Ovarian Hyperstimulation Syndrome: Symptoms and Treatment

Ovarian hyperstimulation is called the response of these organs to the introduction of the drug and their increase. In this case, the body slightly changes various processes: blood thickens, capillaries and blood vessels become thinner, and the liquid hardly leaves the body. Unfortunately, this is not the biggest problem. If it develops, it will eventually lead to a syndrome, which will be much more difficult to cure.

Ovarian hyperstimulation syndrome today is a common pathology in many women, so each of them should know what symptoms and causes may contribute to the onset of the disease. The most important thing is that if you find any similar symptoms, you need to consult a specialist faster, otherwise the problem can cause great harm to the body.

What is OHSS

OHSS (Ovarian Hyperstimulation Syndrome) is a serious complication that can occur after an IVF procedure. The main reason that doctors who have already studied many details of this disease is highlighted is the introduction of an excessive amount of drugs into the female body necessary to stimulate ovulation.

The syndrome can manifest itself at any time. For example, before embryo transfer to the uterus or already after implantation.

Causes

Although modern medicine has reached a fairly high level, no one can definitely determine the possibility of ovarian hyperstimulation in a particular patient after the procedure, however. Every woman’s body will respond to changes in its own way, so preventing a problem right away will be quite difficult.

But even despite this, doctors have approved certain factors that most often contribute to the emergence and rapid development of the disease. For example, this list includes:

• predisposition to pathology at the genetic level in women with natural fair hair color up to 36 years (usually such patients are not prone to fullness);
• transferred polycystic ovary syndrome ;
• excessive activity of estradiol in the circulatory system;
• allergic reactions to drugs that have been confirmed recently.

Foreign scientists have put forward several more points related to the IVF procedure and the most common cases of the onset of the disease. So, they can provoke it:

• significant errors in the dosage of drugs;
• too low a woman's body weight (tendency to anorexia and the like);
• sudden negative reaction to some hormonal drugs;
• similar problems in the past.

Symptoms

When observing the following factors, we can confidently say that ovarian hyperstimulation syndrome develops. Symptoms will help to verify the exact presence of the problem only if at least half of the proposed list is observed:

1. In the initial stage, the patient will feel some heaviness and weakness. There will be swelling, pulling and sudden pain in the lower abdomen. The patient significantly increased urination.
2. With an average level of severity, nausea and vomiting are primarily observed, followed by diarrhea, bloating, and an increase in body weight.
3. A severe degree entails more serious changes - frequent shortness of breath, change in heartbeat. The patient may have hypotension, the abdomen is too enlarged.

Diagnostics

Only after conducting the necessary diagnostics will it become clear how to treat ovarian hyperstimulation syndrome in a particular patient. After all, the body of each person reacts to certain drugs differently.

As mentioned above, ovarian hyperstimulation syndrome in IVF is a fairly common problem. Her treatment will not be too simple, but it is not worth delaying an appeal to a doctor.

Standard diagnostics are based on the following factors:

• Analysis of all patient complaints. For example, with a sharp deterioration in well-being, she has frequent abdominal pain for no specific reason, an alternation of nausea and vomiting.
• A mandatory history of the disease, if the symptoms began to appear after the release of the egg from the ovary.
• Analysis of life history. Previous illnesses, the presence of various bad habits, similar cases of the development of the disease after the IVF procedure are taken into account.
• The results of a general examination by a gynecologist, palpation of the abdominal areas (the ovaries must be palpated).
• An ultrasound scan will accurately show enlarged ovaries, the presence of a fetus, and will also make it possible to detect excess fluid that has accumulated in the abdominal cavity.
• A thorough laboratory blood test. An excessive amount of sex hormones can be detected here, a general analysis will show the presence of areas of condensed blood, and biochemical - barely noticeable signs of changes in the functioning of the kidneys.
• Urinalysis (during the test, a decrease in urine, an increase in density, as well as the release of protein together with urine will be visible).
• Electrocardiography, and then ultrasound of the heart (this will detect some disturbances in cardiac function).
• Chest x-rays will show fluid in the inside of the chest, as well as in the pericardial sac.

