Dr. Derek Haas talks about Ovarian Hyperstimulation Syndrome (OHSS), the symptoms, risks, and how it affects IVF treatments. Ovarian hyperstimulation syndrome (OHSS) is a medical condition that can occur in some women who take fertility medication to stimulate egg growth, and in other women in very rare cases. Ovarian Hyperstimulation syndrome or OHSS, is one of the complications of an IVF cycle. When the ovaries get stimulated and the estrogen level goes up, we trigger the final step of IVF. This trigger in the past was HCG. The presence of the HCG is important because it completes the maturation process for those follicles. However, it leads to an
calamatory cascade which can, if it becomes extreme, lead to OHSS. When HCG re-stimulates the ovaries, the patient experiences their ovaries and the vasculature of their abdomen pelvis becomes leaky, and fluid seeps out of the intravascular space and collects in their pelvic cavity. The patient will experience things like pain, abdominal bloating, nausea, vomiting. In extreme cases, fluid will have to be drained off of their abdomen with a paracentesis. OHSS has become a lot more infrequent, and precautions are taken to avoid OHSS. Basically, we avoid exposure to or at least lessen exposure to HCG. One way to limit HCG exposure is to do what's called a freeze all policy. Meaning we do not transfer the embryo as a fresh embryo. When you transfer an embryo as a fresh embryo, the ovaries have been recently stimulated and then when the patient becomes pregnant, the pregnancy hormone actually re-simulates the ovaries which links to all the problems with OHSS. If we transfer the embryo as part of a frozen embryo cycle, that will not happen. And there would be almost no chance for OHSS. The other way we avoid it is with a loop run trigger instead of an HCG trigger. With a loop run trigger you still get some mild symptoms but it's
never nearly as bad as when you use the HCG trigger. If you have other questions come see us here at Conceive Fertility Center. Thank you.
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