Tips to Prevent OHSS Syndrome (Ovarian Hyperstimulation) Before IVF

What Is Ovarian Hyperstimulation Syndrome?

OHSS Syndrome (Ovarian Hyperstimulation Syndrome) is a condition which occurs during the treatment of infertility through the In Vitro Fertilization (IVF) cycle. In this case, the ovaries over-response to the fertility drugs which are injected throughout the IVF process as a result ovaries are swollen and filled with excessive fluid that can cause serious complications in the fertility process. However, it is a temporary condition that can be managed with proper treatment.

What Are the Symptoms of OHSS?

The symptoms of OHSS range from mid to critical. These symptoms typically appear within 10 days of fertility medications.

• Mid OHSS Symptoms – Diarrhea, nausea, abdominal discomfort, and bloating
• Moderate OHSS Symptoms – Increases of abdominal swelling, moderate abdominal pain and vomiting
• Severe OHSS Symptoms – Rapid weight gain (more than 2 pounds in 24 hours), Shortness of breath, decrease urination, severe abdominal pain along with a high risk of blood clot
• Critical OHSS Symptoms – In rare cases, OHSS becomes life-threatening such as absence of urine, acute kidney failure, irregular heartbeats, blood clots in veins and arteries, suspension of fluid in lungs, and body sepsis.

What Drug Causes Ovarian Hyperstimulation?

Human Chronic Gonadotropin (hCG) is often used as a trigger shot to increase the fertility of ovulation in the process of IVF treatment. Ovarian hyperstimulation syndrome is typically caused by this stimulating injection. Other drugs such as gonadotropins (follicle-stimulating hormone FSH) and luteinizing hormone LH) also increase the risk of OHSS syndrome while used in high doses.

How Do You Treat OHSS?

The primary way to treat OHSS syndrome is cabergoline (a dopamin agonist) simultaneously with the hCG trigger shot. This medication can reduce the risk of developing OHSS syndrome as well as work as a preventive strategy. However, the best way to manage OHSS syndrome is to identify the risk before starting the fertility treatment. To get in-depth information on OHSS syndrome  click here to read a journal.

Another recommended OHSS treatment is to freeze-only cycle where all the embryos are frozen instead of transferring them immediately. This approach reduces the risk of OHSS syndrome in women who have high ovarian stimulation. Freezing the embryos can significantly reduce the risk from severe to moderate while supporting a successful pregnancy with OHSS syndrome.

How To Avoid Hyperstimulation In IVF?

During your IVF process, you can positively avoid OHSS syndrome by several strategies

1. Use of GnRH Antagonists: GnRH antagonist cycle is more advisable instead of GnRH agonist cycle because that has shown evident results to reduce the risk of OHSS syndrome.
2. Customized doses of Gonadotropin: Gonadotropin medication is used to stimulate egg production based on a woman’s ovarian reserve test can help prevent overstimulation rather than using standard doses for everyone.
3. Adding supplementing agents:  Starting with a lower dose of gonadotropins, or combining them with oral medications like clomiphene citrate or letrozole, can also reduce the chances of developing OHSS syndrome.

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What Are the Factors Related to OHSS Syndrome?

Women who are aligned with these conditions would be positive prospects for an OHSS

1. Baseline Characteristics: Young women who are diagnosed with Polysystic Overy Syndrome (PCOS) are more likely to experience hyperstimulation ovarian syndrome. Moreover, conditions such as Antral Follicle Count (AFC) is more than 24 or Anti- Mullerian Hormone (AMH) level is above 3.4 ng/mL are at high risk.
2. Stimulation-Related Factors: A large number of mature follicles at the time of ovulation are triggered (more than 17- 19) retrieving in highest number of eggs (more than 15-18)
3. Genetic Factors: There is insufficient evidence to confirm that genetic predisposition plays a significant role in developing OHSS syndrome.

FAQ:

How Long Does OHSS Syndrome Last?

Typically, it depends on the extent of fluid accumulation and its medical intervention. On an average the typical mild to moderate OHSS resolve 1-2 weeks.

How Many Follicles Are Considered Hyperstimulation?

Having more than 15-20 follicles.

Who Is at Risk Of OHSS Syndrome?

Women with PCOS, age under 35, women who have a high number of follicles, and those undergoing egg donation cycles are at higher risk of developing OHSS.

Does Hyperstimulation Affect Egg Quality?

No, in most cases it does not affect

Does OHSS Syndrome Cause Miscarriage?

As it causes many complications in early pregnancy, therefore, it leads to an increasing risk of miscarriage.

Does OHSS Syndrome Affect HCG Levels?

Yes, OHSS can elevate the hGC levels, as the condition is often triggered by hGC used in the fertility treatment.

Does OHSS Syndrome Delay Periods?

Yes, OHSS can delay your periods due to the hormonal imbalance, severity of the syndrome and individual factors.