IVF (IN VITRO FRTILIZATION)

Ovarian Hyperstimulation Syndrome (OHSS)
Complications in IVF treatment
Complications are very rare in IVF treatment other than the few listed below. Ovarian
hyperstimulation syndrome (OHSS) is one among them.
 
Multiple Pregnancy
 
Ovarian Hyperstimulation Syndrome (OHSS)
Some enlargement of the ovaries is normal during fertility drug treatment. With ovarian
hyperstimulation syndrome (OHSS), though, the ovaries become dangerously enlarged with fluid.
This fluid can leak in to the belly and chest area, leading to complications. But the majority of the
fluid doesn’t come from the follicles themselves. Most of it comes from blood vessels that are
“leaky” due to substances released from the ovary.
Once ovulation takes place, ovarian hyperstimulation syndrome (OHSS) can occur. If your doctor
suspects that you’re at risk, he may cancel your IVF treatment cycle. (Any fertilized embryos from
an IVF treatment cycle may be frozen and saved for use during a future cycle.) Or your doctor
may use medications to delay ovulation by a few days. She may prescribe a GnRH antagonist,
which will prevent the body’s natural LH surge, preventing or delaying ovulation.
Another option may be that your doctor may simply delay administering the hCG trigger shot, a
fertility drug that triggers ovulation. Delaying ovulation to lessen the risk of ovarian
hyperstimulation syndrome (OHSS) is sometimes referred to as “coasting.” This delay of a few
days can lower the risk and severity of ovarian hyperstimulation syndrome (OHSS), without
seriously decreasing your chances of successful pregnancy.
 
Symptoms of ovarian hyperstimulation syndrome (OHSS)
As noted above, ovarian hyperstimulation syndrome (OHSS) can only occur after ovulation has
taken place. Symptoms may occur a few days after ovulation or IVF egg retrieval or they may not
show up for a week or more after ovulation.
 
Mild symptoms include:
 Bloating
 Mild pain or discomfort in the abdomen
 Mild weight gain
 Mild nausea
 Diarrhea
 
More serious symptoms include:
 Rapid weight gain, more than 10 pounds in 3 to 5 days.
 Mild pain or discomfort in the abdomen
 Severe abdominal pain

 Severe bloating
 Severe nausea (so much that you can’t keep down any food or fluids)
 Dizziness
 Trouble with urinating
 Shortness of breath
 Rapid heartbeat
If you experience mild symptoms, you should contact your doctor as soon as possible, so he or
she can monitor the situation. If you experience any of the serious symptoms, contact your
doctor immediately.
 
Prevention and Treatment of Ovarian
Hyperstimulation Syndrome (OHSS)
While you take fertility drugs, your doctor should monitor your body’s response to the
medications with blood tests and ultrasounds. Rapidly increasing estrogen levels or ultrasounds
that show a large number of medium-size follicles, are all possible indicators of ovarian
hyperstimulation syndrome (OHSS) risk.
If you develop a mild case of ovarian hyperstimulation syndrome (OHSS), you probably won’t
need special treatment.
 
Here are some things you can do at home to feel better:
 Don’t overexert yourself; take it easy while you recover.
 While you shouldn’t overexert yourself, you should maintain some light activity. Total bed rest
can increase the risk of some complications.
 Put your feet up. This can help your body get rid of the extra fluid.
 Sex should be avoided until you feel better. Sexual activity may increase your discomfort, and in
the worst case scenarios, may cause ovarian cysts to leak or rupture.
 Do drink plenty of fluids, around 10 to 12 glasses a day.
Your doctor will give you instructions on what to watch for and when to contact him. If your
symptoms get worse, you should definitely let them know. She may ask you to weigh yourself
daily, to monitor weight gain. If you find yourself gaining 4 or more Kg per day, you should call
your doctor.
In rare cases, you may need to be hospitalized. Hospitalization may include receiving fluids
intravenously (through an IV), and they may remove some of the excess fluids in your belly via a
needle. You may also be kept in the hospital for careful monitoring until your symptoms lessen.
Usually, symptoms will decrease and go away once you get your period. If you get pregnant,
though, your symptoms may be prolonged, and it may take several weeks to feel completely
better. Pregnancy can also make the symptoms worse, so your doctor will want to monitor your
situation carefully.