Ovarian Hyperstimulation Syndrome (OHSS)
An over-response to fertility drugs causing swollen, painful ovaries and fluid buildup.
OHSS is an iatrogenic complication of ovarian stimulation in which too many follicles develop and the ovaries release large amounts of vascular endothelial growth factor (VEGF), causing fluid to leak from blood vessels into the abdomen and chest.
Mild OHSS (bloating, mild discomfort) affects up to 30% of IVF cycles, while severe OHSS (difficulty breathing, blood clots, kidney problems) occurs in 1–2% of cycles. Patients with PCOS and high AMH are at greatest risk.
Strategies to prevent OHSS include using a GnRH agonist trigger instead of hCG, freezing all embryos (freeze-all strategy), and careful dose titration of gonadotropins.
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