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Ovarian hyperstimulation syndrome ( OHSS ) is a condition in which the ovaries reply to medications used to induce conception . It is characterized by a meaning ovarian enlargement due to several ovarian cyst and a fluid shift in the tissue paper area . While most cases of OHSS are mild , severe cases occur , although they are rare.(1 )
Who Is At Risk For Ovarian Hyperstimulation Syndrome?
The causes of ovarian hyperstimulation syndrome during IVF treatment are sometimes very various .
woman Under 35 Years Of Age : Some studies can now show a connection between the age of the treated patients and the occurrence of ovarian hyperstimulation syndrome . It is often women before the age of 35 who are involve by the syndrome . This is explained by the fact that the compactness of the gonadotropin receptors in the ovary of immature women is higher and the response to gonadotropin administration from the outside is solid .
Moreover , there is the fact that younger women also have a importantly high number of ovarian follicles , which are able of fertilization . These are considered as ovarian reserves .
Low BMI : Another risk factor could also be a low body weight ( BMI below 20 ) . In woman with low-spirited body weight , the potential difference to develop an overstimulation syndrome with the addition of hormones is high-pitched .
The Presence Of PCOS : The likelihood of overstimulation is further increased by the presence ofPCOS ( polycystic ovary syndrome ) , and about 63 % of the affected patients with a hard course also have a diagnosing of polycystic ovaries.(1)(2 )
Higher Serum Estradiol Concentration And Other Factors
Ovarian hyperstimulation syndrome continue to occur in women who have high serum estradiol concentrations and chop-chop increasing estradiol levels , high follicle numbers , hCG stimulation in the luteal stage , and IVF treatment to become pregnant . An overstimulation syndrome that has already pass in the late history also favors the return of the next one .
If the treatment results in an estradiol value of more than 3,000pg / ml , the cps can be saved before the expiration by so - called coasting . It is of import that the follicle already have a diameter of 15 to 18 mm . If coasting is do , stimulation is suspended . With continued downregulation , the system then waits until the value of oestradiol has dropped below 3,000pg / ml.(2 )
Is There A Blood Test For Ovarian Hyperstimulation Syndrome?
Depending on the aesculapian chronicle and clinical symptoms , weight gain , thirst , abdominal discomfort , slight swelling of the dispirited abdomen , slight sickness and disgorgement are potential signs of ovarian hyperstimulation syndrome . Other sign are :
Superellipse expansion ( diameter > 5 centimetre ) , there are several corpus luteum that show a little amount of blowup in the abdominal cavity .
Blood cell volume and increase in white blood prison cell , dispirited sodium levels , hypoproteinemia
spartan ovarian hyperstimulation syndrome can guide to liver dysfunction ( expressed as hepatocyte terms ) and cholestasis , alkaline phosphatase , alanine transaminase , aspartate aminotransferase , and bilirubin increased creatine kinase .
Patients suspected of having ovarian hyperstimulation syndrome should have a gross blood count analysis , liver and kidney function tests , water supply and electrolyte test , pelvic ultrasound , body weight measurement , determination of the E2 level , etc . carried out.(5 )
Preventing Ovarian Hyperstimulation Syndrome
Nowadays , of course , the finish is to avoid hyperstimulation at best . The pregnancy hormone hCG plays a role here , which is necessary for the maturation of the testis cells and later on for the egg cubicle puncture . There would be no hyperstimulation without hCG . However , if no human chorionic gonadotropin is administer , egg puncture is not potential . In the yesteryear , it was , therefore , necessary to disrupt the treatment cycle .
Today , new arousal computer programme are used . They are make out as antagonist protocol – the eggs are not matured with hCG , but with a GnRH analog . Since hCG is no longer used , hyperstimulation can not be triggered .
However , such a procedure has a disadvantage : the luteal phase is disturbed , improvement is not potential even with a high Elvis of progesterone . The likeliness of gestation after the fertilized egg transfer would then decrease importantly . As a rule , the operation then set about to suspend fertilized egg cell and to reassign them into the uterus in the following cycle under normal and , above all , optimum conditions.(3)(4 )
Treatment For Ovarian Hyperstimulation Syndrome
Mild ovarian hyperstimulation syndrome unremarkably resolves spontaneously within a workweek of diagnosis . You may need an ovarian hyperstimulation syndrome diet . It is advocate to eat a high protein diet .
A restrained ovarian hyperstimulation syndrome requires closelipped monitoring of the vital parameter . Sufficient liquid prevent dehydration .
knockout ovarian hyperstimulation syndrome usually needs hospitalization with invasive intervention . These admit anticoagulants ( blood thinners ) , blood components , electrolyte corrections , and IV fluids . You may take intensive care for cardiovascular monitoring and ovarian hyperstimulation syndrome radiology management.(5 )
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