Ovarian stimulation has the risk for “hyperstimulation” (OHSS) which leads to ovarian enlargement and pain. In this case, accumulation of fluid in abdominal space and chest may occur and the patient may present with abdominal bloating, nausea, vomiting, or loss of appetite. At least 30% of patients having ovarian stimulation encounter a mild OHSS. Such patients can be relieved by analgesics and reducing their physical activity.
In moderate OHSS, the patients may have such symptoms as fluid accumulation in abdominal space and gastrointestinal symptoms. Such patients are closely followed up and usually show good response to an ambulatory care. This will get better within a few weeks without an intervention if no pregnancy has been achieved. 1-2% of patients encounter a severe OHSS.
In this case the symptoms include weight gain, fluid accumulation in the abdomen and chest, electrolyte anomalies, increased blood concentration, and rarely clotting of blood and renal problems. If any respiratory difficulty is present, the fluid accumulated in the abdomen should be drawn through a needle. The patients with severe OHSS may have to stay in the hospital until the symptoms become mild.