Ovarian Hyper-stimulation syndrome is natural response to excessive hormones present in the body. This situation occurs when a woman takes additional hormones in form of medications or drugs to enhance production of eggs in her ovaries. This results to hormonal imbalance in the body and excessive hormones cause this condition to occur. Ovarian Hyper-stimulation syndrome may occur while a woman is undergoing IVF treatment but such cases are less in comparison to medication consumption. Today we will know about tips to prevent this condition with help of our expert.
What is OHSS complication?
According to Dr. Bindiya Khera, Senior Gynaecologist from Fatima Hospital, Lucknow, it is a excessive response to additional hormones present in the body. It affects the person in such a way that is can cause enlarged ovaries, accumulation of fluid in abdomen and cause blood clots as well. Ovarian Hyper-stimulation syndrome affects women in two conditions in majority of cases. Either when she takes more than necessary pills that increase hormonal activity in ovaries or when a woman goes through fertility treatments and their medications. In some conditions, it is easier to control hormones whereas if it increases too much, it can affect different functions of the body as well.
Women having OHSS complications can have these symptoms initially-
- Abdominal distension
- Shortness of breath
Tips to Prevent Ovarian Hyper-stimulation Syndrome
1. Identify the Problem
The first step is to identify seriousness of the situation. This means in this step doctor may examine the risk by measuring follicle count or anti-mullerian hormone levels present in the body. Those who suffer from ovarian Hyper-stimulation syndrome needs to assess the appearing ovaries. If there are less than 12 antral follicles per ovary then it is comparatively safe, but if there is more than 3.5ng/ml in an ovary, then the person is at higher risk of OHSS.
2. Start with a lower dose of fertility drug
If the person is preparing for pregnancy, then she may take fertility drugs. It needs to be given in a minimal amount with people who are at higher risk of having OHSS. This is because if normal dose of fertility drugs is given to a person who has small follicles, it may become a launch pad for the ovarian hyper-stimulation syndrome to occur. Hence a person with greater risk needs to be given even lower dose of fertility drugs. If the response is still not satisfactory, doctor may prevent you from taking such fertility pills further.
3. Reduce the amount of trigger drug
During fertilization, dose of hCG is given to the woman to increase the rate of eggs produced in the body. However this drug acts like a trigger for ovarian hyper-stimulation syndrome, therefore people who could be more vulnerable to OHSS should be given lower amount of drugs. VEGF that is vascular endothelial growth factor is the main cause of ovarian Hyper-stimulation syndrome. hCG stimulates VEGF, hence it is important to lower the dose from 10,000 units to 5000 or even below it depending on the capacity of the woman.
Those women who have a high oestrogen level and follicles smaller than 14mm need to stop their fertility drugs for few days so that oestrogen level comes down to normal level. If this does not happen, it may trigger hCG. This process is called coasting and patients who may tend to get OHSS should try this. It can also help in making their follicle size bigger for better fertility.
5. Use Dopamine agonists
Cabergoline is a dopamine drug that has been long used as a treatment for elevated prolactin levels. This can indirectly affect on VEGF receptors. Use of dopamine drugs can be very beneficial for preventing ovarian Hyper-stimulation syndrome as cabergoline may has affect on the person for around 8-21 days. This can have a positive impact on hCG levels, this dopamine drug needs to be taken once in a day only.
6. Freezing of eggs
Pregnancy increases the risk of OHSS and can also increase its severity; therefore it is important that eggs are made to freeze. For this process, the eggs or embryo needs to be taken out from the mother’s body and freeze it in area meant for keeping these eggs safe. This will prevent the woman from having OHSS and also reduce the risk of complication with the baby. This process is being recommended by many doctors these days as a precautionary step for fertility.
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