This is the most serious complication of IVF. Any patient undergoing ovulation induction is at risk of developing OHSS, although some more than others.
Ovarian hyperstimulation syndrome may be classified as mild, moderate or severe by symptoms and signs. the worst cases seem tends to be associated with pregnancy. Severe OHSS is a life threatening complication following ovarian stimulation.
The symptoms usually begin 4-5 days after the egg collection. The majority of women have a mild or moderate form of the syndrome and invariably resolve within a few days unless pregnancy occurs, that may delay recovery. Patient may complain of pain, a bloated feeling and mild abdominal swelling. In a small proportion of women, the degree of discomfort can be quite pronounced.
In some cases cysts appear in the ovaries (ovarian cysts) and fluid may collect in the abdominal cavity causing discomfort.
Very rarely the ovarian hyperstimulation is severe and the ovaries are very swollen. The woman will feel ill, with nausea and vomiting, abdominal pain. Fluid accumulates in the abdominal cavity and chest, causing abdominal swelling and shortness of breath. Reduction in the amount of urine produced. These complications require urgent hospital admission to restore the fluid and electrolyte balance, monitor progress, control pain and in some very serious cases, termination of pregnancy.
Complications associated with severe OHHS include blood clotting disorders, kidney damage and twisted ovary (ovarian torsion).