Ovarian hyperstimulation is the response of these organs to the administration of the drug and their increase. In this case, the body slightly changes various processes: the blood thickens, the capillaries and vessels become thinner, and the fluid hardly leaves the body. Unfortunately, this is not the biggest problem yet. If it develops, it will eventually lead to a syndrome, which will be much more difficult to cure.
Ovarian hyperstimulation syndrome is a common pathology in many women today, so each of them should know what the symptoms and causes may be that contribute to the onset of the disease. Most importantly, if you find any similar symptoms, you need to contact a specialist as soon as possible, otherwise the problem can cause great harm to the body.
What is OHSS
OHSS (ovarian hyperstimulation syndrome) is a serious complication that can occur after an IVF procedure. The main cause identified by doctors, who have already studied many details of this disease, isthe introduction into the female body of an excessive amount of drugs necessary to stimulate ovulation.
Syndrome can manifest itself at any time. For example, before the transfer of embryos into the uterus or after implantation.
Reasons
Modern medicine, although it has reached a fairly high level, still no one can accurately determine the possibility of ovarian hyperstimulation in a particular patient after the procedure. Each woman's body will react to changes in its own way, so it will be quite difficult to prevent the problem right away.
But even so, doctors have approved certain factors that most often contribute to the onset and rapid development of the disease. For example, this list includes:
- predisposition to pathology at the genetic level in women with natural blond hair color under 36 years old (usually such patients are not inclined to be overweight);
- postponed polycystic ovary syndrome;
- excessive activity of estradiol in the circulatory system;
- recently confirmed allergic reactions to medications.
Foreign scientists put forward a few more points related to the IVF procedure and the most common cases of the disease. So, they can provoke her:
- significant errors in drug dosage;
- too low body weight of a woman (prone to anorexia and the like);
- sudden negative reaction to certain hormonal drugs;
- past similar problems.
Symptoms
When observing the following factors, it can be said with certainty that ovarian hyperstimulation syndrome develops. Symptoms will help to confirm the exact presence of a problem only if at least half of the proposed list is observed:
- In the initial stage, the patient will feel some heaviness and weakness. There will be swelling, pulling and sudden pain in the lower abdomen. The patient will significantly increase urination.
- In moderate severity, nausea and vomiting occur first, followed by diarrhea, bloating, and weight gain.
- Severe degree entails more serious changes - frequent shortness of breath, change in heartbeat. The patient may have hypotension, the stomach is too enlarged.
Diagnosis
Only after carrying out the necessary diagnostics will it become clear how to treat ovarian hyperstimulation syndrome in a particular patient. After all, the body of each person reacts to certain drugs in different ways.
As mentioned above, ovarian hyperstimulation syndrome in IVF is a fairly common problem. Her treatment will not be too simple, but you should not delay contacting a doctor.
Standarddiagnosis is based on the following factors:
- Analysis of all patient complaints. For example, with a sharp deterioration in he alth, she has frequent abdominal pain for no specific reason, alternating nausea and vomiting.
- Mandatory medical history if symptoms began to appear after the release of the egg from the ovary.
- Analysis of life history. Previous illnesses, the presence of various bad habits, similar cases of the development of the disease after the IVF procedure are taken into account.
- Results of a general examination by a gynecologist, palpation of the abdomen (the ovaries must be palpated).
- Ultrasound examination will accurately show enlarged ovaries, the presence of a fetus, and will also make it possible to detect excess fluid that has accumulated in the abdominal cavity.
- Careful laboratory blood test. An excessive amount of sex hormones can be detected here, a general analysis will show the presence of areas of condensed blood, and a biochemical one will show barely noticeable signs of changes in kidney function.
- Urine analysis (when performed, a decrease in urine, an increase in density, as well as the excretion of protein along with urine) will be visible.
- Electrocardiography and then ultrasound of the heart (this will detect some abnormalities in the heart).
- Chest x-rays will show the presence of fluid in the internal cavity of the chest, as well as in the pericardial sac.
