Ovarian Hyperstimulation Syndrome

Diagnosis

Diagnosis of ovarian hyperstimulation syndrome (OHSS) is based on a combination of physical examination, imaging, and laboratory tests. Your healthcare provider will assess your symptoms and perform the following evaluations:

• Physical exam: The provider checks for signs such as weight gain, abdominal swelling, and pain.

• Ultrasound: An ultrasound scan may reveal enlarged ovaries with multiple fluid-filled cysts where follicles have developed. During fertility treatment, vaginal ultrasounds are routinely used to monitor ovarian response.

• Blood test: Blood tests help identify any abnormalities in your blood and assess how well your kidneys are functioning, which can be affected by OHSS.

Treatment

Ovarian hyperstimulation syndrome often improves on its own within one to two weeks. However, if pregnancy occurs, symptoms may last longer. The goal of treatment is to relieve discomfort, reduce ovarian activity, and prevent complications.

Mild to moderate OHSS
Mild cases usually resolve naturally, but moderate OHSS may require closer monitoring and supportive care, including:

• Increasing fluid intake to prevent dehydration

• Regular physical exams and ultrasound monitoring

• Daily tracking of body weight and waist size

• Measuring urine output to assess kidney function

• Blood tests to detect dehydration or electrolyte imbalance

• Draining excess fluid from the abdomen using a needle if swelling is severe

• Medications such as anticoagulants to prevent blood clots

Severe OHSS
Severe OHSS requires hospital care for close monitoring and aggressive treatment. Management may include:

• Intravenous (IV) fluids to restore hydration and balance electrolytes

• Medications such as cabergoline to ease symptoms

• Additional drugs like gonadotropin-releasing hormone (Gn-RH) antagonist or letrozole (Femara) to suppress ovarian activity

• Anticoagulant medications to reduce the risk of blood clots

If complications arise, such as a ruptured ovarian cyst or problems with the liver or lungs, surgery or intensive medical care may be needed. Early detection and proper management are essential to prevent severe complications and ensure a safe recovery.