How to Avoid Overstimulation during IVF
- nataliagardneracup
- Apr 2, 2024
- 3 min read
Updated: Apr 2
OHSS, Ovarian Hyperstimulation Syndrome is an over-stimulation of the ovaries during IVF in response to HCG medication.
It occurs in around 3-5% of women having ART treatment.
Acupuncture can help to prevent OHSS.
What happens to the ovaries?
- The ovaries enlarge and fill with fluid.
- The ovaries release excessive amounts of oestrogen, progesterone and cytokines which cause vascular permeability (blood vessels allow more substances through).
- The fluid leaks from the blood into the abdominal cavity.
- In severe cases it can penetrate the lungs and the heart.
OHSS and PCOS
OHSS is a common complication of IVF for women who have PCOS as their ovaries do not respond in a predictable way to the medication.
What does OHSS mean for the IVF cycle?
- It can prevent a fresh embryo transfer from taking place
- OHSS may continue after transfer and into pregnancy
- Eggs collected are usually frozen for use in a future cycle
- If OHSS is moderate to severe, medical intervention is essential. See your fertility doctor in mild cases and go straight to hospital if moderate to severe.
- If you have a mild case of OHSS it can be treated with acupuncture and your IVF may be able to continue.
Stages of OHSS
1. Mild OHSS
Symptoms:
Abdominal bloating, nausea, diarrhoea, slight weight gain.
What should I do?
- Inform your fertility clinic
- Treat with acupuncture
- Avoid intense exercise and sex
- Light activity only
- Rest with legs raised
- Drink at least 10-12 glasses of fluid per day, especially drinks that contain electrolytes.
- Avoid alcohol or caffeine
2. Moderate OHSS
Symptoms:
Abdominal bloating which would increase the abdominal measurement, weight gain (more than 2lbs per day), vomiting and diarrhoea, scanty and dark urine and excessive thirst.
What should I do?
- Get checked out at hospital.
- You may be prescribed Cabergoline.
- Continue to follow the advice above if you are sent home
- Inform your fertility clinic
3. Severe OHSS
Symptoms:
Fullness and bloating above the belly button, shortness of breath due to fluid collecting in the lungs, urine reduction or darkening, calf and chest pains, lower abdominal pain and stools which are difficult to pass.
What should I do?
- Call an ambulance immediately
- Inform your fertility clinic
Chinese Medicine and OHSS
In Traditional Chinese Medicine OHSS is a Damp or Damp-Heat pattern. It usually comes from a deficiency of the Spleen Qi (energy) which then causes the fluids to accumulate. When heat is added into the mix, for example from Liver Qi stagnation and the stimulation medication, the fluids stagnate with the heat, causing something called:
Damp-Heat
This is what happens to the body in Chinese Medicine:
1. Ovarian stimulation drugs increase Heat in the body.
2. If you suffer from Qi deficiency, your body will struggle to then clear this heat as the body is weaker.
3. Strong Qi is needed to move the fluids in the body. If your body has weak Qi, it can’t move the fluids so they stagnate causing something we call Damp.
4. This Damp stagnation can sometimes mix with the heat from the medication causing Damp-Heat.
5. Damp-Heat symptoms are: calf pain, hard to pass stools, fluid retention, scanty urine, thirst, hot skin, diarrhoea, vomiting and chest obstruction. Your tongue may have a yellow, thick, greasy coating.
6. If the Damp did not mix with Heat your pattern would be Damp.
For example, you may have little or no thirst, vaginal itching, diarrhoea with mucus and a tongue with a white sticky coating.
Am I likely to suffer from OHSS?
OHSS is more likely if you:
- Are young with naturally high hormone levels.
- Respond quickly to stimulation drugs and have high oestrogen.
- Are donating eggs as medication is likely to be increased.
- Have the Chinese Medicine diagnoses of Damp, Spleen Qi Deficiency with Liver Qi Stagnation and Kidney Yin Deficiency. Kidney Yin Deficiency means there is already increased heat in the body and stagnation increases heat. This is exacerbated with the stimulation medication.
- Have PCOS. During the IVF stimulation phase, FSH and hCG are injected at high doses, creating a risk of superovulation. Women with PCOS have multiple half-ripened or unripened follicles which suddenly all develop.
What can you do to prevent OHSS?
1. Avoid dairy
Avoid peanuts
Avoid bananas
Avoid damp environments
Dry your hair after washing and keep the uterus and feet warm.
Eat warm foods and avoid fridge cold foods and drinks.
Exercise as part of a weekly routine to move the Liver Qi before stimulation occurs.
Have weekly acupuncture to clear Damp before you have your IVF cycle.
Check with your clinic if you are at risk and potentially consider a frozen transfer.
I hope this helps!
Comments