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Hyperstimulation Syndrome OHSS in IVF Treatment

What is Hyperstimulation Syndrome in IVF Treatment?

In IVF treatment, a problem that can occur in patients receiving follicle stimulating hormone (FSH), which ensures the development of the egg, is known as hyperstimulation syndrome. During IVF treatment, some women may react to the medications they use. If a significant amount of egg development is achieved, the volume of the ovaries increases, and due to the high levels of hormone secreted from these overstimulated ovaries, some side effects may appear within two weeks. These are called hyperstimulation syndrome.



OHSS usually occurs in patients undergoing IVF treatment, where the ovaries are stimulated with drugs to increase egg production. In addition, this syndrome can also occur in people who have undergone ovulation induction and artificial insemination after egg formation has been achieved. However, hyperstimulation syndrome usually occurs in women undergoing IVF treatment.


OHSS can manifest itself with minor symptoms in every woman who undergoes IVF treatment. The symptoms that occur in a large portion of these people can be kept under control in a way that does not affect daily life too much.


The symptoms of OHSS are as follows:

  • Pain in the lower abdomen due to enlargement of the ovaries

  • Nausea, vomiting and diarrhea

  • Rapid weight gain

  • Shortness of breath in very severe patients due to water accumulation in the lungs

  • Potential for clot formation due to increased blood clotting in very sick patients

  • Changes in fluid and electrolyte balance in the body

  • Dehydration, or lack of water


Why Does Hyperstimulation Occur?

The causes of hyperstimulation syndrome, which occurs in patients with very low or very high egg counts, are not clearly known. However, in most cases, a very high number of eggs must be formed in order for the effects of this syndrome to be experienced severely. As the number of developing eggs increases, the risk of the syndrome also increases.


Hormones secreted by the ovaries and other organs in the female body affect the permeability of tiny blood cells. For this reason, fluid accumulation can occur in areas where it should not be. Fluid accumulation causes swelling and discomfort. In addition, water flowing to the kidneys decreases, so less urine is produced and the body's sodium-potassium balance is disrupted.

People whose hyperstimulation syndrome affects their daily lives and reaches a level that causes discomfort should definitely consult a specialist and start treatment.


In these people:

  • If you are unable to sleep due to constant pain in the lower abdomen and have to constantly use painkillers,

  • If you are experiencing persistent nausea, vomiting and diarrhea problems,

  • If you have difficulty breathing due to swelling in the abdominal area,

  • If there is swelling in one of the legs and there is chest pain or tenderness in the calves, a specialist physician should be consulted.


How is OHSS treated?

  • After consulting a specialist physician due to complaints caused by hyperstimulation syndrome, the physician will draw up a treatment plan according to the continuity and extent of the problem. If the problem continues to be mild,

  • Tension and pain that are not felt strongly in the abdominal area manifest themselves. These pains can be treated with rest and painkillers.

  • The body's balance is maintained through oral fluid intake.

  • Eating small, frequent meals is essential for recovery.

  • Treatment of OHSS, which is usually mild, does not require hospitalization.

  • Moderate and severe hyperstimulation syndrome symptoms significantly reduce the quality of daily life. For this reason, the physician may bring up the issue of hospitalization to closely monitor the patient and control body values.

  • In the treatment of OHSS with moderate and severe symptoms,

  • Intravenous access is opened for the patient to supplement fluid and protein into the body.

  • The person is given medication to relieve nausea and vomiting by injection.

  • Heparin is given by injection to prevent the blood from clotting too much.

  • Daily blood tests are performed to check electrolyte and fluid balance.


If there is a severe hyperstimulation syndrome, a procedure called paracentesis is performed on the patient. In this procedure, the fluid accumulated in the abdominal cavity is withdrawn with a teflon catheter. It is one of the most ideal treatment methods for severe OHSS.


OHSS manifests itself with highly severe symptoms, and with the application of appropriate treatment methods, a significant improvement in the patient usually occurs within a few days.


Women with the most severe symptoms of hyperstimulation syndrome usually recover within 7-10 days. The occurrence of this syndrome can be reduced by implementing low-dose protocols in IVF programs and further exacerbation of symptoms can be prevented. People with Polycystic Ovary Syndrome who are undergoing IVF treatment are at greater risk than normal IVF patients. For this reason, they should definitely consult their doctor before starting treatment and take action to take the necessary precautions.


Hyperstimulation syndrome does not prevent people who are receiving treatment to have a baby from getting pregnant in any way. On the contrary, this syndrome occurs due to an increase in the number of eggs, and the increase in the number of eggs is a very positive and good situation in IVF treatment. For this reason, there is no need to worry about hyperstimulation syndrome during IVF treatment. Depending on the severity and course of the symptoms, the doctor will choose the most ideal treatment method for the person and recovery will be achieved in a short time.

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