In rare cases, worse symptoms can include severe abdominal pain, severe nausea or vomiting, decreased urination, dark-colored urine, shortness of breath, low blood pressure and excessive weight gain. Approximately 10 percent of patients undergoing IVF have mild OHSS, and less than 1 percent of patients need to be admitted to the hospital for severe symptoms. However, symptoms usually resolve spontaneously with the onset of the next period or shortly thereafter. If a patient is pregnant when OHSS hits, the symptoms may worsen and last approximately two to three weeks.
For more information, make an appointment with one of our reproductive endocrinologists. Request an Appointment Contact Us. If after receiving a hormone injection you develop any of the symptoms described above, you should notify our center immediately. Careful monitoring, decreased stimulation medication, taking pain medicine and drinking lots of fluids are recommended.
If there is fluid in the abdomen, drainage of fluid using a syringe paracentesis can provide significant relief in most cases. On occasion, more than one drainage is helpful. A medicine called cabergoline also can reduce the fluid accumulation. There is rarely a need for hospitalization. If OHSS does not improve with outpatient care, the woman may be treated in the hospital with close monitoring.
The doctor may order intravenous IV fluids and medicines for nausea and may remove fluid from the abdomen. Other supportive therapy may be given as needed.
Complications from OHSS can be severe. You may become dehydrated and pressure in your abdomen may increase from too much fluid. These problems can lead to blood clots forming within the blood vessels.
Blood clots can travel to your lungs or to other important organs. This can be potentially life-threatening. These complications can usually be avoided by recognizing the signs, symptoms, and laboratory evidence that OHSS is getting worse and getting appropriate treatment. OHSS symptoms usually appear a few days after ovulation.
It may be hard to tell when something is wrong versus just uncomfortable. Trust your instincts, but also try not to worry. Most cases of OHSS are mild. These symptoms typically develop about 1 to 2 weeks after injecting medications.
The timeline is individual, however, and some women may start symptoms later on down the line. Symptoms tend to range in their severity and may also change over time. Around 1 percent of women develop what is considered severe OHSS. Issues like blood clots, trouble breathing, and severe pain may lead to more serious complications, like an ovarian cyst rupture with excessive bleeding. Mild OHSS may go away on its own within a week or so.
If you get pregnant that cycle, the symptoms may persist a bit longer — more like a few days to a few weeks. Treatment of mild OHSS is conservative and involves things like avoiding strenuous exercise and increasing fluid intake to address dehydration.
You may want to take some acetaminophen for pain. Most importantly, your doctor may ask you to weigh and otherwise monitor yourself daily to track any potential worsening of the condition. Severe OHSS, on the other hand, often requires a hospital stay — and can be very dangerous even fatal if left untreated. Your doctor may decide to admit you to the hospital if:.
At the hospital, you may be given intravenous IV fluids to aid with hydration. In some cases, your doctor may want to alter your dose of fertility medication.
You may be placed on a blood thinner to prevent blood clots. Your doctor may also recommend paracentesis , which is a procedure that can remove excess fluid buildup in your abdomen. And there are certain medications you can take to calm down all that activity going on in your ovaries. While frustrating, your doctor may additionally recommend delaying your scheduled embryo transfer — essentially skipping your current treatment cycle. The good news is that you can freeze your embryos for transfer when you are symptom-free.
Related: The day guide to IVF success. Every case is unique, and your doctor will likely monitor you closely to decide how to proceed.
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