The Cause

Unfortunately, the exact cause of Ovarian Hyperstimulation Syndrome is not yet known. However, it is suspected that the introduction of HCG or human chorionic gonadotropin hormone into your body triggers this health condition. Note that HCG is normally developed in the body of a woman during the pregnancy period. During fertility treatment, the ovarian blood vessels of the patients may react abnormally to the injection of HCG hormone. As a result, your ovarian vessels may leak a fluid that tends to swell the ovaries. Production of excess fluid may move to your abdomen as well, making it look bloated.

Inclusion of HCG hormones in fertility treatment is really important to trigger the mature follicle in your body to release the egg for conception. Naturally, OHSS is likely to develop a week after the injection of HCG hormone. The case will get worse if you get pregnant during the treatment course since your body would develop further HCG hormone during that time in response to the pregnancy. Furthermore, there are many factors that will put women at higher risk of developing OHSS and some of those are listed below.

  • Polycystic Ovarian Syndrome
  • Previous episodes or a history of OHSS
  • A large number of follicles
  • Low body weight
  • Fewer than 30 years in age
  • Higher or increasing level of estrogen hormone in the body of the patient


The complexity of the disorder may range from mild to severe. Note that it is really rare for women to develop severe OHSS. However, it may result in a number of life-threatening complications, some of which are listed below.

  • Fluid collection in the chest and abdomen
  • Kidney failure
  • Electrolyte disturbances
  • Blood clots in the leg
  • Ovarian cyst rupture that can lead to excessive bleeding
  • Ovarian torsion
  • Breathing issues
  • Miscarriage or other pregnancy complications
  • Death in extremely rare cases

Diagnosis and Treatment

There are mainly three ways to diagnose OHSS. The common one is a physical examination in order to monitor excessive weight gain, waist size, or abdominal pain. Furthermore, ultrasound scanning will be a great choice to detect enlarged ovaries, fluid-filled cysts, etc. Usually, doctors may conduct regular vaginal ultrasound scans during fertility treatments. Blood tests can also confirm if or not you have this health condition.

When it comes to treatment, OHSS is likely to get resolved on its own. Otherwise, there are many treatment options you may consider such as the following.

  • Anti-nausea medications
  • Pain killers
  • Adequate fluid intake
  • Drainage of excessive fluid in the abdomen by inserting a needle in the abdominal cavity
  • Use of support stockings to tackle blood clots in the legs

In case of severe OHSS, you will have to get admitted in the hospital for aggressive treatments such as surgeries, anticoagulant medications, gonadotropin-releasing hormone antagonist medications, etc.

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    About the Author

    Dr. Ghassan M. Al-Jazayrly, MD

    A graduate of University of Aleppo Faculty of Medicine, Dr. Al-Jazayrly or, as he is colloquially known: Dr. AJ, is an oncologist and hematologist of a Complete Care Community Health Center (CCCHC) with more than 36 years of experience. In recent years, he’s been involved with a non profit organization known as Every Woman Counts (EWC) which provides free breast and cervical cancer screening and diagnostic services to California’s underserved populations in order to eliminate health disparities for low-income individuals.

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