Any time someone is going through fertility treatments that involve the use of fertility drugs to increase follicle stimulation, they run a risk of developing Ovarian Hyperstimulation Syndrome (OHSS). OHSS occurs when too many follicles develop and the ovaries become enlarged.  While many people using fertility drugs report discomfort during the time of ovulation, those who experience OHSS report severe pain and discomfort among other symptoms and often end up in the hospital for treatment and monitoring.

The first thing that people want to know is what causes OHSS.  The truth is the exact cause is unknown.  Why one person develops it and someone else doesn’t is yet to be determined.  Why a person might develop it during one cycle and the same person does not develop it on a subsequent cycle is still a mystery.  All that is known is that the use of follicle stimulating fertility drugs puts you at risk of developing OHSS.

All that being said, there are some women who seem to be at higher risk than others.  Women who are under age 30, women who are underweight, women who have used hCG for support during the luteal phase, women with polycystic ovarian syndrome, women who have been administered a GnRh agonist, women who have had a previous occurrence of OHSS and women with a large number of eggs or follicles and high estrogen levels all are at a higher risk of developing OHSS.

The best way to treat or prevent OHSS is to monitor follicles through ultrasounds and hormones through blood work.  By comparing estrogen levels and follicle development, doctors can better predict if OHSS is a possibility.  If it appears that it is a possibility, doctors should not administer the hCG until they do subsequent tests.  If you are doing IVF, some doctors may opt to collect eggs, inseminate them and then freeze the embryos for a future IVF procedure using the frozen embryos.  There is also the possibility of stopping the gonadotropin stimulation while continuing to suppress the estrogen levels to make them decline and then doing the egg collection when the estrogen levels are at an appropriate level.  Doctors might also impose such restrictions as limiting or stopping any type of exercise, household activities such as vacuuming or sexual intercourse.

Since the only way a doctor can know whether or not you have OHSS is through monitoring you with blood work and ultrasounds, you need to be aware of the symptoms of the syndrome.  If you experience any of the following, you should report it immediately to your doctor: abdominal pain, diarrhea, nausea and vomiting, abdominal bloating, breathing problems, infrequent need to urine, dark urine or sudden weight gain.

The complications of OHSS can be severe and should not be taken lightly.  Although severe OHSS is rare, it can lead to permanent damage, injury or death.  There are many complications associated with OHSS.  A common complication is twisting of the swollen ovaries (ovarian torsion) that can result in the removal of your ovaries.  Other complications include fluid in the lungs and stomach, blood clots and loss of the functions of your liver and/or kidneys.

Although the exact cause of Ovarian Hyperstimuation Syndrome or OHSS is unknown, knowing the risk categories that you fall under and being aware of your body and how you feel during fertility treatments is important and careful monitoring by your doctor is essential.  Because the complications can be severe, it is always good to be one step ahead of OHSS to prevent ever developing one of them.  Even though the development of severe OHSS is uncommon, it is better to be safe and careful during your treatment to protect your health and to help with the success of the treatment.

This entry was posted on Sunday, July 23rd, 2006 at 6:48 pm and is filed under Fertility. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.