Ovarian hyperstimulation syndrome (OHSS) is a problem that is sometimes seen in women who take fertility medicines that stimulate egg production.
Normally, a woman produces one egg per month. Some women who have trouble getting pregnant may be given medicines to help them produce and release eggs.
If these medicines stimulate the ovaries too much, the ovaries can become very swollen. Fluid can leak into the belly and chest area. This is called ovarian hyperstimulation syndrome (OHSS). OHSS occurs only after the eggs are released from the ovary (ovulation).
You may be more likely to get OHSS if:
You receive a shot of human chorionic gonadotropin (hCG).
You get more than one dose of hCG after ovulation.
You become pregnant during this cycle.
OHSS rarely occurs in women who only take fertility drugs by mouth.
Mild cases of OHSS usually don't need to be treated. The condition may actually improve the chances of becoming pregnant.
The following steps can help you ease your discomfort:
Get plenty of rest with your legs raised. This helps your body release the fluid. However, light activity every now and then is better than complete bed rest, unless your doctor tells you otherwise.
Drink at least 10 to 12 glasses of fluid a day (especially drinks that contain electrolytes).
Avoid alcohol or caffeinated beverages (such as colas or coffee).
Avoid intense exercise and sexual intercourse. These activities can cause ovarian discomfort and may cause ovarian cysts to rupture or leak, or cause the ovaries to twist and cut off blood flow (ovarian torsion).
Take an over-the-counter pain reliever such as acetaminophen (Tylenol).
You should weigh yourself each day to make sure you are not putting on too much weight (5 or more pounds a day).
In the rare case that you develop severe OHSS, you will probably need to go to a hospital. The providers there will give you fluids through a vein (intravenous fluids). They will also remove fluids that have collected in your body, and monitor your condition.
Most mild cases of OHSS will go away on their own after menstruation starts. If you have a more severe case, it can take several days for symptoms to improve.
If you become pregnant during OHSS, the symptoms may get worse and can take weeks to go away.
In rare cases, OHSS can lead to life-threatening complications. These can include:
Severe electrolyte imbalance
Severe fluid buildup in the abdomen or chest
When to Contact a Medical Professional
Call your health care provider if you experience any of the following symptoms:
Less urine output
Excessive weight gain, more than 5 pounds (2kg) a day
Very bad nausea (you cannot keep food or liquids down)
Severe abdominal pain
Shortness of breath
If you are getting injections of fertility medicines, you will need to have regular blood tests and pelvic ultrasounds to make sure that your ovaries aren't over-responding.
Fauser BCJM. Medical approaches to ovarian stimulation for infertility. In: Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology. 7th ed. Elsevier Saunders; 2014:chap 30.
Daniel N. Sacks MD, FACOG, obstetrics & gynecology in private practice, West Palm Beach, FL. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.