Hyperstimulation of the ovaries: symptoms and consequences
Hyperstimulation of the ovaries – this is their response. They increase in size up to 10 cm, and in some cases up to 20. It happens because of high doses of hormonal drugs, recommended for acceptance for IVF to increase the number of eggs.
In the end, the female body produces great amounts of estradiol, thickens the blood, vessels become thinner, the fluid accumulates in the body and excreted with great difficulty, disperses throughout the tissues, causing swelling.
The ovarian hyperstimulation syndrome (ohss) is one of the most difficult consequences of IVF. It can face any woman who consented to the procedure of artificial insemination. This is especially true of those representatives of the fair sex who have long Protocol or has a genetic predisposition.
Ovarian hyperstimulation syndrome may develop even after the occurrence of the desired conception, or appear before the embryo is transferred into the uterus. The earlier the symptoms appear, the harder it will undergo treatment and may not always be effective.
Ovarian hyperstimulation syndrome can occur in mild or severe and each of these women the symptoms can be very different.
Who is most likely to develop the syndrome?
During IVF to predict that the patient will happen to the development of ovarian hyperstimulation syndrome, it is impossible. The syndrome is most often seen in:
- in women up to 35 years old with blond curls and a small body mass;
- women with such abnormalities as Ciscos or Polistes appendages;
- patients with high estradiol levels;
- women prone to allergic reactions;
- patients undergoing IVF who were assigned to the stimulation Protocol and GnRH or preparations of HCG to support luteal phase.
What are the symptoms should be cause to sound the alarm?
During the preparation for IVF, a woman must warn that may develop ovarian hyperstimulation syndrome, and if she shows the first symptoms will need to urgently inform your attending doctor.
Symptoms of mild forms of ohss are:
- discomfort in the abdomen, there is a feeling inside of it, someone blew up;
- waist size increased by several centimeters;
- pain in the lower abdomen as during menstruation;
- frequent urge to urinate;
- a small increase in body mass.
All these symptoms say that the female appendages have increased in size due to the fact that they formed a luteal or follicular cyst. Also occur disorders of blood flow, fluid accumulates in the lungs and peritoneum. In mild treatment, the patient is not required after 14-20 days, all shall, upon the occurrence of the menstrual cycle syndrome is also shrinking.
But in the event of pregnancy, or if conception has not occurred, a mild form of ohss may pass into the middle, and then heavy in the end to determine the complications of such manifestations:
- vomiting and diarrhea;
- complete lack of appetite;
- nausea because excess fluid accumulates not only in the abdominal region, but in the chest;
- heart rhythm is disturbed, blood pressure is greatly reduced;
- the appendages increase in size;
- symptoms of kidney failure.
If women, upcoming or past IVF symptoms, it is urgently required skilled care and effective treatment.
Treatment of mild forms of ohss
Therapy minor forms of the syndrome can be carried out at home without medication. To alleviate the effects need to make in the diet some changes.
- You first need to increase the consumption of fluid, drink about 3 liters a day. It doesn’t have to be water, you can also drink fruit drinks, broth hips, green tea. In no case can not drink gas and alcohol.
- You also need to remove from the diet of fatty and fried. Better to give preference to boiled meat, vegetables, fruit and herbs. Drinking milk, dairy products, porridge from cereals, fish and sea better.
- You also need to change their way of life: no stress and strain, this also applies to psychological.
- Sexual relations should be deleted. Every day we need to measure the body weight and the daily amount of urine. All measurements are important, they will help determine the dynamics of the syndrome after IVF.
How is the treatment of complex forms?
Treatment of severe ohss requires constant supervision, so spend it in the hospital. Therapy can include medicines and surgery.
Daily woman measure body weight, amount of urine per day, measure the belly, are monitoring the work of internal organs.
As the drugs prescribed are those that strengthen the walls of blood vessels and capillaries: antiprostaglandin, corticosteroids, antihistamines. In addition, the doctor recommends a dose of Fraxiparine and Clexane in the prevention of thromboembolism. To improve the composition of blood and not allow it to become thick — suggest to undergo several sessions of plasmapheresis – removal of toxins from the blood.
Severe forms of the syndrome are also treated by surgery – take a puncture of the peritoneum. If the cyst has burst or is there internal bleeding, without surgery can not do. Treatment of severe also hold conservative methods:
- lead to normal water and electrolyte balance;
- symptomatically eliminate vomiting and nausea;
- use painkillers;
- intravenous protein, plasma albumin to normalize the circulating blood volume.
If the time to take action and remove all the symptoms, after a month of therapy will be recovery.
What could be the consequences after hyperstimulation of the appendages?
It is worth remembering that the syndrome can provoke serious consequences:
- embryo implantation in patients with such complications is rare, can not be said about those that have undergone IVF and normally suffered stimulation;
- if conception has occurred, the health status of women with ohss much worse and the signs of his presence can be severe and will be manifested only after 10 weeks;
- the syndrome can cause exacerbation of chronic diseases;
- severe forms of the syndrome can lead to tearing of the cysts, ectopic pregnancy, torsion of the appendages;
- if there was torsion of the appendage, it can cause necrosis, and this means that the ovary will need to remove;
- thrombosis, thromboembolism, liver problems, kidney.
All of these factors can greatly reduce the IVF Protocol and add a woman health problems, and it means that her chances of conceiving are greatly reduced.
To prevent ovarian hyperstimulation syndrome in IVF you can completely abandon the drugs for stimulation of the appendages, it is certainly a big risk, but there is a chance. In this cycle after IVF chances of getting pregnant fall much, but the woman’s body is not exposed to major loads and in case of failure, will be ready with another procedure.
Did not come to serious consequences, also you can just slightly reduce the dose of gonadotropins. If the risk of the development of the syndrome is high, in this case it is better to freeze the embryos, in this state, they can be a long time until an appropriate time for replanting in the uterus.
During stimulation you need time to find and fix all the tumors on the epididymis, and perhaps it is only in the case that the patient will always be under a doctor’s care. If there is a risk of syndrome, it is better to cancel the dose of HCG needed to stimulate.
The best preventive measures are the right individual dose of hormonal therapy and a regular examination that will include measurement of follicle growth.
If you do not follow all the recommendations of doctors, the consequences can be so serious that even IVF won’t help the desired conception.