OHSS Guidelines

OHSS (Ovarian Hyperstimulation Syndrome) – What It Is, Risks, and What to Do

What is OHSS?

Ovarian Hyperstimulation Syndrome (OHSS) is a complication that develops as a result of excessive stimulation of the ovaries, leading to an imbalance in fluid regulation. It typically occurs during IVF treatment.

How Does It Develop?

High hormone levels increase vascular permeability, causing fluid to leak out of the blood vessels. This leads to fluid accumulation in the abdomen (ascites) and bloating.

Types of OHSS

• Mild: Bloating, mild pain
• Moderate: Nausea, vomiting, significant bloating
• Severe: Shortness of breath, rapid weight gain, severe fluid accumulation

Risk Factors

• High AMH
• Polycystic ovary syndrome (PCOS)
• Young age
• Development of many follicles
• High estradiol level

Symptoms

• Abdominal bloating and pain
• Rapid weight gain
• Nausea, vomiting
• Shortness of breath
• Decreased urine output

When Does It Start?

It usually starts within a few days after egg retrieval. If pregnancy occurs, it may last longer.

Prevention Methods

• Use of antagonist protocol
• GnRH agonist trigger
• Freeze-all (postponing embryo transfer)
• Low-dose stimulation

Treatment Approach

• Rest and fluid monitoring in mild cases
• Close monitoring in moderate cases
• Hospital treatment in severe cases

What to Do at Home

• Drink plenty of fluids
• Daily weight monitoring
• Protein-rich diet
• Monitoring symptoms

When Is It an Emergency?

• Rapid weight gain (>2 kg/2 days)
• Severe abdominal pain
• Shortness of breath
• Decreased urine output

Clinical Fact

With the correct protocol and monitoring, OHSS can largely be prevented.

Conclusion

OHSS is a serious but preventable complication. Early diagnosis and proper management are vital.