Ovarian Hyperstimulation
What is Ovarian Hyperstimulation?
Ovarian Hyperstimulation Syndrome (OHSS) is a complication of fertility treatments that can lead to serious health problems due to the overstimulation of the ovaries. OHSS occurs when growth hormones stimulate the ovaries to produce an excessive number of follicles, which produce the eggs needed for fertility treatments. The increase hormones and follicles can lead to a number of serious complications, including severe abdominal swelling and pain, nausea and vomiting, difficulty breathing, rapid weight gain, and in severe cases, blood clots and kidney failure.
Symptoms of Ovarian Hyperstimulation
Early on, symptoms of hyperstimulation may include abdominal bloat, nausea, and abdominal pain. As the condition progresses, other symptoms may include severe abdominal swelling and pain, nausea and vomiting, difficulty breathing, rapid weight gain, and in severe cases, blood clots and kidney failure. Some women may also experience headaches, fatigue and lightheadedness.
Diagnosis of Ovarian Hyperstimulation
OHSS can be diagnosed through a physical examination and an ultrasound of the ovaries to determine the number of follicles. Blood tests can also be used to check hormone levels. Your doctor may also order an MRI or CT scan to look for signs of fluid accumulation. Your doctor may also request that you have your urine checked for signs of dehydration.
Treatment for Ovarian Hyperstimulation
In mild cases of OHSS, supportive care will typically involve drinking plenty of fluids, getting rest, and avoiding any strenuous activity. In more severe cases, treatment may involve:
- Intravenous fluids to help replace electrolytes and minerals lost from vomiting
- Medication to reduce swelling and discomfort
- Bed rest and avoidance of any strenuous activity
- Monitoring of blood tests to check hormone levels
- Oxygen therapy to help with breathing difficulties
In very severe cases, hospitalization may be necessary to monitor symptoms and provide supportive care. In such cases, the fertility treatment may need to be cancelled.
Preventing Ovarian Hyperstimulation
OHSS is generally a rare complication of fertility treatments, and it can be prevented or minimized by minimizing the dose of fertility drugs used in a cycle. Many women are started on a low dose of hormones, and if the response is too aggressive, the dose is lowered or treatment stopped. Additionally, monitoring can be performed to ensure that hormone levels are within an acceptable range for the given treatment cycle.