Can Ovarian Hyperstimulation Cause Miscarriage?

Ovarian hyperstimulation syndrome is a well known and a potentially life-threatening condition of ovulation induction. Hyperstimulation is short-term and does not trigger lasting impacts. Ovarian hyperstimulation syndrome (OHSS) is one probable outcome as a result of treatment with injectable gonadotropins, which are frequently applied to accelerate the ovaries to deliver more egg follicles.

Treatment for this disorder varies closely on how acute it is, and on whether or not any difficulties develop. OHSS may happen in females enduring in vitro fertilization (IVF) or ovulation stimulation with injectable doses. Occasionally, OHSS ensues during fertility therapies using medicines you consume orally, such as clomiphene.

Can Ovarian Hyperstimulation Cause Miscarriage?

Can Ovarian Hyperstimulation Cause Miscarriage?

Ovarian hyperstimulation syndrome can range from mild to severe cases

Mild OHSS: Study estimates that one in three females were identified symptoms of mild OHSS during controlled ovarian stimulation for in vitro fertilization. Mild Ovarian hyperstimulation syndrome typically resolves on its own.

Moderate OHSS- The incidence of moderate Ovarian hyperstimulation syndrome is estimated to be between 2 and 5%, while the severe form may occur in 0.2-3.1% of all cycles. Symptoms of moderate OHSS involve extreme thirst and dehydration.

Severe OHSS- The severity of Ovarian hyperstimulation syndrome should be graded according to a standardized classification approach. Several schemes have been developed for classifying the severity of Ovarian hyperstimulation syndrome based on the RCOG guideline. Severe OHSS often results in acute symptoms, such as renal breakdown, severe respiratory distress disorder, hemorrhage from the ovarian burst, and thromboembolism.1

What Are The Complications That Can Occur With Severe Ovarian Hyperstimulation Syndrome?

Severe ovarian hyperstimulation syndrome is unusual but can be deadly. One of the primary symptoms of ovarian hyperstimulation syndrome is pregnancy loss from miscarriage or termination because of complications. A prospective randomized study shows that cabergoline (a potent dopamine receptor agonist on D₂ receptors) reduces the early onset of Ovarian hyperstimulation syndrome with no changes in pregnancy, implantation, or miscarriages rates.

Women with acute and serious ovarian hyperstimulation disorder should be hospitalized for intravenous hydration and monitoring. Since severe OHSS is a life-threatening condition, iatrogenic complications can occur even in healthy young women desiring fertility. Furthermore, in an acute situation, endangering syndrome is the primary focus and the anticipated pregnancy becomes of secondary importance.

The initial Ovarian hyperstimulation syndrome configuration is correlated with exogenously directed HCG and a greater probability of a preclinical miscarriage, while late Ovarian hyperstimulation syndrome may be strongly correlated with the conception cycles, particularly multiple gestations, and is more prone to be serious.

Ovarian hyperstimulation syndrome signs typically show up after a few days of the release of eggs from the ovaries. In general, these symptoms resolve within a week or two, unless gestation ensues. Pregnant ladies often continue to have symptoms for 2-3 weeks or higher after a positive pregnancy test. The warning sign slowly goes away, and the rest of the pregnancy is not affected.2,3

Case Study On Obstetric Outcome Of Women With IVF Pregnancies

A study was conducted to evaluate the obstetric outcome of women with in vitro fertilization pregnancies hospitalized for ovarian hyperstimulation syndrome. The main outcome measures are Ovarian hyperstimulation syndrome morbidity, early pregnancy outcome, and obstetric complications. Results showed that the incidence of Ovarian hyperstimulation syndrome requiring hospitalization was just 1.1% among the 3500 IVF cycles.

Forty patients were hospitalized for severe Ovarian hyperstimulation syndrome in which 31 were singleton, 8 twins and 1 triplet. This is for a mean duration of hospitalization of 10 days compared with a control group of 80 IVF pregnancies. Early Ovarian hyperstimulation syndrome occurred in 22% of patients and late Ovarian hyperstimulation syndrome occurred in the remaining patients and the miscarriage rate was much similar to the OHSS group.4,5

References:

  1. Early and late ovarian hyperstimulation syndrome: early pregnancy outcome and profile. https://www.ncbi.nlm.nih.gov/pubmed/15576388
  2. Can ovarian hyperstimulation affect pregnancy? – From the American society of reproductive medicine. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/ovarian-hyperstimulation-syndrome-ohss/
  3. Is ovarian hyperstimulation syndrome associated with a poor obstetric outcome? https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/j.1471-0528.2000.tb10393.x
  4. Increased early pregnancy loss in IVF patients with severe ovarian hyperstimulation syndrome https://academic.oup.com/humrep/article/17/1/107/554121
  5. Update on prediction and management of OHSS – Outcome of IVF pregnancies following severe OHSS https://www.rbmojournal.com/article/S1472-6483(10)60047-8/pdf

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