Diagnosis

For ovarian hyperstimulation syndrome, your doctor may make a diagnosis based on:

  • A physical exam. Your doctor will take note of any weight gain, increases in your waist size and abdominal pain you may have.
  • An ultrasound. If you have OHSS, an ultrasound may show that your ovaries are bigger than normal, with large fluid-filled cysts where follicles developed. During treatment with fertility drugs, your doctor regularly evaluates your ovaries with a vaginal ultrasound.
  • A blood test. Certain blood tests allow your doctor to check your blood concentration and whether your kidney function is being impaired because of OHSS.

Treatment

Ovarian hyperstimulation syndrome generally resolves on its own within a week or two or somewhat longer if you're pregnant. Treatment is aimed at keeping you comfortable, decreasing ovarian activity and avoiding complications.

Mild to moderate OHSS

Mild OHSS typically resolves on its own. Treatment for moderate OHSS may involve:

  • Anti-nausea medication, prescription painkillers or both
  • Frequent physical exams and ultrasounds
  • Daily weigh-ins and waist measurements to check for drastic changes
  • Measurements of how much urine you produce each day
  • Blood tests to monitor for dehydration, electrolyte imbalance and other problems
  • Adequate fluid intake
  • Drainage of excess abdominal fluid using a needle inserted in your abdominal cavity
  • Support stockings, to help prevent blood clots

Severe OHSS

With severe OHSS, you may need to be admitted to the hospital for monitoring and aggressive treatment, including IV fluids. Your doctor may give you a medication called cabergoline to lessen your symptoms. In some cases, your doctor may also give you another medication — known as a gonadotropin-releasing hormone (Gn-RH) antagonist — to help suppress ovarian activity.

Serious complications may require additional treatments, such as surgery for a ruptured ovarian cyst or intensive care for liver or lung complications. You may also need anticoagulant medications to decrease the risk of blood clots in your legs.

Lifestyle and home remedies

If you develop ovarian hyperstimulation syndrome, you'll probably be able to continue your day-to-day routine. Follow your doctor's advice, which may include these recommendations:

  • Try an over-the-counter painkiller such as acetaminophen (Tylenol, others) for abdominal discomfort, but avoid ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), as these drugs can interfere with implantation of the newly fertilized egg.
  • Avoid sexual intercourse, as it may be painful and can cause a cyst in your ovary to rupture.
  • Maintain a light physical activity level, avoiding strenuous or high-impact activities.
  • Weigh yourself on the same scale and measure around your abdomen each day, reporting unusual increases to your doctor.
  • Call your doctor if your signs and symptoms get worse.

Preparing for your appointment

Depending on how severe your ovarian hyperstimulation syndrome is, your first appointment may be with your primary care provider, your gynecologist or infertility specialist, or possibly with a treating doctor in the emergency room.

If you have time, it's a good idea to prepare in advance of your appointment.

What you can do

  • Write down any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
  • Make a list of any medications and vitamin supplements you take. Write down doses and how often you take them.
  • Have a family member or close friend accompany you, if possible. You may be given a lot of information at your visit, and it can be difficult to remember everything.
  • Take a notebook or notepad with you. Use it to write down important information during your visit.
  • Prepare a list of questions to ask your doctor. List your most important questions first.

Some basic questions to ask include:

  • What's the most likely cause of my symptoms?
  • What kind of tests do I need?
  • Does ovarian hyperstimulation syndrome usually go away on its own, or will I need treatment?
  • Do you have any printed material or brochures I can take home with me? What websites do you recommend?

Make sure that you completely understand everything that your doctor tells you. Don't hesitate to ask your doctor to repeat information or to ask follow-up questions for clarification.

What to expect from your doctor

Some potential questions your doctor might ask include:

  • When did your symptoms begin?
  • How severe are your symptoms?
  • Does anything make your symptoms better?
  • Does anything seem to make your symptoms worse?
Aug. 03, 2017
References
  1. Ovarian hyperstimulation syndrome. American Society for Reproductive Medicine. https://www.asrm.org/FACTSHEET_Ovarian_Hyperstimulation_Syndrome/. Accessed Aug. 29, 2016.
  2. Humaidan P, et al. Ovarian hyperstimulation syndrome: Review and new classification criteria for reporting in clinical trials. Human Reproduction. 2016;31:1997.
  3. Busso CE, et al. Pathogenesis, clinical manifestations, and diagnosis of ovarian hyperstimulation syndrome. http://www.uptodate.com/home. Accessed Aug. 29, 2016.
  4. Hoffman BL, et al. Treatment of the infertile couple. In: Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com. Accessed Aug. 29, 2016.
  5. Kwik M, et al. Pathophysiology, treatment and prevention of ovarian hyperstimulation syndrome. Current Opinion in Obstetrics and Gynecology. 2016;28:236.
  6. Busso CE, et al. Management of ovarian hyperstimulation syndrome. http://www.uptodate.com/home. Accessed Aug. 29, 2016.
  7. D'Angelo A, et al. Coasting (withholding gonadotrophins) for preventing ovarian hyperstimulation syndrome. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002811.pub3/full. Accessed Aug. 29, 2016.

Ovarian hyperstimulation syndrome