ovarian hyperstimulation syndromeAll women who undergo ovarian stimulation during an IVF treatment, experience enlargement of their ovaries and a complex change in their hormone balance.
For up to 4% of women this can be quite unpleasant with abdominal bloating and pelvic discomfort. However, for 1% of stimulated women, the abdominal pain and fluid retention is so severe that admission to hospital is necessary. This problem, labelled the "Ovarian Hyperstimulation Syndrome" (OHSS), usually presents a couple of days after embryo transfer.
Treatment requires:
- correcting the fluid imbalances with an intravenous drip;
- relieving pain for which injections of pethidine are often necessary; and
- injections of heparin to counter the tendency of the blood to clot abnormally.
 Fortunately this condition usually corrects itself. It usually resolves after several days, with a natural excretion of the abnormal accumulation of fluid, however it may persist for weeks, especially if a pregnancy has been achieved. Later the pregnancy can be expected to proceed normally.
However on rare occasions very serious complications have been associated with the OHSS:
- The abnormal blood clotting has caused strokes;
- Blood clots have migrated to the lungs, a complication which can be life threatening;
- The enlarged ovaries can twist or bruise, requiring surgery;
- The weeping of fluid into the abdomen may be accompanied by a similar collection of fluid around the lungs and heart, interfering with their proper function;
- The liver or kidneys may stop working effectively.
Women contemplating ovarian stimulation should be aware that the procedure carries risks that are comparable with the risks of elective surgery.
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