Summary about Disease
Ovarian Hyperstimulation Syndrome (OHSS) is an exaggerated response to excess hormones, usually occurring in women undergoing fertility treatments such as in-vitro fertilization (IVF). It causes the ovaries to become swollen and leaky, leading to fluid accumulation in the abdomen. In severe cases, it can be life-threatening.
Symptoms
Symptoms can range from mild to severe and include:
Mild: Abdominal bloating, mild abdominal pain, nausea, vomiting, diarrhea, mild weight gain.
Moderate: Excessive weight gain, abdominal pain, persistent nausea and vomiting, signs of dehydration.
Severe: Rapid weight gain (more than 1 kg per day), severe abdominal pain, persistent severe nausea and vomiting, decreased urination, shortness of breath, dizziness, blood clots.
Causes
OHSS is primarily caused by the use of injectable hormone medications (such as human chorionic gonadotropin or hCG) to stimulate egg development in the ovaries during fertility treatments. These hormones cause the ovaries to release substances that increase vascular permeability, leading to fluid shifts.
Medicine Used
Treatment depends on the severity of OHSS.
Mild: Pain relievers (acetaminophen), anti-nausea medication.
Moderate: Careful monitoring of fluid intake and output, electrolyte balance, paracentesis (removal of fluid from the abdomen) may be necessary.
Severe: Hospitalization, intravenous fluids, medications to prevent blood clots (anticoagulants), paracentesis or thoracentesis (drain fluid from around lungs), monitoring of kidney and liver function. Cabergoline, a dopamine agonist, may also be used to reduce vascular endothelial growth factor (VEGF).
Is Communicable
No, Ovarian Hyperstimulation Syndrome is not a communicable disease. It is a complication arising from fertility treatments.
Precautions
Careful monitoring during fertility treatments.
Low-dose hCG or alternative ovulation triggers.
"Coasting" (withholding gonadotropin injections for a few days to allow estrogen levels to fall before hCG trigger).
Cryopreservation (freezing) of all embryos and delaying embryo transfer to a later cycle.
Adequate hydration during and after stimulation.
High protein diet as recommended by physician.
How long does an outbreak last?
The duration of OHSS varies. Mild cases may resolve within a week or two. Moderate to severe cases can last for several weeks, especially if pregnancy occurs, as pregnancy sustains the production of hCG, which can prolong the syndrome.
How is it diagnosed?
Diagnosis is based on:
Medical history (recent fertility treatments).
Physical examination (assessing abdominal distension, tenderness).
Ultrasound (to visualize enlarged ovaries and fluid in the abdomen).
Blood tests (to check hormone levels, electrolytes, kidney and liver function, blood counts).
Timeline of Symptoms
Symptoms typically appear a few days after the hCG trigger shot, around the time of egg retrieval or shortly after. Symptoms usually peak about 7-10 days after the trigger. If pregnancy occurs, symptoms may worsen and persist for a longer duration (several weeks).
Important Considerations
OHSS can be life-threatening, especially in severe cases.
Early detection and prompt treatment are crucial.
Women undergoing fertility treatments should be closely monitored.
Patients should immediately report any concerning symptoms to their healthcare provider.
Pregnancy can worsen OHSS.