Self-management

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.

Prevention

To decrease your chances of developing ovarian hyperstimulation syndrome, you'll need an individualized plan for your fertility medications. Expect your doctor to carefully monitor each treatment cycle, including frequent ultrasounds to check the development of follicles and blood tests to check your hormone levels.

Strategies to help prevent OHSS include:

  • Adjusting or changing medication. Your doctor uses the lowest possible dose of gonadotropins to achieve the goals of stimulating your ovaries and triggering ovulation. Giving women who have polycystic ovary syndrome the drug metformin (Glucophage, Glumetza, others) during ovarian stimulation may help prevent hyperstimulation.
  • Coasting. If your estrogen level is high or you have a large number of developed follicles, your doctor may have you stop injectable medications and wait a few days before giving HCG, which triggers ovulation. This is known as coasting.
  • Avoiding use of an HCG trigger shot. Because OHSS often develops after an HCG trigger shot is given, alternatives to HCG for triggering have been developed using Gn-RH agonists, such as leuprolide (Lupron), as a way to prevent or limit OHSS.
  • Freezing embryos. If you're undergoing IVF, all the follicles (mature and immature) may be removed from your ovaries to reduce the chance of OHSS. Mature follicles are fertilized and frozen, and your ovaries are allowed to rest. You can resume the IVF process at a later date, when your body is ready.
Nov. 04, 2016
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.