By Neus Ferrando Gilabert BSc, MSc (embryologist).
Last Update: 04/25/2014

The patient undergoing a fertility treatment is comprehensively monitored on a regular basis by means of blood tests and pelvic ultrasound exams.

Usually from the second or third day onwards, you should visit the doctor almost every day and, depending on the response of the ovary, the dose may be readjusted so that uncontrolled ovarian hyperstimulation does not occur.

If a woman’s level of oestrogens is too exaggerated or if it increases too quickly while injections are still in the process of insertion, the risk of developing ovarian hyperstimulation syndrome may increase. In such case, you may need a lower dose or stop the treatment temporarily.

Prevention of ovarian hyperstimulation syndrome

Prevention measures

There is no fully effective action for the prevention of the ovarian hyperstimulation syndrome. However, the usual prevention measures taken can be summarised hereafter:

  • The patient’s profile: particular attention must be paid to women under age 30-35, women with previous history of OHSS, and women suffering from polycystic ovary syndrome.
  • Where there is high risk of developing OHSS, ovarian stimulation must be stopped or the injection of hCG must be delayed.
  • hCG administration: the dose of hCG can be diminished. Another option may be not using hCG to trigger ovulation. In the latter case, recombinant LH or GnRh analogs can be used if they have not been used for ovulation induction.
  • Follicular puncture and aspiration: it reduces the severity of OHSS.
  • During the luteal phase support, hCG should be avoided. Instead, natural micronized progesterone can be used.
  • Albumin prescription.

If the risk of ovarian hyperstimulation syndrome (OHSS) does not disappear even after adopting preventive measures, the cycle of artificial insemination, in vitro fertilisation, or ICSI should be stopped.

Ovarian hyperstimulation syndrome

Another option may be performing the embryo transfer some time after, allowing thus OHSS to fully disappear. To that end, embryo cryopreservation will be necessary.

Authors and contributors

 Neus Ferrando Gilabert
BSc, MSc
Bachelor's Degree in Biology from the University of Valencia (UV). Postgraduate Course in Biotechnology of Human Assisted Reproduction from the Miguel Hernández University of Elche (UMH). Experience managing Embryology and Andrology Labs at Centro Médico Manzanera (Logroño, Spain). More information