A. Ovarian hyperstimulation syndrome is a potentially serious complication of fertility treatment, particularly of in vitro fertilisation (IVF).
A. It is normal to have some mild discomfort after egg collection. If you are worried or develop any of the symptoms below, you should seek medical advice.
OHSS can range from mild to severe:
A. Fertility drugs, usually gonadotrophins, are used to stimulate the ovaries during IVF treatment to make eggs grow. Sometimes there is an excessive response to these drugs, leading to OHSS.
Overstimulated ovaries enlarge and release chemicals into the bloodstream. Fluid from the blood vessels leaks into your abdomen and in severe cases into the space around the heart and lungs. OHSS can affect the kidneys, liver and lungs. A very small number of deaths due to OHSS have been reported.
A. Mild OHSS is common in women having IVF treatment; affecting as many as 33 in 100 women (33%).
However, just over 1 in 100 women (1%) will develop moderate or severe OHSS.
The risk is higher in women who:
A.
If you become pregnant, OHSS can get worse and last up to a few weeks or longer.
A. If you have mild OHSS, you can be looked after at home.
Ensure that you drink fluids at regular intervals depending on how thirsty you feel.
If you have pain, take paracetamol or codeine (no more than the maximum dose).
You should avoid anti-inflammatory drugs (aspirin or aspirin-like drugs such as ibuprofen), which can affect your kidneys.
It is advisable to remain active to reduce the risk of thrombosis.
A. Call for medical help if you develop any of the symptoms of OHSS, particularly if the pain is not getting any better or if you start to vomit, have urinary problems or chest pain or have difficulty breathing.
A. Your doctor will ask you to describe your symptoms and will examine you. In addition, your doctor may:
A diagnosis is made on the basis of your symptoms, the examination findings and the results of your tests.
If you are well enough to go home, you may be advised to attend for regular check-ups.
A. Many women can be managed as outpatients but you may need admission if:
If you are vomiting, you may need a drip to replace the fluids you have lost. The fluid will help to keep you hydrated and may contain sugar and carbohydrates (for energy), and minerals and chemical elements (for regulating and maintaining the organs in your body).
It is important that, if you are admitted to a hospital which is not the one where you had your fertility treatment, your care is discussed and coordinated with a specialist in this condition.
A. Although there is no treatment that can reverse OHSS, it will usually get better with time. Treatment is to help symptoms and prevent complications.
This includes:
If your abdomen is tense and swollen because of fluid build-up, you may be offered a procedure known as a paracentesis. This is when a thin needle or tube is inserted under ultrasound guidance into your abdomen to remove fluid. You may be offered a local anaesthetic for this procedure. This treatment helps relieve discomfort and improve kidney function and your breathing. Rarely, advice may be sought from a more specialist team which may involve anaesthetists and/or intensive care doctors.
A. To lower the risk of developing a blood clot in your legs or lungs, you will be advised to continue wearing support stockings and taking heparin (blood-thinning) injections until 12 weeks of your pregnancy.
A. Your fertility clinic should provide you with full written information about your fertility treatment, including the risk of OHSS and a 24-hour help number.
A. The key points to remember are: