What is OHSS?

OHSS stands for ovarian hyperstimulation syndrome. It can occur during fertility treatment, usually when you’re taking medication which – alongside stimulating egg development – may cause your ovaries to swell and leak fluid.

OHSS is your body’s response to excess hormone levels. It can be very painful – at best, uncomfortable – and symptoms include abdominal pain, tenderness in the ovaries, nausea, sudden weight gain and extreme bloating.

Occasionally, OHSS can occur when taking medication by mouth – such as clomiphene – but it’s more commonly connected to injectable hormone medication.

OHSS Signs & Symptoms

Symptoms usually kick in during the week after your ovulation stimulation starts – but it can take longer to start feeling off.

Mild to moderate OHSS symptoms include:

  • abdominal pain
  • bloating
  • nausea and/or vomiting.
  • diarrhea
  • tenderness around your ovaries

Severe OHSS symptoms include:

  • rapid weight gain (over 2.2 pounds (1 kg) in 24 hours)
  • severe abdominal pain
  • decreased urination.
  • shortness of breath
  • tight or enlarged abdomen.

Risk Factors for OHSS

  • PCOS – if a woman has polycystic ovary syndrome that could potentially put them at risk for OHSS.
  • High estrogen levels before receiving your hCG injection.
  • Any women who may have experienced OHSS in a prior cycle.


  • Moderate and reduce the dosage amount while monitoring the ovary growth and egg production.
  • If they grow too quickly the follicle will become atretic
  • Using Lupron to mature and trigger egg maturation and this assists to help manage the prevention of OHSS.
  • Restarting the Lupron after the retrieval also further reduces the risk.
  • At the time of the trigger adding cabergoline (oral medication) to suppress what is going on the surface of the ovary to assist in the prevention of OHSS

Successful pregnancy with OHSS

In most cases, Laurel Fertility Care can help patients continue treatment, despite OHSS. And you can still get pregnant with OHSS – your symptoms may just get a little worse.

Whichever clinic you’re with, you should be monitored closely (just in case). If you’re at-risk of developing severe OHSS symptoms, your specialist may recommend stopping treatment.

When do you call your doctor?

Mild OHSS symptoms will usually resolve after about a week. More severe OHSS symptoms can last weeks, however, particularly if you do get pregnant.

If you experience severe abdominal pain, experience an enlarged abdomen and shortness of breath.  Our dedicated team monitors all patients to help prevent or be aware of any reaction to the fertility medication provided. Contact us at 415- 673-9199 to schedule an appointment with one of our providers to answer all the questions you may have about OHSS.


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