Pacific Fertility Center

IVF and the Risk of OHSS

By Vicken Sahakian, M.D. on March 13, 2019

A woman's reproductive systemCountless people in the Los Angeles, CA have come to Pacific Fertility Center for in vitro fertilization (IVF), an effective treatment for male and female infertility. Thanks to our advance care techniques and patient-focused procedures, we have helped numerous patients start healthy, happy families.

While generally safe, there are some risks for people undergoing IVF. Ovarian hyperstimulation syndrome (OHSS) is one serious complication that could occur. Let’s consider what OHSS involves, why it happens, and what patients should look out for so it can be treated as soon as possible.

What Is Ovarian Hyperstimulation Syndrome (OHSS)?

Ovarian hyperstimulation syndrome (OHSS) is a condition that affects women using fertility drugs that promote higher levels of hormones that cause follicles in the ovaries to develop. The primary hormone to look out for is human chorionic gonadotropin (HCG), as high levels of HCG are linked to OHSS. It’s estimated that 1 to 2 percent of women who undergo any sort of ovarian stimulation experience OHSS.

When the ovaries are overstimulated, it can lead to ovarian pain and much more serious problems, including rapid weight gain, shortness of breath, and vomiting. If not treated, OHSS could prove fatal, which is why fertility specialists must always be mindful and observant about this condition arising.

Why OHSS May Occur During IVF

During IVF, women will receive fertility drugs and injections that stimulate and boost levels of certain fertility hormones in their bodies, HCG among them. These fertility drugs are meant to enhance the potential for success during IVF treatment, and ensure optimal timing of different phases in a woman’s cycle.

When hormone levels are too high or imbalanced, they can lead to a number of side effects and adverse conditions. OHSS is among them since HCG is essential during an IVF cycle.

Signs and Symptoms of OHSS

When a woman suffers from a mild case of OHSS, the common symptoms include:

  • Mild or moderate abdominal pain
  • Tenderness around the pelvis and ovary area
  • Bloating
  • Nausea
  • Vomiting
  • Diarrhea
  • Sudden weight gain exceeding 6 pounds

Mild OHSS will typically wear off after a week of being administered fertility drugs, but patients should inform their doctor immediately if they experience the above symptoms. The mild OHSS may persist for several weeks if the IVF cycle results in a successful pregnancy.

Severe cases of OHSS include the following symptoms:

  • Severe abdominal pain
  • Enlarged abdomen
  • Rapid weight gain of up to 40 pounds
  • Shortness of breath
  • Decrease need to urinate

If you experience any of the above symptoms of severe OHSS, be sure to speak with your doctor as soon as possible. Immediate medical attention is necessary.

Risk Factors for OHSS

Common risk factors associated with a heightened risk of OHSS include:

  • Polycystic ovary syndrome (PCOS)
  • Large number of follicles within the ovaries
  • Patient is younger than 30
  • Patient is underweight
  • High levels of estrogen before receiving HCG shot
  • Patient has past issues with OHSS

Treating OHSS

The right treatment for OHSS will depend on the severity of the condition.

Mild OHSS can be treated with the use of anti-nausea medication, pain relievers, and proper medical monitoring.

Severe OHSS will often require a patient to be be admitted into a hospital for professional monitoring and aggressive treatment of all symptoms. This may include IV drips and medications that are designed to suppress the activity of the ovaries. More advanced treatment may be necessary depending on how seriously the OHSS affect the patient.

Preventing OHSS

In order to prevent OHSS, our fertility doctors will be mindful of the patient’s medical history and make IVF adjustments as needed. This may include:

  • Altering or adjusting medications and fertility drugs used during IVF
  • Waiting a few days before administering HCG if estrogen levels are high or there are many developed follicles (coasting)
  • Not using an HCG trigger shot if OHSS risk is significant
  • Freezing viable eggs or embryos to reduce the need for another IVF cycle

Learn More About IVF Treatment

For more information about effective IVF treatment and how our team can help you, be sure to contact our team of experienced fertility doctors. We at Pacific Fertility Center are here to help. You can reach our office in Los Angeles at (310) 586-3458, and our office in Glendale at (818) 952-0328.

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