Eliminating Ovarian- Hyperstimulation Syndrome

Ovarian Hyperstimulation Syndrome (OHSS) occurs in women who have had FSH (Follicle Stimulating Hormone) administered as part of infertility treatment.

The high hormone levels and increased ovary size can cause side effects such as increased abdominal distension, nausea, pain and shortness of breath and can result in hospitalisation for lengthy periods. The incidence of OHSS in artificial reproductive programs is 1 to 5% of all patients and it is very rare to see this condition in women who have had less than 10 eggs collected.

At our Toowoomba clinic, Dr John Esler continues to report no incidence of OHSS since 2006. Traditionally, cycles involve starting patients on Synarel (a GnRH agonist) on day 21 and triggering ovulation on day 14 with HCG (Human Chorionic Gonadotrophin) which is usually Ovidrel or Pregnal.

OHSS is known to be due to the administration of HCG and more common in people with Polycystic Ovarian Syndrome. To help eliminate OHSS, Dr Esler uses an antagonist (Cetrotide) from day 7 to day 11 as either a single or multiple dose. Ovulation is then triggered with a high dose of Synarel, inducing the secretion of androgenous LH (Luteinising hormone). This eliminates the need to administer HCG. Dr Esler also uses a combination of Crinone Gel, Progesterone pessaries and provera tablets during the luteal phase to further eliminate the usage of HCG.

He contributes this regime to his success in minimising the incidence of OHSS in his Toowoomba patients. Dr Esler also reports that his new regime is producing the same number of eggs and has maintained embryo quality and success rates.