As a specialist in fertility treatments, one of my primary goals is to ensure the safety and well-being of my patients undergoing Controlled Ovarian Hyperstimulation (COH) for IVF or egg freezing. Ovarian Hyperstimulation Syndrome (OHSS) is a potential risk, but with careful monitoring and advanced strategies, we can significantly reduce the likelihood of severe symptoms.
Understanding OHSS
OHSS can occur when the ovaries over-respond to stimulation medications, resulting in the growth of a large number of follicles. This can lead to severe symptoms such as extreme bloating, fluid accumulation in the abdomen and lungs, and blood clots.
My Approach to Preventing OHSS
1. Personalized Monitoring and Medication Dosage
- Regular Monitoring: I carefully monitor each patient’s response to stimulation medications. This allows me to make timely adjustments to ensure the number of growing follicles is kept within a safe range.
- Tailored Dosage: Based on factors such as age, ovarian reserve, BMI, and medical history, I customize the dosage of stimulation medications. This personalized approach helps control the ovarian response and reduce the risk of OHSS.
2. Choosing the Right Trigger Shot
- HcG vs. Lupron: The type of trigger shot plays a crucial role in managing OHSS risk. For patients at higher risk, I prefer using a Lupron trigger over an HcG trigger. Lupron reduces the severity and duration of OHSS symptoms, while HcG can potentiate symptoms but typically lasts about 7 days.
3. Implementing “Freeze All” Cycles
- Avoiding Fresh Transfers: In patients at risk of OHSS, I often recommend “freeze all” cycles. By freezing all embryos and avoiding a fresh transfer immediately after retrieval, we can prevent the exacerbation of OHSS symptoms that can be caused by the HcG hormone produced during early pregnancy.
4. Managing OHSS Symptoms
- Symptom Management: If OHSS does occur, my team and I provide comprehensive support to manage symptoms and ensure patient comfort. In most cases, symptoms subside within a few days if no fresh transfer is performed.
- Adjusting Treatment Plans: In rare situations, if the ovarian response is too robust, we may pause the stimulation cycle to prioritize the patient’s health and restart treatment in the subsequent cycle.
Ensuring Patient Comfort and Safety
Your health and safety are my top priorities. Before starting COH, we will discuss your individual risk factors for OHSS and develop a tailored treatment plan that you feel comfortable with. Understanding these risks and having a clear plan in place will help optimize your treatment experience and outcomes.