Varieties

In medicine, there are two types of syndrome:

1. Early. It develops immediately after ovulation. In the event that pregnancy does not occur, this means the departure of the syndrome and the arrival of a new menstruation.
2. Late. It develops and makes itself felt only in the second or third month of pregnancy. In this case, ovarian hyperstimulation syndrome, the treatment of which will be difficult, is quite difficult.

In addition, there are three main degrees of disease severity:

1. Easy. Not too noticeable deterioration in well-being, some discomfort and swelling in the abdomen.
2. Medium. Abdominal pain, worsening, and swelling are more noticeable. Also, a feeling of nausea, vomiting is becoming more frequent. And in the abdominal cavity, fluid begins to accumulate.
3. Heavy. Severe deterioration of a person’s condition, weakness, very sharp abdominal pains are felt. The pressure decreases, shortness of breath appears due to accumulated fluid.

Treatment

In the case of a mild form, ovarian hyperstimulation syndrome (with IVF) treatment implies only as changes in the standard diet:

• You need to make a schedule for fluid intake and adhere strictly to it. It can be not only ordinary mineral water, but also green tea or homemade compote. Alcohol and carbonated drinks should be excluded.
• In food, eat not too fatty meat, vegetables and fish in a boiled state.
• Exercise should not be large, excessive overvoltage should also be avoided.

But the treatment of moderate and severe forms of the disease takes place exclusively in a hospital. Here the patient is constantly monitored (monitoring respiratory function, the work of the cardiovascular system, liver and kidneys). The patient is provided with therapy with drugs that reduce vascular permeability (antihistamines, corticosteroids, etc.), as well as drugs that reduce the risk of thromboembolism (Clexane, Fraxiparin, etc.).

Complications

Ovarian hyperstimulation syndrome can lead to some problems that also harm the patient's body. These include:

• fluid accumulation (sometimes up to 20 l) in the abdominal cavity;
• rupture of one ovary and severe bleeding;
• heart problems (when the muscle cannot function in a normal rhythm);
• exhaustion of two ovaries is premature.

How to avoid a problem

Before a woman finally decides on an IVF procedure, doctors should definitely consider all possible preventive measures:

1. To cancel the introduction of a specific ovulatory dose of a drug that is used during the procedure.
2. For some time, cancel the embryo transfer and subsequent transfer to the uterus during the next menstruation.
3. As much as possible to get rid of cysts, as well as follicles, which constantly appear during the period of stimulation.

There are many opinions on how to prevent ovarian hyperstimulation syndrome. Reviews of such a plan can be found on various forums on the Internet, but nevertheless, to save health it is not enough just to listen to other people. You need to be aware of the seriousness of the situation and if any symptoms appear, you should rather consult a doctor.

Prevention

In addition to the basic methods listed above, there are other methods of prevention. Their action will be much more effective for some patients. After all, women who want to have a baby carefully monitor their own health so that their fetus does not have any problems.

Prevention of ovarian hyperstimulation syndrome is as follows:

1. The dosage of any medicine must be checked.
2. The dose of gonadotropins can be reduced if this does not harm the desired result after the procedure. With a successful dose reduction, you can be sure almost one hundred percent that the disease has already been avoided.
3. After passing all the tests and passing the required procedures, the doctor can conclude about the possibility of freezing the embryo. It will also play an important role in avoiding the problem.

Who is in danger?

It is impossible to accurately guess who is at risk of developing the disease. But there are the most frequent cases in which ovarian hyperstimulation syndrome manifested itself. Among them is a small body weight of a girl or woman who decided to carry out the procedure, as well as a patient with cystic or polycystic ovary (this can be a disease in the present tense or already experienced in the past).

Medicine at the modern level has achieved many successes, but nevertheless, it still cannot reach ideal results. Therefore, before the in vitro fertilization procedure, no doctor can guarantee the absence of the disease after IVF. But if you notice its development in the first stages, then the treatment will not be too long.