What is Ovarian Hyperstimulation Syndrome (OHSS)?

Ovarian Hyperstimulation Syndrome is related to the number of follicles that develop during ovarian stimulation and the level of increase in your estradiol (estrogen), partnered with the HCG trigger injection. These factors will gauge the amount of risk you have for this condition. Doctors plan for and monitor this possibility before, during, and after your treatment cycle. Do not be alarmed, as you may experience a mild to moderate degree of one or more OHSS symptoms, but it is rare for this condition to reach a level that requires hospitalization. 

Preventative and home management of symptoms, starting when your trigger day is soon approaching, or by the day after HCG injection:

  • Increase protein intake.
  • Drink electrolyte enhanced water in an amount that results in light yellow urine most of the day. If your urine is clear, you can decrease fluid intake slightly.
  • Walk frequently, as tolerated, to maintain circulation.
  • Prop legs up when sitting.
  • Weigh yourself daily and try to keep all factors the same or very similar. For example, weigh yourself first thing in the morning on the same scale without clothing on. Call your doctor’s office right away if you gain 2 lbs or more within 24 hours.
  • Tylenol or Acetaminophen can be taken for pain. DO NOT take Advil, Aleve, Ibuprofen, Naproxen, or aspirin.
  • Change positions slowly: sit for a moment before standing.

Symptoms of OHSS include:

  • Dark yellow or amber colored urine.
  • Decreased urine output despite high fluid intake.
  • Abdominal discomfort or pain.
  • Difficulty breathing due to the ovaries pushing up on the diaphragm.
  • Dizziness.
  • Weight gain.
  • Increased heart rate.
  • Nausea, vomiting, diarrhea.

Your doctor’s office will likely be following up with you daily if they suspect you are at risk for symptoms of OHSS. It is just important for them to ensure you are safe. They will also be able to give you advice for managing any specific symptoms. It is possible that you will be asked to go in for lab work and an ultrasound to assess the degree of your symptoms, if you have any. If your symptoms change at any point, or if you have questions/concerns regarding your symptoms, contact your doctor’s office right away. If you begin to experience symptoms that require immediate attention, go to your nearest emergency room. 

A medication called Dostinex or Cabergoline may be prescribed to help alleviate potential OHSS symptoms. This medication starts on the same day as the trigger injection, but before the instructed trigger time. Usually your coordinator or doctor will ask you to start the Dostinex right away and then instruct you to take your HCG trigger injection at a specific time later that night.