What Is Ovarian Hyperstimulation Syndrome & What Are Its Causes?


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Some women are denied the easy path to a baby. For many women around the world, infertility is a sad reality. In many cultures, it is still taboo to talk about infertility openly. Thankfully, people are beginning to realize that infertility is just another physical disorder. And fortunately, today medical science has made it possible for infertile couples to fulfill their long cherished dream – to have a baby!

Among the many solutions offered by medical science, IVF or In-vitro Fertilization is the most radical. Even 50 years ago, IVF would have seemed like fantasy. However, today it is the one technology that is turning dreams into reality.

But this dream comes at a cost. IVF is not easy. For women undergoing IVF, the battle is both mental and physical. Ovarian Hyperstimulation Syndrome or OHSS is one of the many problems women face while preparing for IVF.

What Causes Ovarian Hyperstimulation?

IVF entails a cocktail of hormones that a woman needs to inject into her body. Some of the hormones work to stimulate the development of eggs in the ovaries.

Unfortunately, doctors still don’t know that exact amount of the drugs a woman might need. This sometimes leads to an overdose of medication, which in turn can cause OHSS. The ovaries under this condition swell up and become painful.

But not all cases of OHSS come with fertility treatments. In rare cases, women may develop OHSS spontaneously.

[ Read: Ivf Cost ]

OHSS Risk Factors:

If you fulfill any of the following criteria, your chances of developing OHSS will go up:

  • Polycystic ovary syndrome or PCOS
  • Large number of follicles
  • Young age
  • Low body weight
  • High level of estrogen before an HCG trigger shot
  • Migraine headaches

[ Read: Fertility Drugs For Women ]

What Are The Symptoms Of Ovarian Hyperstimulation Syndrome?

No matter the cause, symptoms of OHSS remain the same. These signs become visible about ten days after you take your injectable. Some fortunate women only encounter mild OHSS, but some can end up with severe symptoms too.

1. Mild OHSS Symptoms:

If you get a case of mild OHSS, you may encounter the following symptoms:

  • Abdominal pain that comes and goes. This pain is often not too unbearable.
  • Bloating
  • Nausea
  • Vomiting
  • Diarrhea

2. Severe OHSS Symptoms:

With severe ovarian hyperstimulation syndrome, you might experience the following symptoms:

  • Rapid weight gain
  • Severe abdominal pain
  • Severe nausea accompanied with vomiting
  • Dark urine
  • Shortness of breath
  • Dizziness

[ Read: Yoga For Fertility ]

When To See A Doctor:

If you notice any of the above-mentioned symptoms while undergoing IVF, talk to your doctor promptly.

In rare cases, OHSS can lead to severe life-threatening complications, including:

  • Fluid accumulation in the stomach and chest
  • Blood clots (especially in the legs)
  • Kidney failure
  • Bleeding due to cyst rupture in the ovary

If you develop breathing problems or severe pain in the legs, seek urgent medical care. This may indicate an urgent situation that needs prompt medical attention.

How Is OHSS Diagnosed?

If your doctor suspects OHSS, he may use the following methods to make a diagnosis:

  • Clinical Observation: Weight gain, abdominal bloating and pain – your doctor will make note of all these symptoms to reach a conclusion.
  • Ultrasound: An ultrasound will be the best tool to make a final diagnosis of OHSS.

Treatment Of Ovarian Hyperstimulation Syndrome:

Most cases of OHSS work themselves out. It may take a week or two, but in general OHSS does not pose a serious threat. The treatment for OHSS is mostly geared up to make you comfortable and avoid further complications.

1. Treatment For Mild OHSS:

A mild case of OHSS can be treated with:

  • Medication to treat nausea and pain
  • Regular monitoring including ultrasounds, weight measurement, and blood tests
  • Consuming ample amount of fluids
  • Draining excess abdominal fluid
  • Preventing blood clots through support stocking

[ Read: Tips To Get Pregnant With PCOS ]

2. Treatment For Severe Ovarian Hyperstimulation Syndrome OHSS:

The treatment plan for severe OHSS includes:

  • Intravenous (IV) fluids
  • Medications like Cabergoline (1) and Gn-RH antagonist
  • Surgery (in case of a ruptured ovarian cyst)
  • Anticoagulant medications to prevent blood clots

Is It Possible To Prevent OHSS?

There are certain measures that can be taken to prevent OHSS. They include:

  • Tweaking Dosage: Your doctor can prevent a case of OHSS by using the lowest possible dose of gonadotropins.
  • Coasting: What is coasting? Well, if your doctor asks you to stop injectable medication in case of high level of estrogen or a large number of developed follicles, it is called coasting.

The biggest question that haunts women undergoing IVF is ‘will it work?’ And if a woman ends up with OHSS, it is but normal to worry about the success of her IVF cycle. Fortunately, there’s nothing to indicate that OHSS can cause problems with a subsequent pregnancy (2), so rest easy.

Your dream will soon become a living, breathing child. The journey may be tough, but the result will make everything else seem trivial. Just hang on!

Why don’t you share your IVF story with us? We’ll love to hear from you!

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