Ovarian Hyperstimulation Syndrome: Causes, Risk Factors, Symptoms, Diagnosis and Treatment


Ovarian hyperstimulation syndrome, abbreviated as OHSS, occurs in some women who use fertility medications. These medications may cause swelling and fluid leakage from the ovaries if they overstimulate them, though the symptoms only occur after ovulation. MedlinePlus, a service of the US National Library of Medicine and the National Institutes of Health, points out that 10 percent of women who undergo in vitro fertilization suffer from OHSS. The MayoClinic adds that less than 2 percent of women have more severe OHSS.

Causes of Ovarian Hyperstimulation Syndrome

Gonadotropins, a hormonal drug used for controlled ovarian stimulation, are most likely to cause OHSS. This medication may contain luteinizing hormone (LH), follicle-stimulating hormone (FSH), human menopause gonadotropin (hMG) or human chorionic gonadotropin (HCG). LH triggers ovulation and supports egg maturation, while FSH stimulates the follicles, which are the location of egg maturation. HCG causes the release of the egg from the follicle, and hMG contains both LH and FSH.

Ovarian Hyperstimulation Syndrome Risk Factors

Women who have certain conditions have a higher risk of developing OHSS. For example, women who have polycystic ovary syndrome, a condition in which women have multiple small cysts in their ovaries, have an increased risk of OHSS. Women who are younger than age 35 or a low body weight also have a higher risk. Other risk factors for OHSS include a large number of follicles and very high estrogen levels while in fertility treatment.

Symptoms of Ovarian Hyperstimulation Syndrome

Most women have mild OHSS. Symptoms of mild OHSS include abdominal bloating, weight gain, mild pain in the abdomen, mild nausea, diarrhea and tenderness. These symptoms can start three to 10 days after using the medication. While less common, some women can have severe OHSS. Women with severe OHSS can have shortness of breath, severe pain or swelling in the abdomen, decreased urination, dark urine, dizziness, nausea, vomiting and a tight abdomen. Weight gain can occur with severe OHSS, in which the woman gains 10 or more pounds within a period of three to five days.

Ovarian Hyperstimulation Syndrome Diagnosis

Doctors diagnose OHSS based on the symptoms displayed. OHSS can also be detected with a vaginal ultrasound exam, which the doctor uses during the fertility treatment. The image created by the vaginal ultrasound will show if the ovaries are swollen, an indicator of OHSS. MedlinePlus adds that other possible tests used to confirm the diagnosis of OHSS include a liver function test, chest x-ray, urine output test, complete blood count and electrolytes panel.

Treatment of Ovarian Hyperstimulation Syndrome

MedlinePlus notes that mild OHSS does not need to be treated, though women can reduce their discomfort with at-home option. For example, patients should drink 10 to 12 glasses of fluid a day, including beverages that contain electrolytes. For the pain, patients can take acetaminophen. Patients should avoid alcohol, caffeine, exercise and sexual intercourse. OHSS patients should rest, keeping their legs elevated. With severe OHSS, patients are hospitalized and receive intravenous fluids.


MayoClinic.com: Ovarian Hyperstimulation Syndrome (OHSS)


MedlinePlus Medical Encyclopedia: Ovarian Hyperstimulation Syndrome (https://www.nlm.nih.gov/medlineplus/ency/article/007294.htm)