IVF Side Effects - OHSS

Normal conception takes place within a woman's body. The woman ovulates, the sperm attaches and penetrates the egg, thereby fertilizing it, and the egg moves into the prepared uterus where it implants and grows. In nine months (or 42 weeks), if all goes well, a baby is born. This process is known as natural conception or unassisted conception.

When IVF Is Necessary

Sometimes, things don't go according to nature and help is necessary in order to procreate. IVF, in vitro fertilization, is a method of assisted reproduction technology (ART) that helps a woman become pregnant when natural conception doesn't work. There are many different types of ART. IVF is one of many; however, it is also one of the more expensive methods as well. The procedure of IVF is performed to treat various types of infertility:

· When a woman is advanced in age (after 35)

· When a fallopian tube is damaged or blocked by disease (PID) or surgery

· Endometriosis

· Male factor infertility, including low sperm count and blockage

· Unexplained infertility

Top IVF Risks

As with all types of invasive procedures, there are risks involved. IVF is a huge commitment of time, money, energy, emotion, and physical stamina. Some of the risks revolve around stress and depression; others concern the medications and procedures that are necessary. There are risks with egg retrieval that include reactions to anesthesia, bleeding and infection, as well as organ damage. A multiple pregnancy is a high risk for women who have more than one embryo transferred to the womb and carrying a multiple pregnancy can also be risky.

OHSS - What It Is

Sometimes, in response to the ovarian stimulation necessary to encourage the ovaries to release more than one egg at a time, the woman's body reacts to the medications and to the process itself. When this happens, a condition known as ovarian hyperstimulation syndrome (OHSS) can occur.

Normally, a woman produces one egg a month from one of her ovaries. When she undergoes IVF, medications are often given to help the ovaries produce more eggs in a month than usual. The drugs are called ovarian stimulation drugs and if they stimulate the ovaries too much, then the ovaries react by becoming very swollen. They leak fluid into the belly and the chest from the follicles (fluid filled sacs that contain the eggs). This condition is a potential complication from almost any fertility drug. Usually the reactions are quite mild, but they can be very severe as well. The condition is called ovarian hyperstimulation syndrome (OHSS) and it is an IVF side effect. OHSS occurs only after ovulation, when the eggs are released from the ovary.

Risk Factors for OHSS

A shot of human chorionic gonadotropin (hCG) will likely exacerbate this condition and the risk increases if more than one dose of hCG is administered after ovulation and pregnancy occurs. OHSS is generally considered an IVF side effect of injected hormones and drugs. One in ten women undergoing IVF will experience some degree of OHSS.

Additional risk factors for OHSS include:

· Being younger than 35 years of age

· A very high level of estrogen while undergoing fertility treatments


The symptoms of OHSS can range from mild to very severe. Most women have mild to moderate cases of OHSS and have symptoms such as:

· Abdominal bloating

· Mild pain in the abdomen

· Weight gain

When the symptoms are more severe, they present as:

· Significant and fast weight gain of 3 to 5 pounds within a few days

· Severe spin or swelling in the belly area

· Decreased urination

· Shortness of Breath

· Fatigue

· Very enlarged ovaries

· Dehydration

· Fluid collecting in the belly and lungs, and in extreme cases

· Blood clot leading to kidney failure

Severe Cases of OHSS

A severe case of OHSS will elicit the immediate monitoring and oversight of a doctor and quite likely a hospital stay. If a hospital stay is necessary, the belly will be measured and several tests will be administered to determine the woman's condition. An ultrasound, either abdominal or vaginal, or both; chest x-ray; complete blood count; electrolyte panel; liver function test; and urine output tests are all necessary to gain information about the OHSS.

In most cases hospitalization is not necessary for treatment and by following some basic guidelines, the condition can be alleviated.

· Lots or rest with legs raised to allow the release of fluid. Unless instructed otherwise, some light activity is suggested.

· Drink at least 10 to 12 glasses of fluid, preferably containing electrolytes.

· No alcohol or caffeine (soda pop, coffee)

· Avoiding intense exercise and sexual intercourse that can cause ovarian discomfort

· An OTC pain reliever to manage pain

· Weighing in daily to ensure there is no weight gain exceeding 5 pounds per day

Most mild cases of OHSS go away on their own after menstruation begins. A more serious case can take a few days to dissipate. If a woman becomes pregnant during OHSS, the symptoms can become aggravated and it takes much longer for this IVF side effect to go away.

Find out what other risk factors and side effects are associated with IVF here.

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