Introduction To Ovarian Hyperstimulation Syndrome (OHSS)

Written By Vaishali Thapa - March 06, 2025

Read Time - 3 min read

Ovarian hyperstimulation syndrome is a serious medical complication that occurs in women undergoing IVF (in-vitro fertilization).^1,2 In the past, approximately 10% of women who went through IVF treatments experienced OHSS. But thanks to advancements in IVF protocols and techniques, the risk rate of developing this complication has dropped to less than 5%. Additionally, one must take note that OHSS affects <1% of women undergoing hormonal fertility treatment. However, it’s still very detrimental as it can cause kidney failure, blood clots, and respiratory distress.³

In this blog, we'll discuss ovarian hyperstimulation syndrome in depth. This will help you make informed decisions prior to availing IVF treatment. We also hope that by understanding the risk factors and potential complications associated with OHSS, you'll be able to take proactive steps to prevent this serious medical condition.

Now, let’s start with the basics!

What Is OHSS?

It’s the excessive response to medicines that are taken by women to stimulate their egg production.²^,4 The fertility medications that can potentially give rise to ovarian hyperstimulation syndrome are clomiphene citrate (orally taken), and gonadotropins (injectables).²^,4 However, between the two medications, it is the latter that is associated with higher risk of developing OHSS.^4,5

Now, let’s take a closer look at what causes OHSS.

Causes

When a woman undergoes IVF treatments, ovarian stimulation is done as a prerequisite step to trigger the mature follicle in the ovaries, which will eventually help in releasing eggs. Nevertheless, in some cases, the introduction of high levels of the pregnancy hormone hCG (or ovarian stimulation medications) can end up causing the ovarian blood vessels to swell with fluids, which eventually leaks into the abdomen region.²^,3,⁶

Apart from this, it must be noted that some women have a certain genetic mutation in their hormone receptors, which could put them at increased risk of developing ovarian hyperstimulation syndrome.³

So far we’ve learned about what OHSS stands for, how it affects women undergoing IVF and what causes it. Now, let’s learn about its symptoms.

Symptoms

Typically, the symptoms of ovarian hyperstimulation syndrome takes up to 1 week to manifest itself. However, occasionally they can also take 2 weeks (or even more time) to appear. The symptoms of ovarian hyperstimulation syndrome ranges from mild to severe and could even get worse, if not attended to in due time.²

i. Mild to moderate symptoms:²^,7

Bloating
Diarrhea
Mild abdominal pain
Nausea and vomiting
Pain or sensitivity at/ around ovary region
Weight gain

ii. Severe symptoms:²^,7

Bloated and swollen pelvic region
Blood clots
Decreased urination
Difficulty in breathing
Persistent nausea, vomiting and diarrhea
Rapid weight gain (more than 1 kg in a day and 4.5 kg in a couple of days)

In the next section, we’ll take a look at some factors that can put women at an increased risk of developing ovarian hyperstimulation syndrome.

Risk Factors

The following factors can potentially increase a woman’s chances of developing OHSS if she’s undergoing IVF: ^2,3,7

i. Polycystic ovary syndrome (a common reproductive disorder that is characterized by irregular menstrual cycles, excessive hair growth, and abnormal ovulation appearance on ultrasound examination)

ii. Age under 35 years

iii. A medical history of ovarian hyperstimulation syndrome

iv. High or rapidly increasing estrogen levels (before hCG is injected)

v. High number of ovarian follicles that may have developed due to fertility treatments

vi. Just received high dosages for hCG hormone (during IVF cycle)

If you think you could be at risk of getting OHSS, don’t wait any longer, consult your doctor immediately.

Treatment

Since OHSS is a temporary condition, it goes away on its own within 1-2 weeks. Anyhow, if the condition persists and becomes severe, there are several alternatives available for alleviating its symptoms, which include:⁸^,9

An IV-drip to replenish the body fluids
Anticoagulant medications
Anti-sickness or nausea medications
Drainage of excess fluid
Intake of pain relief medications
Medications to avoid blood clots
Medications to suppress ovarian function

Preventive Care

Despite being an irreversible condition, ovarian hyperstimulation syndrome can be potentially prevented by taking certain measures. These methods can somewhat decrease the risk of developing OHSS, which include: using a small amount of ovarian stimulation medications, using leuprolide instead of hCG, and taking cabergoline (oral medication) to avoid swelling and fluid accumulation.¹⁰

However, in case a pregnancy is achieved at this time, it is recommended to stop the process by either freezing your eggs or the embryo, since conception can result in developing persistent OHSS.¹⁰ Though if you wish to go for “egg freezing,” you might want to take a look at LifeCell’s OvaVault!- which is coming soon!

InferGenes Female: Ultimate Diagnosis Aid!

Ovarian hyperstimulation syndrome can also be diagnosed via physical examination, ultrasound scans, and blood tests. However, these tests don’t provide a complete picture of a woman's reproductive health. This is where the need for a test like LifeCell’s InferGenes Female arises. Now, you may wonder “what’s so special about it?” Well, our at-home self-collection test can help you find out the root cause of an impending reproductive problem, much like OHSS.

Not only this, it uses NGS (Next Generation Sequencing) technique to assess 26 clinically relevant genes that are known to cause female fertility problems like primary ovarian insufficiency (POI), polycystic ovarian syndrome (PCOS), etc. And other genetic disorders which may lead to infertility such as Fragile X syndrome and Turner syndrome.

Moreover, taking this test can provide you with invaluable insights in many cases, some of which are given below:

If you’ve been trying to conceive but been unsuccessful
If you have a family history of genetic diseases and want to know what will be the probability of you passing it down to your baby
If you have lately received abnormal hormone test results
If you’re planning to to have a family soon

Parting Thoughts!

While even the thought of ovarian hyperstimulation syndrome can be quite unsettling, it must be known that this condition can impact any woman. However, by taking a comprehensive test (like LifeCell’s InferGenes- Female), you can stay informed about your reproductive health, while also reducing the risk of developing OHSS.

To know more about InferGenes, call us at 1800 266 5533.