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 my IVF cycle?
- It can prevent 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, Western medical intervention is essential. See your fertility doctor or go straight to hospital.
- 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
- Treat with Qigong free energy clearing
- 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
- Take an over-the-counter pain relief
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, 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 (fluid collecting in the lungs), urine reduction or darkening, calf and chest pains, lower abdominal pain, 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 (TCM) OHSS is a Damp or Damp-Heat pattern. It usually comes from a deficiency of Qi which then causes a stagnation of Damp.
This is what happens to the body according to TCM:
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, chest obstruction. Your tongue would have a yellow, thick greasy coating.
6. If the Damp did not mix with Heat your pattern would be:
Damp Stagnation with symptoms: cool skin, little or no thirst, diarrhoea with mucus, 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 stimulating drugs and have high oestrogen (E2)
- Are donating eggs (medication likely to be increased)
- Have the Chinese Medicine (acupuncture) diagnoses of Damp, Spleen Qi Deficiency and possibly also Kidney Yin Deficiency. Kidney Yin Deficiency means there is already increased heat in the body. This is exacerbated with the stimulation medication.
- Have PCOS – During 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 I do to prevent OHSS?
If you have Damp or Spleen Qi Deficiency:
1. To ascertain whether you suffer from Damp, look at this article, “What TCM Fertility Diagnosis do I have?”
2. Book in with an acupuncturist to clear Damp before you have your IVF cycle.
If you have PCOS:
1. In order to prevent OHSS, if you have PCOS, you can buy aPCOS Healing meditation here.
2. Check out the free resources on Instagram at creation.acupuncture
3. Book in with an acupuncturist who can counter-act the side-effects of the medications.
If you suspect that you have high hormone levels:
1. Get a blood test or ask your fertility doctor the results of your day 1-3 blood test.
I hope this article was helpful. Sending you love, peace and joy.