If you’re living with polycystic ovary syndrome (PCOS) and considering fertility treatment, you’ve probably come across the term ovarian hyperstimulation syndrome, or OHSS. It’s a possible complication of IVF, and it tends to crop up more in people with PCOS.
In this blog, we’ll walk through what OHSS actually is, why it’s more common in PCOS, and how we manage it during your IVF journey.
- What is OHSS?
- Why are people with PCOS more likely to develop OHSS?
- How follicles in the ovaries work
- How we minimise risk
- Next steps
What is OHSS?
Ovarian hyperstimulation syndrome (OHSS) happens when the ovaries overreact to fertility medication. These medications are designed to encourage your ovaries to produce more follicles than usual. Follicles are tiny fluid-filled sacs that each contain an egg, and stimulating more than one gives a better chance of successful IVF.
But sometimes, the ovaries get a bit too enthusiastic.
In OHSS, your body responds to the stimulation by producing too many follicles, which can cause the ovaries to swell and leak fluid into the abdomen. It’s usually mild, but in rare cases, OHSS can become serious and need hospital care.
Symptoms might include:
- Bloating or a feeling of fullness
- Abdominal discomfort
- Nausea
- Rapid weight gain
- Shortness of breath (in severe cases)
Why are people with PCOS more likely to develop OHSS?
PCOS affects how your ovaries function. One of the key features is that the ovaries tend to have lots of small, immature follicles. These follicles don’t always grow and release eggs in the way they should, which can cause irregular cycles or ovulation problems.
Because of this, when someone with PCOS starts ovarian stimulation for IVF, their ovaries can respond quite strongly - even to low doses of medication. Instead of producing a handful of mature follicles, they might produce many more, increasing the risk of OHSS.
Think of it like turning on a garden hose. For most people, you need a strong twist of the tap to get the water flowing. But with PCOS, the hose is already pressurised, so even a gentle turn can release a gush.
How do follicles work in the ovaries?
Each month, your ovaries naturally prepare a group of follicles for ovulation. Usually, one follicle becomes dominant, grows large enough, and releases an egg - that’s ovulation. The others quietly disappear.
In IVF, we use medications to encourage multiple follicles to grow at the same time. This increases the number of eggs we can collect, giving you more opportunities for fertilisation and embryo development.
Monitoring during treatment helps us track how your follicles are developing, and we tailor your medication dose based on how your body responds. If you have PCOS, we’re extra cautious to find that sweet spot, stimulating your ovaries just enough, without tipping into OHSS territory.
How we keep you safe at Care Fertility
At Care Fertility, our teams are experienced in supporting patients with PCOS. Before you even meet your doctor, we’ll arrange your fertility tests so they have a clear picture of your hormone levels and ovarian reserve. This helps us create a stimulation plan that suits your body.
We keep a close eye on follicle growth during treatment, using regular scans and blood tests. If we spot signs that your ovaries are responding too strongly, we’ll adjust your plan or use a different trigger injection to lower your risk of OHSS.
Your safety is always our priority. And if you ever feel unsure or uncomfortable during treatment, we’re here to listen and act, every step of the way.
What happens next?
Having PCOS shouldn’t stop you from starting a family. We’ll work with you to create a plan that’s safe, effective, and entirely tailored to your body.
If you’ve got questions or you’re ready to take the next step, give our team a call. We’ll get you booked in for your fertility tests and guide you through everything from your first scan to your final treatment plan.
