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Ovarian Hyperstimulation Syndrome

The main risk of Follicle Stimulating Hormone (FSH) and Clomid therapy is Ovarian Hyper-Stimulation Syndrome (OHS), although this is far less likely to occur with Clomid as usually only 2-3 follicles develop. OHS has been categorised into mild, moderate and severe forms.

With mild stimulation, the ovaries are enlarged. There is some abdominal pain and swelling, but usually no treatment other than rest is required. The moderate form of the syndrome results in significant enlargement of the ovaries and the collection of a large amount of fluid in the abdomen. Nausea and vomiting may develop which may require medication for treatment.

Sometimes hospitalisation is required. Severe hyper-stimulation syndrome can be a life-threatening condition. There is massive enlargement of the ovaries, extensive accumulation of abdominal fluid, changes in blood clotting, and dehydration. This can result in blood clots, heart failure and kidney failure. Intravenous fluids and drainage of abdominal fluid and careful monitoring possibly in intensive care are required for treatment.

The Wesley Monash IVF Service also has a stimulation and treatment protocol in place for those patients at risk of developing hyper-stimulation, to reduce the likelihood of this occurring. Since this protocol was introduced, the incidence of OHS has been minimal.

Patients who are at risk of developing hyper-stimulation will not have a fresh embryo transfer after egg pick-up. The embryos will instead be frozen and transferred the following month. This is because if patients with hyperstimulation become pregnant, the symptoms of hyper-stimulation often become much worse

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