Managing fertility treatment risks

Like all medical treatments, fertility treatment carries some risks and you will be briefed on these with you before you go ahead. Risks can include reactions to fertility drugs that may be prescribed, multiple births, ectopic pregnancy, OHSS and also the risks associated with any pregnancy.

Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian Hyperstimulation Syndrome (OHSS) is a serious risk particularly for patients with polycystic ovaries. OHSS occurs when a patient’s ovaries over-respond to the medication. They are enlarged and fluid ‘weeps’ into the abdominal cavity. We assess this by the patient’s history and by ultrasound.

Key Symptoms:

  1. The patient may complain of breathlessness and be breathless; she may require the use of a pillow to prop herself up at night in order to sleep.
  2. Pain and swelling in the abdomen. As fluid builds up in the abdomen the patient will experience a feeling of bloatedness.
  3. Nausea. The patient may feel sick and may even vomit.
  4. Feeling faint
  5. A decrease in the amount of urine being passed.

Identifying the patients who are at risk of OHSS is crucial. All patients who embark on an IVF cycle have an ultrasound assessment to check for polycystic ovaries because patients who have PCOS present a higher risk of developing OHSS. These patients are therefore monitored very closely and the dose of FSH they are prescribed is usually less than those without PCOS. Bear in mind that 30% of patients with PCOS have no physical symptoms so ultrasound assessment is very important in identifying patients at risk. Although OHSS is rare, it is extremely important that a patient raise any concerns she may have sooner rather than later so if it is a cause for concern it can be treated immediately and effectively.