Most occurrences of OHSS are minor and only cause little pain. Severe occurrences of the medical condition are uncommon, but they can be fatal.
Causes of Ovarian Hyperstimulation Syndrome
OHSS primarily develops due to specific factors associated with fertility treatments, when these treatments stimulate the production of multiple eggs at once. The primary causes of ovarian hyperstimulation syndrome are: 1. Elevated hCG Levels: OHSS commonly arises due to heightened levels of human chorionic gonadotropin (hCG), the pregnancy hormone. Fertility treatments have hCG to trigger the release of mature eggs. However, in some instances, the body’s response to hCG can be excessive and lead to the development of OHSS. 2. Fertility Medications: The use of fertility medications, mainly injectable hormones, to stimulate the ovaries into producing a larger number of eggs is a prevalent cause of OHSS. These medications can exaggerate ovarian response and culminate the syndrome. 3. Genetic Factors: In extremely rare cases, some individuals may possess genetic mutations in hormone receptors, causing them to be predisposed to OHSS without the use of hormonal treatments. These genetic elements can render the ovaries more susceptible to hormonal fluctuations.
Symptoms of Ovarian Hyperstimulation Syndrome
Ovarian Hyperstimulation Syndrome (OHSS) triggers within a week after injectable medications are administered to induce ovulation during fertility treatments. These symptoms of ovarian hyperstimulation syndrome can be mild to severe and fluctuate in intensity over time.
Mild to Moderate OHSS:
In cases of mild to moderate OHSS, individuals may experience:
- Mild to moderate abdominal pain
- Abdominal bloating or an increase in waist size
- Nausea
- Vomiting
- Diarrhoea
- Tenderness in the ovarian region
Severe OHSS:
Severe OHSS can have more serious symptoms, which can include:
- Rapid weight gain, exceeding 2.2 pounds (1 kilogram) in just 24 hours
- Severe abdominal pain
- Persistent and severe nausea and vomiting
- Formation of blood clots
- Reduced urination
- Shortness of breath
- An abdomen that feels tight or appears enlarged
Treatment of Ovarian Hyperstimulation Syndrome
If you are undergoing fertility treatment and begin to experience symptoms of OHSS, it is imperative to consult your healthcare provider for timely evaluation and management. The diagnostic process may involve the following procedures:
- Physical Exam: A physical examination can reveal weight gain and abdominal bloating signs. Monitoring your daily weight gain is essential for a more accurate diagnosis. Your doctor will also assess your belly for indications of severe bloating.
- Ultrasounds and X-rays: Imaging techniques such as ultrasounds and X-rays can help identify fluid accumulation in various body regions. OHSS escalates when fluid leaks into the abdomen and torso, leading to bloating and weight gain. Additionally, ultrasounds provide insights into the extent of ovarian swelling, often reflecting the severity of OHSS.
- Blood Tests: Blood tests are performed in conjunction with ultrasounds for individuals undergoing fertility treatment. These tests assess hormone levels, detect blood abnormalities, and evaluate the impact of swollen, leaking ovaries on kidney function. Regular blood tests can facilitate early OHSS detection, allowing for prompt intervention.
The type of treatment recommended depends on the severity of OHSS:
Mild OHSS:
Mild cases of OHSS often resolve on their own within approximately two weeks. Treatment for mild OHSS primarily focuses on alleviating discomfort and preventing complications. In most instances, treatment of Ovarian Hyperstimulation Syndrome or hospitalisation is unnecessary unless symptoms worsen.
Severe OHSS:
Severe OHSS cases may necessitate hospitalisation and more intensive treatments. Early intervention is vital in preventing severe complications. Treatment of Ovarian Hyperstimulation Syndrome includes:
- Intravenous (IV) fluids to address dehydration and electrolyte imbalances
- Medications to alleviate severe symptoms
- Medications to reduce ovarian activity
- Manual drainage of accumulated abdominal fluid using a syringe if significant leakage has occurred
Timely and appropriate treatment is essential in managing severe OHSS effectively and reducing the associated health risks.
Conclusion
Ovarian Hyperstimulation Syndrome is a potential complication of fertility treatments. While it can be uncomfortable and, in severe cases, life-threatening, early recognition and appropriate management are key to ensuring the best possible outcome. Patients and healthcare providers should work together to minimise the risk of OHSS and respond promptly if symptoms of ovarian hyperstimulation syndrome arise. If you suspect OHSS, seek medical attention immediately to receive the necessary care and support.
