Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian Hyperstimulation Syndrome (OHSS) is one of the more serious complications of IVF.

OHSS is caused by a high amount of hormones in the system, leading to swollen or painful ovaries. This can happen within 10 days of starting IVF injectable medications. Fluid can leak and build up in the ovaries due to human chorionic gonadotropin (HCG) being produced in excess.

Symptoms of OHSS

Mild – Moderate OHSS

Mild abdominal pain

Bloating

Nausea or vomiting

Diarrhea

Tender ovaries

Sudden weight gain of over 5lb (2.7kg)

Moderate – Severe OHSS

Rapid, large weight gain of over 30 lbs (14kg)

Severe abdominal pain

Shortness of breath

Severe, persistent nausea and vomiting

Decreased urination

Tight, enlarged or bloated abdomen

Only 5.5% of women get severe OHSS, but this can require hospitalization to drain excess fluid in the body.[1]

While studies have called for more in-depth treatment prevention or management[2][3], there are a few current ways, such as:

Adjusting medications and medicines
Avoiding an HCG trigger
Doing a freeze-all cycle[4]

OHSS is possible in any IVF case, but may be a higher possibility in cases with PCOS or many eggs created or taken during retrieval. Ask your doctor if you have any more questions or concerns.

[1] Delvigne, A., and Serge Rozenberg. 2002. “Epidemiology and Prevention of Ovarian Hyperstimulation Syndrome (OHSS): A Review.” Human Reproduction Update 8 (6). Oxford University Press: 559–77. https://doi.org/10.1093/humupd/8.6.559.

[2] Delvigne, A., and Serge Rozenberg. 2003. “Review of Clinical Course and Treatment of Ovarian Hyperstimulation Syndrome (OHSS).” Human Reproduction Update 9 (1). Oxford University Press: 77–96. https://doi.org/10.1093/humupd/dmg005.

[3] Golan, Abraham, and Ariel Weissman. 2009. “A Modern Classification of OHSS.” Reproductive BioMedicine Online 19 (1). Elsevier: 28–32. https://doi.org/10.1016/S1472-6483(10)60042-9.

[4] “Ovarian Hyperstimulation Syndrome.” 2017. Mayo Clinic. 2017. https://www.mayoclinic.org/diseases-conditions/ovarian-hyperstimulation-syndrome-ohss/symptoms-causes/syc-20354697.