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Ovarian hyperstimulation syndrome is an exaggerated response to excess hormones. It usually occurs in women who take injectable hormonal drugs to stimulate the development of eggs in the ovaries. Ovarian hyperstimulation syndrome (OHSS) causes swelling and pain in the ovaries.
OHSS can occur in women undergoing in vitro fertilization (IVF) or ovulation induction with injectable drugs. OHSS is less common during fertility treatments with oral medications such as clomiphene.
Treatment depends on the severity of the condition. OHSS may improve on its own in mild cases, while hospitalization and additional treatment may be required in severe cases. Ovarian hyperstimulation syndrome Treatment in Hyderabad
Ovarian hyperstimulation syndrome symptoms often begin within a week of using injectable drugs to stimulate ovulation, although it can sometimes take two weeks or more for symptoms to appear. Symptoms can be mild to severe, and they can work or get better over time.
Mild to moderate OHSS
The following symptoms may occur in mild to moderate ovarian hyperstimulation syndrome:
- Mild to moderate abdominal pain
- Abdominal bloating or enlarged waist
- Tenderness in the area of your ovaries
The cause of ovarian hyperstimulation syndrome is not fully understood. It does play a role that high levels of human chorionic gonadotropin (HCG) – a hormone typically produced during pregnancy – are introduced into your system. The ovarian blood vessels respond abnormally to HCG and begin to leak. This fluid swells the ovaries and sometimes large amounts travel to the abdomen.
During fertility treatments, HCG can be given as a “trigger” for a mature follicle to release its egg. OHSS usually occurs within a week of receiving an HCG injection. If you become pregnant during a course of treatment, OHSS can work when your body begins to make its own HCG in response to pregnancy.
Injectable fertility drugs are more likely to cause OHSS than treatment with clomiphene, a pill-type drug that you take orally. Sometimes OHSS occurs spontaneously regardless of fertility treatments.
Sometimes OHSS occurs in women with no risk factors. Factors known to increase your risk for OHSS include:
- Polycystic Ovary Syndrome – a common reproductive disorder that causes irregular periods, excessive hair growth, and an abnormal appearance of the ovaries on ultrasound
- Large number of follicles
- Under 35
- Low body weight
- High or rising levels of estradiol (estrogen) before an HCG trigger
- Previous episodes of SHO
To reduce your chances of developing ovarian hyperstimulation syndrome, you need a personalized plan for your fertility medication. Expect your doctor to carefully monitor each cycle of treatment, including frequent ultrasounds to check for follicular development and blood tests to check your hormone levels.
Strategies for preventing OHSS include:
- Adjust the medication. Your doctor will use the lowest possible dose of gonadotropins to stimulate your ovaries and induce ovulation.
- Adding medication. Certain medications seem to reduce the risk of OHSS without affecting the chances of pregnancy. These include low-dose aspirin; Dopamine agonists such as carbergoline or quinogloid; and calcium infusions. Taking the drug metformin (Glumetza) while the ovaries are being stimulated may help prevent overstimulation in women with polycystic ovarian syndrome.
- Cabotage. If your estrogen levels are high, or if you have a large number of developed follicles, your doctor may ask you to stop taking the injectable drugs and wait a few days before giving HCG, which will trigger ovulation. This is called cabotage.
- Avoid using an HCG trigger shot. Because OHSS often develops after an HCG trigger shot, alternatives to HCG for triggering using Gn-RH agonists such as leuprolide (Lupron) have been developed to prevent or limit OHSS. Ovarian hyperstimulation syndrome Treatment in Hyderabad