A Pew research study uncovered that 33 percent of Americans have used fertility treatments themselves or know someone else who has. And according to the American Society for Reproductive Medicine , less than 3 percent of couples undergoing fertility treatments wind up using advanced reproductive technologies — like in vitro fertilization IVF — to conceive.
The IVF process involves stimulating egg production to later retrieve the eggs and fertilize them in a lab. After that, the embryos are transferred back into the uterus with the hope of implantation. OHSS happens when the ovaries swell with fluid that eventually leaks into the body. This condition is a direct result of the drugs used in IVF and other procedures that enhance egg production and maturity.
This is just a fancy way of saying that it results from hormone therapy used in certain fertility treatments. Specifically, a woman undergoing IVF typically receives an hCG human chorionic gonadotropin trigger shot before retrieval to help her eggs mature and to put them into an important process called meiosis when the egg releases half of its chromosomes before ovulation.
While this medication helps prime the eggs, it may cause the ovaries to swell and leak fluid into the abdomen, sometimes significantly. Again, these drugs are used to promote egg production or release mature eggs. Risk factors include things like having polycystic ovary syndrome PCOS or having a large number of follicles in any given cycle.
Women younger than age 35 are also at a higher risk of developing this complication. Related: 5 things to do and 3 things to avoid after your embryo transfer. It may be hard to tell when something is wrong versus just uncomfortable.
Trust your instincts, but also try not to worry. Most cases of OHSS are mild. These symptoms typically develop about 1 to 2 weeks after injecting medications. The timeline is individual, however, and some women may start symptoms later on down the line. Symptoms tend to range in their severity and may also change over time. Around 1 percent of women develop what is considered severe OHSS. Issues like blood clots, trouble breathing, and severe pain may lead to more serious complications, like an ovarian cyst rupture with excessive bleeding.
Mild OHSS may go away on its own within a week or so. If you get pregnant that cycle, the symptoms may persist a bit longer — more like a few days to a few weeks. Treatment of mild OHSS is conservative and involves things like avoiding strenuous exercise and increasing fluid intake to address dehydration.
Office visits for ultrasound exams to measure the ovaries and fluid in the abdomen, and blood tests, are routinely done. Decreased activity and drinking lots of electrolyte-rich fluids over ounces per day are recommended.
Medicines for nausea are available. If there is fluid in the abdomen, drainage of fluid using a syringe paracentesis can provide significant relief in most cases. On occasion, more than one drainage is helpful. A medicine called cabergoline also can reduce the fluid accumulation. There is rarely a need for hospitalization. If OHSS does not improve with outpatient care, the woman may be treated in the hospital with close monitoring.
The doctor may order intravenous IV fluids and medicines for nausea and may remove fluid from the abdomen. Other supportive therapy may be given as needed.
Complications from OHSS can be severe. You may become dehydrated and pressure in your abdomen may increase from too much fluid. These problems can lead to blood clots forming within the blood vessels. Blood clots can travel to your lungs or to other important organs. However, symptoms usually resolve spontaneously with the onset of the next period or shortly thereafter.
If a patient is pregnant when OHSS hits, the symptoms may worsen and last approximately two to three weeks. For more information, make an appointment with one of our reproductive endocrinologists.
Request an Appointment Contact Us. If after receiving a hormone injection you develop any of the symptoms described above, you should notify our center immediately. Careful monitoring, decreased stimulation medication, taking pain medicine and drinking lots of fluids are recommended. There is also some increased risk of developing a blood clot if you have OHSS, so your doctor may recommend taking a baby aspirin. Although very uncommon, severe OHSS symptoms can be treated through hospitalization for intravenous fluid hydration or, in rare circumstances, inserting a needle in the abdomen to remove excess fluid.
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