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Ovarian hyperstimulation syndrome is a disease that may appear in patients prepared for IVF surgery. When the stimulation of the ovaries gets out of hand, a number of disorders can develop that threaten a woman's life. What is ovarian hyperstimulation syndrome? What are its causes and symptoms? How is this condition treated?

Ovarian hyperstimulation syndrome( OHSS- ovarian hyperstimulation syndrome) is a complication afterinfertility treatmentand preparations for the procedurein vitro . If ovulation is overstimulated during any of these therapies, a number of disorders may develop that threaten a woman's life.


  1. Ovarian Hyperstimulation Syndrome: Causes
  2. Ovarian Hyperstimulation Syndrome: Risk Factors
  3. Ovarian Hyperstimulation Syndrome: Symptoms
  4. Ovarian hyperstimulation syndrome: diagnosis
  5. Ovarian Hyperstimulation Syndrome: Treatment

Ovarian Hyperstimulation Syndrome: Causes

The cause of the ovarian hyperstimulation syndrome is the excessive stimulation of ovulation with the use of various hormonal preparations (including gonadotropins). In the course of infertility treatment and preparation for IVF treatment, the patient receives medications that aim to obtain many large follicles in one cycle, from which an egg is released during ovulation. Ovarian hyperstimulation syndrome can be described when, as a result of the therapy, the production of eggs is higher than expected: there are a lot of follicles (even about 20-30, with the correct number being 5-10), each of them produces hormones, and the ovaries grow to unnatural levels. sizes (even 12 cm).

Ovarian Hyperstimulation Syndrome: Risk Factors

The risk of ovarian hyperstimulation syndrome increases when human chorionic gonadotrophin (hCG) is used for stimulation. This preparation leads to an increase in the production of estrogen. It's important to know that the likelihood of OHSS symptoms is reduced when you administer clomiphene citrate.

In addition, the risk factors are:

  • age of the patient (over 30)
  • menstrual disorders
  • polycystic ovary syndrome
  • repeatabilityin vitro preparation procedures

Ovarian Hyperstimulation Syndrome: Symptoms

The firstsymptoms of ovarian hyperstimulation syndromeusually appear several days after the collection of eggs for in vitro fertilization. Depending on the severity of symptoms, there is a mild, moderate, severe and critical form, with the vast majority of OHSS cases being classified into the first two types.

  • mild form: flatulence, slight abdominal pain (due to ovarian enlargement)
  • moderate: moderate abdominal pain, nausea and vomiting, ascites, which is visible on ultrasound
  • severe form: ascites and respiratory problems (caused by the accumulation of large amounts of exudate in the peritoneum, pleura and pericardium), oliguria, blood thickening, hypoproteinaemia
  • critical form: intense ascites, accumulation of large amounts of exudate in the peritoneum, pleura and pericardium, high blood concentration (hematocrit>55%), anuria, thromboembolic problems, acute respiratory distress syndrome. This may result in hypovolemic shock (which is the result of a decrease in circulating blood volume) and kidney failure, with consequent death.

Ovarian hyperstimulation syndrome: diagnosis

In order to diagnose the disease, an ultrasound examination is performed to assess the size of the ovaries and the presence of fluid in the peritoneal cavity. Laboratory tests and chest X-rays are also performed.

Ovarian Hyperstimulation Syndrome: Treatment

In the case of mild disease, only conservative treatment is used, because the concentration of gonadotropin drops spontaneously after about 7 days in a non-pregnant woman and after 10-20 days in a pregnant woman.

Moderate and severe form requires hospitalization.

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