One of the most dangerous risks a woman undertakes when she decides to use fertility drugs is the risk of Ovarian Hyperstimulation Syndrome, or OHSS. This condition occurs when the ovaries become swollen with fluid, which then leaks into the body. The fluid can cause shortness of breath, excessive weight gain and swelling.
During fertility drug treatment some swelling of the ovaries is normal, but when OHSS occurs there is a dangerous amount of additional fluid in the ovaries. Most of this fluid comes from leaky blood vessels which drain into the ovaries.
Mild cases, which affect about 10% of women undergoing IVF treatment, and lead to a small weight gain and discomfort in the abdomen. As long as these symptoms are monitored closely they will usually resolve themselves at home.
Severe cases of OHSS may require hospitalization as they can lead to significant pain and difficulty breathing. If you are having any of these symptoms you should seek medical attention immediately.
In some instances your doctor may become aware that you are at risk of OHSS before you ovulate, and may wish to delay or prevent ovulation in order to reduce the risk. If you are scheduled for IVF your eggs can be saved for future implantation, or your ovulation can be delayed by a few days to prevent severe OHSS.
Symptoms of OHSS
OHSS occurs after ovulation, so if you have OHSS you will see symptoms a few days after ovulation, or after IVF egg retrieval. On some occasions it can take a week or more for symptoms to show.
Mild symptoms of OHSS:
- Bloating, mild pain or discomfort in abdomen
- Mild weight gain
- Mild nausea
Serious symptoms of OHSS:
- Excessive weight gain (10 pounds in 3-5 days)
- Severe pain in abdomen and bloating
- Severe nausea, unable to keep down anything
- Difficulty urinating
- Shortness of breath, trouble catching your breath
- Rapid heartbeat
If you are undergoing fertility treatment and begin experiencing mild symptoms you should try to get in touch with your doctor as soon as possible. They will likely want to monitor your symptoms to ensure they don’t get worse. If you experience any sever symptoms you should seek medical attention immediately.
Prevention and Treatment of OHSS
During fertility treatment your doctor should be monitoring your reaction to the medication by taking regular blood samples and ultrasounds. If your blood indicates a rapid increase in estrogen, or your ultrasound shows large numbers of medium-sized follicles you may be at risk for OHSS.
If you have a mild case of OHSS there are some home treatments you can use to help you feel better:
- Use an over-the-counter pain reliever
- Try to take it easy, but maintain some light activity
- Elevate your feet, this will help your body get rid of fluid
- Avoid sexual intercourse until the OHSS has resolved, as this may make you feel more uncomfortable and can cause ovarian cysts to rupture
- Don’t drink alcohol or caffeine
- Drink lots of fluids, 10 to 12 glasses per day, and choose drinks with electrolytes
The best way to ensure that your symptoms do not get worse is to weigh yourself daily. A weight gain of 2 pounds or more per day indicates significant fluid retention and should result in a trip to your doctor.
On occasion OHSS may become so severe that hospitalization is required. Some of the fluid in your belly may need to be removed with a needle, and you may need to receive fluid intravenously.
In most cases symptoms will gradually decrease and then disappear when you get your period, but if you become pregnant the symptoms may be prolonged for several weeks. Sometimes the symptoms will become worse, and careful monitoring will be required.