Ovarian hyperstimulation syndrome

Diagnosis

The diagnosis of OHSS could be predicated on:

• Physical examination. Your doctor will check for any weight gain, waist circumference increases, and any potential stomach discomfort.
• A blood test. Your doctor can check for irregularities in your blood and determine whether OHSS is affecting your kidney function by ordering specific blood tests.
• An ultrasound. An ultrasound may reveal that you have OHSS if your ovaries are larger than normal and contain huge cysts filled with fluid where follicles should have formed. Your doctor will periodically do a vaginal ultrasound to assess your ovaries while you are on fertility medication.

Treatment

Ovarian hyperstimulation syndrome (OHSS) typically resolves on its own within a week or two, and it may take longer if you are pregnant. Treatment aims to ensure your comfort, reduce ovarian activity, and prevent complications.

For mild to moderate OHSS, treatment may include:

• Increased fluid intake.
• Regular physical exams and ultrasounds.
• Daily weigh-ins and waist measurements to monitor changes.
• Tracking daily urine output.
• Blood tests to check for dehydration, electrolyte imbalances, and other issues.
• Draining excess abdominal fluid using a needle inserted into the abdominal cavity.
• Medications to prevent blood clots (anticoagulants).

In cases of severe OHSS, hospitalization may be necessary for close monitoring and aggressive treatment, including intravenous (IV) fluids. Your healthcare provider may prescribe cabergoline to alleviate symptoms. Additional medications like gonadotropin-releasing hormone (Gn-RH) antagonists or letrozole (Femara) may also be used to suppress ovarian activity.

In severe cases with serious complications, surgical intervention may be required to address a ruptured ovarian cyst, or intensive care may be needed to manage liver or lung complications. Anticoagulant medications may be administered to reduce the risk of blood clots in the legs.