When undergoing IVF or fertility treatments, one term that often worries women is Ovarian Hyperstimulation Syndrome (OHSS). It’s a condition that can occur when the ovaries over-respond to fertility medications used during assisted reproductive techniques such as IVF or ICSI. While it can sound alarming, understanding its causes, prevention, and treatment can help you stay informed and confident throughout your fertility journey.
At Medfemme Women’s Clinic, Hauz Khas, we believe that awareness is the first step toward safe fertility care. Here’s everything you need to know about Ovarian Hyperstimulation Syndrome (OHSS).
What is Ovarian Hyperstimulation Syndrome (OHSS)?
Ovarian Hyperstimulation Syndrome is a medical condition where the ovaries become swollen and painful due to an excessive response to fertility hormones—particularly human chorionic gonadotropin (hCG) and gonadotropins. These hormones are used to stimulate egg production, but in some women, the ovaries release too many eggs, leading to fluid leakage and swelling in the abdomen.
OHSS can range from mild to severe:
- Mild OHSS: Abdominal bloating, mild pain, and nausea
- Moderate to severe OHSS: Rapid weight gain, shortness of breath, and fluid accumulation in the chest or abdomen
Although most cases are mild and self-limiting, severe OHSS can require hospitalization.
Why Does OHSS Happen?
OHSS develops primarily due to an exaggerated reaction of the ovaries to fertility medications. Women undergoing IVF (In Vitro Fertilization) are often prescribed hormonal injections to stimulate egg development. Sometimes, this stimulation leads to:
- Rapidly growing ovaries
- Increased capillary permeability (leakage of fluid into the abdomen)
- Elevated estrogen levels
Who Is at Higher Risk?
Some women are more likely to develop Ovarian Hyperstimulation Syndrome than others. The major risk factors include:
- Polycystic Ovary Syndrome (PCOS)
- High number of developing follicles
- Younger age (<30 years)
- Low body weight
- Previous history of OHSS
- High estrogen levels during IVF cycles
Symptoms of Ovarian Hyperstimulation Syndrome (OHSS)
Recognizing early symptoms of OHSS is crucial for timely management. Symptoms typically appear within 7–10 days after the hCG trigger injection or egg retrieval.
Mild Symptoms
- Bloating or abdominal discomfort
- Mild nausea or vomiting
- Tenderness in the ovaries
Moderate to Severe Symptoms
- Rapid weight gain (more than 2–3 kg in a few days)
- Difficulty breathing or shortness of breath
- Swelling in the abdomen or legs
- Reduced urine output
- Severe abdominal pain
If you experience any of these symptoms after IVF, contact your fertility specialist immediately.
Prevention: How to Reduce the Risk of OHSS
The best way to manage Ovarian Hyperstimulation Syndrome is through prevention and careful monitoring during IVF treatment. At Medfemme Women’s Clinic, our specialists take several precautions to minimize the risk:
1. Individualized Stimulation Protocols
Not every woman requires the same medication dose. Your doctor will tailor the IVF protocol based on your ovarian reserve, hormone levels, and previous response to stimulation.
2. Using GnRH Agonist Trigger Instead of hCG
Replacing the traditional hCG trigger with a GnRH agonist can significantly reduce the risk of OHSS in high-risk patients.
3. Freeze-All Strategy
If estrogen levels rise too high during stimulation, all embryos can be frozen instead of transferring them immediately. This allows the ovaries to recover before embryo transfer.
4. Close Monitoring
Regular ultrasounds and blood tests help track follicle growth and hormone levels, ensuring any early signs of OHSS are detected and managed promptly.
Treatment for Ovarian Hyperstimulation Syndrome
If OHSS develops, the treatment depends on its severity.
Mild OHSS
- Rest and hydration
- Avoiding strenuous activity
- Over-the-counter pain relief under medical supervision
Moderate to Severe OHSS
- Hospital admission for fluid management
- Monitoring urine output and kidney function
- Paracentesis (draining abdominal fluid if necessary)
- Stopping or delaying embryo transfer until recovery
Common Questions About Ovarian Hyperstimulation Syndrome
Is Ovarian Hyperstimulation Syndrome dangerous?
In most cases, OHSS is mild and resolves naturally. Severe forms, though rare, can lead to serious complications if untreated.
Can OHSS affect my fertility?
No, when managed properly, Ovarian Hyperstimulation Syndrome does not affect long-term fertility or future IVF success.
Can I prevent OHSS completely?
While complete prevention isn’t always possible, early identification and customized treatment protocols can drastically reduce the risk.
Conclusion
Ovarian Hyperstimulation Syndrome (OHSS) is one of the most discussed complications of IVF treatment—but with expert monitoring and early detection, it is completely manageable. If you’re planning fertility treatment or are concerned about OHSS, book a consultation with Medfemme Women’s Clinic, Hauz Khas, for safe, personalized care.
