What are the symptoms of ovarian hyperstimulation syndrome (OHSS)?
The signs and symptoms of OHSS vary depending on the severity of the condition. Symptoms often begin within a week after using medication to stimulate ovulation, though it can take two weeks for symptoms to develop.
Symptoms of mild to moderate OHSS include:
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- Abdominal pain.
- Bloating.
- Slight weight gain (more than 2 pounds per day).
- Nausea.
In more severe cases of OHSS, symptoms may include:
- Excessive weight gain.
- Severe nausea and vomiting.
- Severe abdominal swelling.
- Difficulty breathing.
- Blood clots.
- Decreased urination.
- Severe abdominal pain.
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Contact your healthcare provider if you’re receiving fertility medication to get pregnant and have any symptoms of OHSS. Your team is likely closely monitoring you and would tell you if you’re at risk for developing OHSS based on your estrogen levels and number of follicles on your ultrasound. Most cases are mild and resolve on their own, but it’s best to discuss your symptoms with your provider.
What causes ovarian hyperstimulation syndrome (OHSS)?
In most cases, OHSS develops because of the hormone HCG (human chorionic gonadotropin) stimulating your ovaries. Your ovaries typically produce just one egg at a time, but hormone treatments stimulate your ovaries to grow a lot of eggs at one time. People undergoing fertility treatments often receive a “trigger shot” of HCG to help the eggs mature before the egg retrieval process of IVF. When people develop a lot of potential eggs, the ovaries can respond excessively to this medication, and they can develop OHSS.
In people with OHSS, drugs used in fertility treatments cause the blood vessels surrounding their ovaries to leak fluid. Sometimes this fluid moves into your belly and causes symptoms like swelling and pain.
What are the risk factors for this condition?
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People assigned female at birth (AFAB) at a higher risk for OHSS include those who:
- Have PCOS.
- Have previously had OHSS.
- Have a large number of follicles or high levels of estrogen during IVF stimulation.
- Received high doses of HCG during an IVF cycle.
- Have undergone a “fresh” rather than “frozen” embryo transfer (when people get pregnant while their ovaries are still stimulated, the pregnancy can prolong OHSS).
In addition, while there isn’t clear evidence, there may be a higher risk for OHSS in those who:
- Are younger than 30 years old.
- Weigh less than average.
What are the complications of OHSS?
People with OHSS are at risk for developing a thrombosis (blood clot) in the lungs or legs. Medicines can help decrease your risk for this complication. There’s also an increased risk of stroke. Tell your healthcare provider if you experience a painful, swollen leg or chest pain.
In rare cases, an ovarian cyst associated with OHSS can burst, causing dangerous bleeding. People with this complication may need surgery to stop the bleeding.
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