Ovarian Hyperstimulation Syndrome: Meaning, Symptoms, Treatment

Written by Medicover Team and Medically Reviewed by Dr Venkata Laxmi Simhadri , Gynecologists

Ovarian Hyperstimulation Syndrome (OHSS) is a condition that can occur in women who are receiving fertility treatments, especially those that involve hormone injections to help produce eggs. While mild cases of OHSS are quite common and generally not harmful, severe cases can lead to serious health issues if not addressed. It is important for people to be aware of OHSS and how it relates to pregnancy, as this condition can affect early pregnancy and overall chances of fertility.

Symptoms of Ovarian Hyperstimulation Syndrome

Ovarian Hyperstimulation Syndrome Symptoms vary depending on severity. They can appear a few days after hormone injections or egg retrieval procedures.

Mild OHSS Symptoms

Abdominal bloating and mild pain
Nausea and occasional vomiting
Diarrhea
Slight weight gain

Moderate OHSS Symptoms

Noticeable abdominal swelling
Persistent nausea and vomiting
More rapid weight gain (over 2 pounds per day)
Decreased urine output

Severe OHSS Symptoms

Severe abdominal pain
Shortness of breath
Gaining more than 15 pounds in a week can be a warning sign.
Fluid buildup in the chest can make it hard to breathe.
Blood clots (rare but serious)
Dehydration

Causes of Ovarian Hyperstimulation Syndrome (OHSS)

OHSS occurs when the ovaries react too strongly to fertility medications, especially injectable gonadotropins. While these drugs help produce multiple eggs, some women experience an exaggerated response that can lead to swelling, fluid buildup and discomfort.

Key OHSS Causes

High levels of human chorionic gonadotropin: This hormone helps release eggs but can also make blood vessels leak, causing fluid to build up in the belly and chest.
Ovarian sensitivity to fertility drugs: Some women's ovaries respond more strongly to fertility drugs.
Polycystic ovary syndrome (PCOS): Women with PCOS are at higher risk of OHSS because they already have more follicles.
High estrogen levels: Excessive ovarian stimulation can increase estrogen, worsening OHSS risk.
Multiple follicles developing: Producing many eggs can enlarge the ovaries and cause fluid accumulation.

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Risk Factors of Ovarian Hyperstimulation Syndrome

Certain factors increase the chances of developing OHSS during fertility treatments. Awareness of these ovarian hyperstimulation syndrome risk factors helps doctors monitor and manage patients safely.

Being younger than 35 years old
Having PCOS
Producing a high number of follicles during stimulation
High doses of fertility medication
Previous history of OHSS
High levels of estrogen before hCG injection

Women with these risk factors need closer monitoring during fertility treatments.

When to See a Doctor

It is important to seek medical attention promptly if you notice any concerning symptoms after fertility treatment:

Severe abdominal pain or swelling
Rapid weight gain in a short period
Difficulty breathing or chest pain
Decreased urination
Persistent vomiting or dehydration
Swelling in the legs, which may indicate a blood clot

Diagnosis of Ovarian Hyperstimulation Syndrome

OHSS is diagnosed based on symptoms, medical history and tests to assess severity and potential complications. Radiological evaluation, referred to as ovarian hyperstimulation syndrome radiology, helps doctors monitor ovarian size and fluid accumulation safely.

Methods Used in OHSS Diagnosis:

Physical Examination: Doctors check abdominal swelling, tenderness, pain and breathing problems during OHSS Diagnosis to assess the condition's severity.

Ultrasound Imaging: Ultrasound helps in OHSS Diagnosis by detecting enlarged ovaries, multiple follicles and fluid buildup in the abdomen or pelvis.

Blood Tests: Blood tests assist in OHSS Diagnosis by measuring hormone levels like estrogen and hCG, and checking kidney function and dehydration risk.

Chest X-ray or CT Scan: For advanced OHSS Diagnosis, chest X-rays or CT scans are used to detect fluid accumulation in the chest or breathing related complications.

Weight and Urine Output Monitoring: Checking weight and urine helps doctors track OHSS progress safely.

Ovarian Hyperstimulation Syndrome Treatment

Treatment for OHSS depends on severity. Options range from home care in mild cases to hospital management in severe cases. The goal is to relieve symptoms, prevent complications and support recovery.

Mild OHSS Treatment

Mild cases can often be managed at home with simple measures to reduce discomfort and prevent worsening symptoms.

Rest and stay well-hydrated
Avoid strenuous activity
Use pain relievers as directed by your doctor.
Monitor weight and note any symptom changes
Light walking or gentle stretching can improve circulation without straining ovaries

Moderate OHSS Treatment

Moderate OHSS requires closer medical supervision to prevent complications.

Frequent monitoring by a doctor
Medications to reduce fluid buildup
Adjustments in fertility treatment cycles
Monitoring electrolyte balance and blood pressure to prevent dehydration-related issues

Severe OHSS Treatment

Severe OHSS requires hospitalization for intensive care. Treatment focuses on preventing organ damage and managing complications.

Hospitalization for close monitoring
IV fluids to prevent dehydration
Blood-thinning medications to prevent clots
Paracentesis (removal of abdominal fluid)
Oxygen therapy if breathing is affected
Monitoring kidney and liver function to catch complications early

Ovarian Hyperstimulation Syndrome Diet

A supportive diet helps reduce symptoms, maintain energy and prevent further complications.

High-protein foods (lean meats, eggs, legumes) to reduce fluid retention
Low-sodium diet to prevent worsening bloating
Plenty of fluids to stay hydrated
Fiber-rich foods to prevent constipation
Small frequent meals to reduce abdominal discomfort

Foods to Avoid:

Processed salty foods (chips, fast food)
Excess caffeine and alcohol
High-fat, greasy meals that worsen bloating
Include potassium rich foods (bananas, spinach) to support fluid balance

Prevention Tips for OHSS

To reduce the risk of OHSS, ovarian hyperstimulation syndrome prevention includes adjusting medication doses, monitoring ovarian response and healthy habits.

Use lower doses of fertility drugs to avoid overstimulation
Monitor ovarian response with frequent ultrasounds and blood tests
Coasting technique: pause fertility drugs if hormone levels rise too high before hCG
Use GnRH agonists instead of hCG in high-risk cases
Freeze embryos (freeze-all strategy) if OHSS risk is elevated
Individualized treatment plans tailored to each patient
Educate patients on early symptom recognition and home monitoring

Conclusion

Ovarian Hyperstimulation Syndrome (OHSS) can happen during fertility treatments and may be mild or very serious. Spotting symptoms early, knowing the risk factors and getting quick medical help are important. With proper monitoring, prevention and healthy habits, the chances of serious problems can be reduced, helping women undergo fertility treatments safely.

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