Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian hyperstimulation syndrome (OHSS) is a medical condition that can occur in some women who undergo fertility treatment, particularly those who receive injections of hormones to stimulate the growth and release of eggs from the ovaries.

Causes and Risk Factors

OHSS is caused by an overresponse to fertility medications, such as gonadotropins, which are used to stimulate the ovaries to produce multiple eggs. This can lead to the growth of numerous large follicles in the ovaries, resulting in an excessive production of fluid and hormones.

Risk factors for OHSS include:

• Polycystic ovary syndrome (PCOS)
• Young age
• Low body weight
• High doses of fertility medications
• Prior history of OHSS

Symptoms

The symptoms of OHSS can range from mild to severe and may include:

• Bloating and abdominal swelling
• Abdominal pain
• Nausea and vomiting
• Diarrhea
• Weight gain
• Shortness of breath
• Decreased urine output

Classification

OHSS is classified into three categories:

• Mild OHSS: characterized by mild symptoms and minimal fluid accumulation in the abdomen
• Moderate OHSS: characterized by more severe symptoms and significant fluid accumulation in the abdomen
• Severe OHSS: characterized by life-threatening complications, such as respiratory distress, cardiac problems, and thromboembolism

Treatment

Treatment for OHSS depends on the severity of the condition and may include:

• Supportive care, such as rest, hydration, and pain management
• Paracentesis, a procedure to remove excess fluid from the abdomen
• Albumin infusions to help maintain blood volume and prevent dehydration
• Hospitalization for close monitoring and treatment of complications

Prevention

To reduce the risk of OHSS, fertility specialists may use various strategies, including:

• Using lower doses of fertility medications
• Monitoring follicle growth and hormone levels closely
• Freezing embryos instead of transferring them immediately
• Canceling the fertility cycle if there is a high risk of OHSS

Complications

Severe OHSS can lead to life-threatening complications, including:

• Respiratory distress
• Cardiac problems
• Thromboembolism
• Kidney damage

Frequently Asked Questions (FAQs)

What is Ovarian Hyperstimulation Syndrome (OHSS)?
A potentially life-threatening condition that can occur in women undergoing fertility treatment.

What causes OHSS?
Typically caused by excessive stimulation of the ovaries with fertility medications.

Who is at risk for OHSS?
Women undergoing fertility treatments, particularly those with polycystic ovary syndrome (PCOS) or high egg reserve.

What are the symptoms of OHSS?
May include abdominal pain, bloating, nausea, vomiting, and weight gain.

Can OHSS be prevented?
Possibly, by careful monitoring and adjustment of fertility medication dosages.

How is OHSS diagnosed?
Through physical examination, ultrasound, and blood tests to evaluate ovarian size and fluid accumulation.

What are the complications of OHSS?
May include blood clots, kidney damage, and respiratory problems in severe cases.

How is OHSS treated?
Typically involves hospitalization for monitoring and supportive care, with possible drainage of excess fluid.

Can OHSS recur?
Possibly, in women who undergo additional fertility treatments or have a history of OHSS.

Is OHSS life-threatening?
Can be, in severe cases, if left untreated or if complications arise.