How to Treat OHSS in Adult Women

Ovarian hyperstimulation syndrome (OHSS) is a problem that is known to occur in women who are using the fertility medications for the stimulation of egg production. Being part of assisted conception methods, ovulation induction could come along with a number of problems- OHSS is the most serious consequences of the process.

The problem may occur upon ovary stimulation into superovulation through the use of drugs like the HCG (human chorionic gonadotropin) or the human menopausal gonadotropin. Ovarian hyperstimulation syndrome is an acute inflammatory condition that comes with increased levels of the CRP (C-reactive protein). This is where the ovaries may form 20 or more follicles thus swelling due to high levels of the hCG serum resulting into unusual levels of estrogen production.

Types of OHSS

The problem can be categorized as mild, moderate, or severe and life-threatening. The classifications are as outlined below with their features:

• Mild OHSS
• Mild abdominal pains
• Abdominal bloating
• The size of the ovary is less than 8cm
• Moderate OHSS
• Moderate abdominal pain
• Ovarian size between8 and 12 cm
• Ascites evident through ultrasound
• Nausea and vomiting
• Severe OHSS
• Oliguria
• Hypoproteinaemia
• Clinical ascites
• Ovary size above 12cm
• Haemoconcetration above 45%
• Critical OHSS
• Oligo-anuria
• Thromboembolism
• Acute respiratory distress syndrome
• Tense ascites
• Haematocrit above 55%

What causes OHSS?

Women, normally, release a single egg every month. In some cases, women with troubles getting pregnant could be given some medicines to aid them in producing eggs. The medication could stimulate the ovaries too much thus making them to swell and fluid leaking into the belly and the chest area. This often occurs after the ovulation- it is known as the ovarian hyperstimulation syndrome (OHSS).

OHSS is likely to occur if:

• You have been given a shot of human chorionic gonadotropin (hCG)
• You get pregnant during this cycle
• You are given more than a dose after ovulation

Other risk factors that could lead to OHSS include:

• If you are aged below 35 years
• If you have polycystic ovarian syndrome
• In case of high levels of estrogen during fertility treatment

Common symptoms

The signs of this problem could range from mild to severe.

Mild symptoms include:

• Weight gain
• Abdominal bloating
• Mild abdominal pain
• Diarrhea
• Mild nausea

Severe symptoms include:

• Dizziness
• Rapid heartbeat
• Difficulties urinating
• Breath shortness
• Serious bloating
• Serious abdominal pains
• Swelling in the belly area

Diagnosis

The doctor should carefully monitor the symptoms by observing the belly area as well as the abdominal size. Diagnosis tests and examinations include:

• Electrolytes panel
• Vaginal or abdominal ultrasound
• Testing the liver function
• Measuring the urine output
• Complete blood count
• Chest x-ray

Medication

Your healthcare giver should carefully observe the body’s response to the treatment while under the fertility doses. In case the OHSS problem is developing, you require treatment as soon as possible. Some of the practices to help you in treating the condition include:

• Drinking enough water daily
• Avoiding alcohol; or even caffeinated drinks
• Enough rest with legs raised
• Limiting intense exercise and sexual intercourse
• Taking over-the-counter painkillers

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