Why does ohss get worse with pregnancy

This can make breathing uncomfortable and cause shortness of breath. The kidneys can stop working properly and make very little urine. The blood becomes more concentrated and therefore more likely to cause clots. OHSS is much less common now than it was 10 years ago because our understanding has improved with research into the condition and especially in ways to prevent or reduce the chance of it happening.

Almost everyone gets a mild version of it which settles within a couple of days. It usually happens to women who are having IVF but can happen after ovulation induction treatment. It is important to recognise that any woman using fertility drugs is at some risk of OHSS. Sometimes OHSS does not cause symptoms until the pregnancy has implanted and pregnancy hormone is being made, from about a week after your embryo has been transferred.

Chemicals produced from over-stimulated ovaries cause the blood vessels to leak fluid and this increases the risk of blood clots. If you have been found to have any risk factors listed above, the dose of hormones prescribed to make your ovaries produce multiple eggs will be modified and reduced.

You will be scanned earlier and the dose changed mid-cycle if necessary, up or down. Please ask your Consultant or Nurse Practitioner if you want to know more about this. Very occasionally, the ovaries will respond excessively quite early in the treatment. In this situation the treatment may be stopped and restarted with a lower dose injection.

If you produce more than 30 eggs at the time of egg collection we will advise you that all the embryos that result from fertilisation should be frozen. The size of the ovary is a marker of the degree of OHSS. If symptoms are present, a transvaginal or abdominal ultrasound can be done to measure ovary size and the amount of fluid collected. OHSS can be serious, so careful monitoring and managing the symptoms are important whenever it occurs. Office visits for ultrasound exams to measure the ovaries and fluid in the abdomen, and blood tests, are routinely done.

Decreased activity and drinking lots of electrolyte-rich fluids over ounces per day are recommended. Medicines for nausea are available. If there is fluid in the abdomen, drainage of fluid using a syringe paracentesis can provide significant relief in most cases. On occasion, more than one drainage is helpful. A medicine called cabergoline also can reduce the fluid accumulation.

There is rarely a need for hospitalization. If OHSS does not improve with outpatient care, the woman may be treated in the hospital with close monitoring. The doctor may order intravenous IV fluids and medicines for nausea and may remove fluid from the abdomen. Other supportive therapy may be given as needed. Complications from OHSS can be severe.

This condition is a direct result of the drugs used in IVF and other procedures that enhance egg production and maturity. This is just a fancy way of saying that it results from hormone therapy used in certain fertility treatments. Specifically, a woman undergoing IVF typically receives an hCG human chorionic gonadotropin trigger shot before retrieval to help her eggs mature and to put them into an important process called meiosis when the egg releases half of its chromosomes before ovulation.

While this medication helps prime the eggs, it may cause the ovaries to swell and leak fluid into the abdomen, sometimes significantly. Again, these drugs are used to promote egg production or release mature eggs. Risk factors include things like having polycystic ovary syndrome PCOS or having a large number of follicles in any given cycle.

Women younger than age 35 are also at a higher risk of developing this complication. Related: 5 things to do and 3 things to avoid after your embryo transfer. It may be hard to tell when something is wrong versus just uncomfortable. Trust your instincts, but also try not to worry. Most cases of OHSS are mild.

These symptoms typically develop about 1 to 2 weeks after injecting medications. The timeline is individual, however, and some women may start symptoms later on down the line. Symptoms tend to range in their severity and may also change over time. Around 1 percent of women develop what is considered severe OHSS. Issues like blood clots, trouble breathing, and severe pain may lead to more serious complications, like an ovarian cyst rupture with excessive bleeding.

Mild OHSS may go away on its own within a week or so. If you get pregnant that cycle, the symptoms may persist a bit longer — more like a few days to a few weeks. Treatment of mild OHSS is conservative and involves things like avoiding strenuous exercise and increasing fluid intake to address dehydration.

You may want to take some acetaminophen for pain. Most importantly, your doctor may ask you to weigh and otherwise monitor yourself daily to track any potential worsening of the condition. Severe OHSS, on the other hand, often requires a hospital stay — and can be very dangerous even fatal if left untreated.

Your doctor may decide to admit you to the hospital if:. At the hospital, you may be given intravenous IV fluids to aid with hydration.