Ovarian hyperstimulation syndrome affects those women who take injectable hormone medications. These are used in order to stimulate egg production and development from the ovaries while trying to conceive. Ovarian stimulation is needed for women before undergoing in vitro fertilization (IVF), intrauterine insemination or ovulation induction.
Rarely, ovarian hyperstimulation syndrome occurs when taking oral hormonal therapy or even spontaneously, not related to any fertility treatments. If there is too much hormone in your body, then ovarian hyperstimulation syndrome occurs, leading to swollen and painful ovaries. In only rare cases, severe ovarian hyperstimulation syndrome occurs.
It is characterized by rapid weight gain, abdominal pain, shortness of breath, nausea, and vomiting, etc.
Signs and symptoms of ovarian hyperstimulation syndrome
Signs and symptoms of ovarian hyperstimulation syndrome usually start within the first 10 days after using injectable hormonal therapy for ovarian stimulation. This is in order to increase the chances of conceiving among women who have problems with fertility. These signs and symptoms of ovarian hyperstimulation syndrome range from mild, moderate to severe.
Sometimes can get worse or even improve with time.
Mild to moderate signs and symptoms of ovarian hyperstimulation syndrome include:
• Abdominal pain, usually mild, moderate and rarely severe pain,
• Abdominal bloating,
• Tenderness around the ovarian area,
• Sudden weight gain within a very short time, etc.
In some cases, these signs and symptoms last only for about a week. If the woman achieves to conceive, these signs and symptoms may get worse and last for a couple of days and up to a couple of weeks.
Signs and symptoms of severe ovarian hyperstimulation syndrome include:
• Severe abdominal pain,
• Shortness of breath,
• Enlarged abdomen,
• Decreased urination,
• Extreme weight gain about 15 to 20 kg within a very short period of time, a week or less,
• Severe nausea,
• Severe vomiting,
• Blood clots in the lower extremities, etc.
In cases when you notice any of the above – mentioned signs and symptoms and you are taking fertility treatment as well, you should consult your doctor. You should do this especially in cases of severe signs and symptoms of ovarian hyperstimulation syndrome. Not every woman who takes fertility treatment develops ovarian hyperstimulation syndrome.
Certain women have an increased risk for this factor such as:
• Being under the age of 30 years old,
• Having had ovarian hyperstimulation syndrome in the past,
• Suffering from polycystic ovarian syndrome,
• Having a large number of follicles,
• Having a low body weight,
• Having high levels of estradiol before getting an HCG trigger shot, etc.
The certain woman once they develop ovarian hyperstimulation syndrome have the possibility of developing various complications. Complications occur in about 1 or 2% of all women who undergo ovarian stimulation and develop ovarian hyperstimulation syndrome.
Possible complications include:
• Breathing problems,
• Ovarian torsion,
• Electrolyte disturbances,
• Blood clots usually in lower extremities,
• Kidney failure,
• Fluid collection in the abdomen and sometimes even at the chest,
• Rupture of a cyst, leading often to severe bleeding,
• Pregnancy loss due to miscarriage,
• Termination of a pregnancy due to complications,
• In rare cases, even death may occur.
How is ovarian hyperstimulation syndrome diagnosed?
This syndrome is diagnosed based on:
• Physical examination,
• Blood test.
How is ovarian hyperstimulation syndrome treated?
In general, ovarian hyperstimulation syndrome resolves on its own within a couple of days. However, if a woman achieves to conceive, it might take longer than a week or two for these signs and symptoms to resolve. The goal of the treatment is to keep the affected woman comfortable. It is also to decreasing the ovarian activity and avoiding any possible complications which can be even life – threatening complications.
In cases of a mild to moderate ovarian hyperstimulation syndrome, recommended treatments are:
• anti – nausea medications,
• adequate fluid intake,
• daily weight measurements,
• frequent physical examinations,
• frequent ultrasound or sonogram examinations,
• blood tests to monitor the electrolyte balance, dehydration and the possibility of developing blood clots,
• a drainage of the excessive fluid from the abdomen or chests if collected, etc.
In cases of severe ovarian hyperstimulation syndrome, the affected woman needs to be hospitalized and closely monitored. Aggressive treatment is recommended until the signs and symptoms resolve. In some cases, gonadotropin – releasing hormone antagonists might be needed to suppress the ovarian activity.