provider.
Even if you have a mild case of OHSS , your provider will want to observe you for sudden weight gain or worsening symptoms. Contact your provider right away if you develop breathing problems or pain in your legs during your fertility treatment.
This may indicate an urgent situation that needs prompt medical attention. The cause of ovarian hyperstimulation syndrome isn't fully understood. Having a high level of human chorionic gonadotropin HCG — a hormone usually produced during pregnancy — introduced into your system plays a role. Ovarian blood vessels react abnormally to HCG and begin to leak fluid. This fluid swells the ovaries, and sometimes large amounts move into the abdomen.
During fertility treatments, HCG may be given as a "trigger" so that a mature follicle will release its egg. If you become pregnant during a treatment cycle, OHSS may worsen as your body begins producing its own HCG in response to the pregnancy. Injectable fertility medications are more likely to cause OHSS than is treatment with clomiphene, a medication given as a pill you take by mouth.
Occasionally OHSS occurs spontaneously, not related to fertility treatments. Leeds Fertility will keep a close eye on you following your egg collection with a face-to-face examination on the third and fifth days after your collection. You will be advised to drink according to your thirst. You should not force yourself to drink excessively. This can be done at Leeds Fertility on an out-patient basis, provided we know of your symptoms early in the day.
If your symptoms develop around or after a positive pregnancy test, it can take a bit longer to get better. The condition does not harm the pregnancy or increase the risk of miscarriage. The treatments are also safe in pregnancy: they are mainly to relieve the symptoms until the condition burns itself out. Please contact Leeds Fertility on during office hours to discuss your concerns and symptoms.
We may need to see you so calling earlier in the day If you become very concerned when the clinic is closed, e. You will probably be advised to attend your local emergency department. Ovarian hyperstimulation syndrome OHSS can develop from IVF and ovulation induction therapies ; however, with good care and common sense, it can be avoided. OHSS is a serious condition. Women may experience a broad spectrum of signs and symptoms ranging from mild, moderate to severe forms.
When this condition develops, most women will experience enlarged ovaries see ultrasound image , mild forms with abdominal bloating, discomfort, shortness of breath and mild weight gain—this primarily water weight. However some women may develop a severe form of OHSS: it can cause massive fluid accumulation in the belly and around the lungs, heart and other areas. Fluid accumulation may cause breathing and circulation problems. The kidneys can be compromised as well. OHSS occurs in patients who have a high response to ovulation induction medication and is especially acute for those patients who, with a high response to medication, then receive an HCG injection during ovulation induction or to trigger ovulation in preparation for egg retrieval.
It rapidly intensifies the moment pregnancy occurs when the placenta normally infuses the pregnancy hormone, HCG, into her circulation. It is therefore imperative to prevent OHSS by careful monitoring, using conservative administration of medications, and patient education.
Fertility clinics should always have guidelines and treatment plans to prevent this serious disorder. In rare cases, the OHSS occurs in spite of normal estradiol or normal follicular stimulation.
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