Ovarian hyperstimulation

Many women must take high doses of fertility medications to get multiple eggs for in vitro fertilization. This can lead to a rare but dangerous condition known as ovarian hyperstimulation syndrome (OHSS).

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Feeling bloated and uncomfortable is normal during treatment with fertility medications. But as the ovaries get bigger and produce more eggs, women tend to have more symptoms. Some women retain a lot of fluid in their abdomen. Some become nauseated and vomit; eventually, this can lead to dehydration. Some women even have fluid in their lungs. With dehydration and fluid retention, women can have a serious drop in blood pressure and a slightly higher risk of blood clots. These severe symptoms are very rare.

Younger women are more likely to produce more eggs and thus more likely to experience the symptoms of overstimulation. Young women with polycystic ovarian syndrome have the highest risk. Overstimulation is less common in older women.

Call your doctor if you need large amounts of pain medication, can't keep any food down, think you are getting dehydrated, or stop urinating (a sign of dehydration). The symptoms aren't necessarily related to the number of eggs produced; some women who hardly produce any eggs while taking fertility medicines are very uncomfortable, while some women produce dozens of eggs with few symptoms.

If a woman has OHSS, the symptoms may get worse for three to five days after her eggs are retrieved for IVF, then will gradually get better. If your doctor thinks you are at risk for a worse form of OHSS, you may not be able to have the embryos transferred to the uterus during that cycle. Pregnancy can make the syndrome worse because hormones stimulate the ovaries more. You can freeze the embryos and wait until another cycle to transfer them. The symptoms will go away when you get your period, two weeks after the retrieval.