In vitro fertilization is a "lifeline" for many couples who want to have children, but one of the most serious consequences of this procedure is the ovarian hyperstimulation syndrome. This pathology is the response of the body to the introduction of a large number of hormonal drugs that are needed to stimulate the ovaries.
The first symptoms of ovarian hyperstimulation appear in the early stages of pregnancy, that is, after the patient returned home after finding positive dynamics. A sign of hyperstimulation of the ovaries is a feeling of discomfort in the lower abdomen, a feeling of heaviness and "bursting" due to a significant increase in the ovaries. Along with these changes, blood circulation is disrupted and fluid in the abdomen accumulates, which can be noticeable by an increase in waistline by 2-3 cm and a slight increase in weight. These signs characterize the mild form of the ovarian hyperstimulation syndrome, which, as a rule, disappears by itself in 2-3 weeks and does not require any special treatment. If a mild-to-severe disease passes into a severe one, the patient may experience vomiting, flatulence, and diarrhea. Due to the accumulation of fluid, not only in the lower abdomen, but also in the lungs, dyspnoea and nausea appear. With a severe degree of the syndrome, the ovaries can grow at a rate of more than 12 cm, causing acute renal failure, which requires immediate hospitalization.
Treatment of ovarian hyperstimulation syndrome
Based on the clinical manifestations of the disease, the treatment of ovarian hyperstimulation is performed in a conservative or surgical way.
The main principles of conservative treatment include the following procedures:
- providing bed rest for prevention of ovarian trauma;
- the appointment of a diet with a high content of protein products;
- compliance with the drinking regime: up to 3 liters per day;
- restoration of water-electrolyte balance with the help of hemodez solutions, etc .;
- suppression of nausea and vomiting with medications and adjusting the daily ration;
- elimination of pain syndrome with pain medication;
- injection of intravenous fluid (plasma, protein, albumin) to restore the volume of circulating blood;
- the use of antihistamines to reduce the permeability of capillaries.
If the patient has signs of internal bleeding when the ovary ruptures , then surgical intervention is practiced along with the use of conservative therapy. In most cases, with timely diagnosis and adequate therapy, the patient is expected to recover after 3-6 weeks of treatment.
How to avoid ovarian hyperstimulation?
Before the IVF procedure, care should be taken carefully to prevent ovarian hyperstimulation.
- refusal to stimulate with a pronounced tendency to develop ovarian hyperstimulation syndrome or a significant reduction in the dose of gonadotropic drugs;
- a temporary abolition of the embryo transplant procedure followed by its cryopreservation for transfer to the uterine cavity in the next menstrual cycle.
- elimination of the maximum possible number of follicles and cysts that appear in the process of stimulation;
- abolition of the administration of an ovulatory dose of chorionic gonadotropin or maintenance doses.
Some women can be attributed to the risk group for the development of ovarian hyperstimulation syndrome. This group includes young women under 35, especially those with a low body mass index. Also, women with polycystic ovary syndrome and those who received chorionic gonadotropin drugs in the past have the opportunity to have complications. The syndrome often occurs in women with high activity of estradiol in the blood serum, as well as in women with a variety of developing follicles.