When you're ready to become pregnant, your doctor will monitor your progress. This is done using a variety of tests.
The most important test is serum estradiol levels and follicle-stimulating hormone (FSH) levels. These two factors are used to determine if ovulation is occurring and how many eggs are present in the ovaries.
Unfortunately, there are times when these tests may not be accurate and this can lead to Ovarian Hyperstimulation Syndrome (OHSS).
What is Ovarian Hyperstimulation Syndrome (OHSS)
Ovarian Hyperstimulation Syndrome (OHSS) is a complication of in vitro fertilization (IVF), which is a procedure used to help women conceive.
OHSS can be life-threatening, so it's important to understand the condition and how you can avoid it if you're undergoing fertility treatments.
What Is Ovarian Hyperstimulation Syndrome?
Ovarian Hyperstimulation Syndrome occurs when ovaries become swollen and produce too many eggs for IVF procedures to use.
This happens because your doctor uses drugs or hormones to stimulate the ovaries, the part of the female reproductive system that produces eggs so that more than one egg will be available for harvesting during an IVF cycle.
But the downside of these drugs is that they may cause your ovaries to release multiple eggs at once instead of releasing just one egg every month like they would during menstruation without stimulation from medicine or hormones.
This results in an increased risk for ovarian hyperstimulation syndrome due to excessive hormone production by those overactive follicles on their own.
Hormone injections are given to women with infertility issues to help them release more than one egg during ovulation.
These injections contain follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which act on the pituitary gland in your brain and stimulate it to release FSH and LH into your bloodstream.
When this happens, it stimulates your ovaries to produce more than one egg at once. And if there are enough of these hormones in your system, they can lead you down a slippery slope toward OHSS.
This means there are two main ways that you could get OHSS; through taking fertility drugs or having an underlying health problem affecting how well your body produces hormones like FSH and LH.
General symptoms of OHSS
If you have OHSS, you may experience the following:
- abdominal pain
- swelling of the legs, ankles, and feet. Your ankles may feel like they're "full of water." You may also notice that your feet swell up.
- increased blood pressure
If you have severe OHSS, your blood levels may drop, leading to fainting spells, rapid heartbeat, blurred vision, and confusion. You may also experience abdominal pain that is similar to menstrual cramps.
Your doctor may diagnose you with OHSS based on your symptoms, your medical history, and a physical exam. But it's important to note that other conditions can cause similar symptoms.
So if you're experiencing any of these symptoms, make sure to tell your doctor about them as soon as possible.
What are the risk factors of OHSS?
While the exact cause of OHSS is unknown, it's thought to be linked to the amount of estrogen in your body. This can happen when you're taking fertility drugs to stimulate ovulation or have an imbalance of sex hormones due to pregnancy complications.
If a woman has polycystic ovary syndrome (PCOS) or history in the family, this may also increase her risk of developing OHSS. Also, previous bouts of OHSS can pose a risk of having it again.
It is also thought that age, abnormal body weight, and undergoing fresh embryo transfer can all increase the risk of OHSS. Whatever the case, it's still not clear exactly what causes OHSS. Having OHSS can have some serious complications.
Complications of OHSS and how it affects women
If you have severe OHSS, you may need to be hospitalized. This is because the condition can cause complications such as blood clots in the lungs (pulmonary embolism), anemia, and other blood disorders.
There's a chance that you can develop kidney failure from severe OHSS. This is because there's increased pressure on the kidneys when your body holds too much fluid.
In rare cases, severe OHSS can be life-threatening. The condition can also lead to the loss of pregnancy if you're pregnant and suffering from it.
The good news is that OHSS is treatable, and there are several different ways to do so. If you have been diagnosed with OHSS, your doctor will most likely suggest treatments such as bed rest, medication, and monitored fluid intake to help reduce the symptoms.
In some cases, they may also recommend that you take a diuretic to help reduce the symptoms of swelling.
If you have severe symptoms, however, then you'll need more advanced treatment options. This could include the removal of fluid from your abdomen or injecting medication into your uterus.
If the doctors feel it's necessary, they may also suggest that you undergo a dilation and curettage (D&C) procedure. This is where a doctor removes any tissue in the uterus that has died due to lack of blood flow and other complications related to OHSS.
The doctor would likely recommend laparoscopic surgery to remove your ovaries so they're no longer producing hormones and ovulating. This will help reduce the symptoms of OHSS and prevent the condition from returning.
How to prevent OHSS
Even though the root cause isn't clear yet, there are a few ways you can prevent the onset of OHSS. The most effective is to avoid the use of fertility drugs altogether. But if there isn't an option for you, there are still some things you can do to help reduce the risk.
One of the most important is getting plenty of rest before and after your egg retrieval treatment. Your doctor may also recommend that you follow a low-salt diet and avoid strenuous activities such as exercise for several days before and after your procedure.
Reduce the number of drugs used during induction, because several studies have found that decreasing drug dosage can reduce ovarian response and decrease the risk of developing OHSS.
Another option is to use ovulation-triggering drugs, which allow you to schedule an egg retrieval without worrying about overstimulating your endometrium.
OHSS can be dangerous to your health, but it’s often treatable. If you suspect that you have this condition and need treatment, call your doctor right away.
He or she will probably want you to go to the hospital for additional tests and treatment options so that your body can get back on track as soon as possible.
If you’re worried about the risk of developing OHSS, talk to your doctor about your birth control options. He or she may be able to prescribe a pill with a lower dose of hormones or one that contains just progesterone instead of both estrogen and progesterone. This can reduce the risk of overstimulation and lower your chances of developing OHSS.
You can also contact us if you have any fertility questions or concerns.