Varieties
In total, two types of syndrome are distinguished in medicine:
- Early. It develops immediately after ovulation. In the event that pregnancy does not occur in any way, then this means the withdrawal of the syndrome and the arrival of a new menstruation.
- Late. It develops and makes itself felt only in the second or third month of pregnancy. In this case, ovarian hyperstimulation syndrome, which will be difficult to treat, is quite difficult.
In addition, there are three main degrees of severity of the disease:
- Easy. Not too noticeable deterioration in well-being, some discomfort and swelling in the abdomen.
- Average. More noticeable pain in the abdomen, deterioration and swelling. There is also an increased feeling of nausea and vomiting. And fluid begins to accumulate in the abdominal cavity.
- Heavy. A strong deterioration in a person’s condition, weakness, very sharp pains in the abdomen are felt. Pressure drops, shortness of breath due to accumulated fluid.
Treatment
In the case of a mild form of ovarian hyperstimulation syndrome (with IVF), treatment implies only changes in the standard diet:
- You need to make a schedule for fluid intake and strictly adhere to it. It can be not only ordinary mineral water, but also green tea or homemade compote. Alcohol and carbonated drinks should be avoided.
- Eat not too fatty meat, vegetables and fish in a boiled state.
- Physical activity should not be heavy, excessive overexertion should also be avoided.
But the treatment of medium andsevere forms of the disease takes place exclusively in the hospital. Here, constant monitoring of the patient's condition is carried out (monitoring of respiratory function, the work of the cardiovascular system, liver and kidneys). The patient is provided with therapy with drugs that reduce vascular permeability (antihistamines, corticosteroids, etc.), as well as drugs that reduce the risk of thromboembolism (Clexane, Fraxiparin, etc.).
Complications
Ovarian hyperstimulation syndrome can lead to some problems that are also harmful to the patient's body. These include:
- accumulation of fluid (sometimes up to 20 liters) in the abdominal cavity;
- rupture of one ovary and severe bleeding;
- heart problems (when a muscle cannot function at its normal rate);
- Two ovaries exhausted prematurely.
How to avoid the problem
Before a woman finally decides on an IVF procedure, doctors should definitely consider all possible preventive measures:
- Cancel the specific ovulatory dose of any drug used during the procedure.
- For a while cancel the embryo transfer and subsequent transfer to the uterus at the next menstruation.
- To get rid of cysts as much as possible, as well as follicles that constantly appear during the stimulation period.
There are many opinions on how to prevent ovarian hyperstimulation syndrome. Reviews of such a plan can befound on various forums on the Internet, but still, to save he alth, it’s not enough just to listen to other people. You need to be aware of the seriousness of the situation and if any symptoms appear, you should immediately consult a doctor.
Prevention
Besides the basic methods listed above, there are other methods of prevention. Their action will be much more effective for some patients. After all, women who want to have a baby carefully monitor their own he alth so that their fetus does not have any problems.
Prevention of ovarian hyperstimulation syndrome consists of the following rules:
- The dosage of any medical drug must be checked.
- The dose of gonadotropins can be reduced if this does not interfere with the desired result after the procedure. With a successful dose reduction, you can be almost one hundred percent sure that the disease has already been avoided.
- After passing all the tests and passing the required procedures, the doctor can conclude that the embryo can be frozen. This will also play an important role in avoiding the problem.
Who is at risk of illness
It is impossible to guess who is at risk of the disease. But there are the most frequent cases in which ovarian hyperstimulation syndrome manifested itself. Among them is a small body weight of a girl or woman who decided to undergo the procedure, as well as a patient with cystosis or polycystic ovaries (this can be a disease both in the present and already suffered in the past).
Medicine at the modern level has achieved many successes, but still it cannot reach ideal results yet. Therefore, before the in vitro fertilization procedure, no doctor can guarantee the absence of disease after IVF. But if you notice its development in the early stages, then the treatment will not be too long.
