The 'epidemic' of OHSS

The problem of ovarian hyperstimulation syndrome and why doctors are keen to look at less aggressive forms of IVF.

According to Oxford Journals Human Reproduction (Vol. 14, No. 12, 2930-2931, December 1999), there has been a severe increase in the number of women suffering from the potentially fatal disorder, ovarian hyperstimulation syndrome, or OHSS.

Ovarian hyperstimulation syndrome happens when the body over-reacts to fertility drugs given to induce ovulation, by producing an excessive amount of eggs. The ovaries become bloated and painful and may rupture. The woman will have severe pain and even loss of consciousness and may have multiple organ failure and in extreme cases, death.

The journal stated that overuse of high-dose stimulation protocols has led to a rise in severe cases of OHSS. According to the authors, fertility doctors are being more 'liberal' in their use of these drugs.

In a study which was carried out between 1987-1996 the incidence of OHSS resulting from IVF rose from 0.06% to 0.24% which is an alarming four fold increase, with cases peaking in 1994.

Doctors began using human albumin to treat OHSS in 1993 but there is conflicting evidence as to whether it works as a preventative for OHSS since rates actually increased in the year after administration. Some people are also allergic to human albumin products so for them this would make matters worse.

The authors concluded their paper by stating:

'A drug-free IVF procedure, e.g. spontaneous cycles or in-vitromaturation, as already practised by some teams in the worldwould present enormous progress in definitely preventing OHSS,but will probably take some years to become a successful procedure which could then be proposed routinely.'