As the name implies, OHSS is when a woman’s ovaries respond with symptoms of a massive influx of hormones. The condition almost exclusively presents as a result of hormone therapy related to fertility treatments. In most cases, excessive exposure to human chorionic gonadotropin (hCG) is the primary culprit. Women with OHSS may experience various symptoms, such as bloating, nausea, vomiting, diarrhea, pain near the ovaries, and abdominal pain. More severe cases can include weight gain, serious pain, poor urination, blood clots, abdominal swelling, and even difficulty breathing.
Why is OHSS linked to IVF?
Many ART treatments often leverage ovarian stimulation. However, in vitro fertilization (IVF) requires egg retrieval if a couple wants to use the woman’s eggs. The process relies on hCG to stimulate the ovaries to produce multiple eggs versus the single release that naturally happens during ovulation. To optimize success rates, IVF attempts to retrieve several eggs simultaneously. OHSS doesn’t occur in all fertility cases but is quite common. The following tips can reduce the likelihood of the condition occurring.
1. Consider safeguarding medications
Ovarian hyperstimulation syndrome doesn’t have to be an inevitable side effect for women undergoing fertility treatment. Consider incorporating medications that act as a safeguard against developing more serious side effects. For example, certain nonsteroidal anti-inflammatory drugs (NSAIDs) can counteract some OHSS problems at low doses. Women with polycystic ovarian syndrome (PCOS) might opt to include antihyperglycemic drugs along with hormone therapy. Meanwhile, calcium infusions can also help. A fertility specialist will be able to make recommendations on what medication may be helpful.
2. Adjust levels as needed
Not all IVF participants need the full-strength version of hormone treatments. Individuals concerned about OHSS can consider asking a fertility specialist about adjusting the dosage. Likewise, pay attention to hormone monitoring. If estrogen levels are high, ask if the fertility specialist would consider “coasting.” The term refers to the option of ceasing hormone injections until the time has arrived for the trigger shot.
3. Rethink the trigger shot
Carefully timed for a certain part of the cycle, the trigger shot is the catalyst that activates the ovaries to begin releasing the eggs. Typically, the injectable contains human chorionic gonadotropin. However, new alternatives are available that don’t rely on this hormone. Instead, an agonist or drug is used to encourage egg release. Sometimes, a physician may decide that a trigger shot isn’t needed at all or may recommend swapping out the traditional version for the agonist alternative.
Is OHSS inevitable?
While no physician can predict whether or not a woman will experience OHSS from hormone treatments, taking a proactive approach is essential. Be an involved patient and inform the doctor immediately if any OHSS symptoms occur so prompt action can be taken.