Brave & Curious with Dr Lora Shahine

Ep 43 Preventing and Treating OHSS: A Scary IVF Risk


Listen Later

Ovarian Hyperstimulation Syndrome (OHSS) is one of the scariest risk factors of IVF, but it doesn’t have to be. With preparation, treatment choices, and prevention, you can avoid this uncomfortable and potentially dangerous risk factor from ovarian stimulation.

To maximize the number of eggs retrieved for IVF and egg freezing, fertility treatment involves stimulating the ovaries to mature more eggs. A higher egg number can often predict a higher success rate with treatment, but a side effect can be significant fluid shifts and bloating also known as OHSS. 

When OHSS occurs, it can be mild, moderate, or severe, with symptoms ranging from discomfort and bloating to significant dehydration, shortness of breath, nausea, and even hospitalization for recovery.

In this episode, Dr. Shahine does a deep dive into OHSS. 

You'll learn

  1. What OHSS is
  2. Why OHSS happens and Who is at risk
  3. Ways to prevent OHSS
  4. Ways to treat symptoms if it occurs so you have a speedy recovery

This week’s fertility story is about an OHSS patient Dr. Shahine will never forget from her training. It’s a reminder to never to ignore your care team’s instructions. 

In this episode you'll hear: 

[00:00] Intro: What is OHSS and why is it scary?

[01:07] My experience caring for patients with OHSS over the years 

[02:13] OHSS Definition, Classification

[05:29] Physiology of OHSS – Why does it happen?

[07:12] Risk factors for OHSS – Who is at risk?

[09:41] Treatment options to prevent and recover quickly from OHSS

[09:55] Prevention of OHSS 

  • What to know before you start stimulation 
  • Choosing a protocol and medications to add to decrease risk 
  • Metformin, trigger shot, cabergoline, and more

[21:47] Treatment if OHSS happens 

  • How to recover faster
  • Increasing electrolytes and protein at home, 
  • When do you need IV fluids or hospitalization to recover (rarely)

[25:58] Fertility story of Dr. Shahine’s Patient: Warning of the dangers of OHSS 

[31:51] Outro and thank you 

Resources mentioned: 

Try LMNT daily during your stimulation process to increase electrolyte intake and decrease the symptoms of bloating during IVF and egg freezing. Mix one packet in 40 ounces of water and sip throughout the day. 

LMNT has sodium and potassium to help decrease bloating as well as magnesium to prevent constipation (common after egg retrieval) 

Using this link: drinklmnt.com/DrShahine or code DrShahine at checkout to get a sample pack of all flavors with your first purchase.

 Dr. Shahine’s YouTube Videos on OHSS

Mastering OHSS Prevention

OHSS is the Biggest Risk Factor for IVF: What you need to know

 

Stay Up to Date in Fertility News and Events:  Weekly Newsletter

Follow @drlorashahine

Instagram | YouTubeTiktokHer Books 

 

Studies mentioned in podcast

Who is at risk of OHSS? 

  1. Younger age: One study showed 60% of women who got OHSS were less than 35 yo 
    • https://academic.oup.com/ajhp/article-abstract/65/12/1148/5127940?redirectedFrom=fulltext 
  2. Lower BMI: Some studies show a higher risk of OHSS if BMI 5  https://www.sciencedirect.com/science/article/abs/pii/S0002937814001689 
  3. Antral Follicle count >24 https://www.sciencedirect.com/science/article/abs/pii/S0015028212005961 
  4. For more information on ovarian reserve testing see my video: https://youtu.be/bYJWXIY6GHg 
  5. Patients with PCOS often have a high AMH and high AFC – if you’re diagnosed with PCOS – ask about OHSS risk in IVF 
  6. A high response to stimulation in the IVF cycle can predict risk of OHSS 
    • Estradiol levels at time of trigger  >3500 pg/mL: https://pubmed.ncbi.nlm.nih.gov/12773437/ 
    • More than 20 follicles https://www.tandfonline.com/doi/full/10.1080/14647270601021743 
    • More than 15 eggs retrieved https://www.sciencedirect.com/science/article/pii/S0015028213034584 

 Aspirin and OHSS: https://www.sciencedirect.com/science/article/pii/S0015028209001320 

Metformin and OHSS: https://academic.oup.com/humrep/article/26/8/2178/645906 

Trigger shot and OHSS: https://www.sciencedirect.com/science/article/abs/pii/S1472648310602003 

Cabergoline and OHSS: https://academic.oup.com/jcem/article/92/8/2931/2597480

...more
View all episodesView all episodes
Download on the App Store

Brave & Curious with Dr Lora ShahineBy Dr. Lora Shahine

  • 4.9
  • 4.9
  • 4.9
  • 4.9
  • 4.9

4.9

131 ratings


More shows like Brave & Curious with Dr Lora Shahine

View all
Food Psych Podcast with Christy Harrison by Christy Harrison, MPH, RD, CEDS

Food Psych Podcast with Christy Harrison

3,073 Listeners

Fertility Friday | Fertility Awareness Mastery for Women's Health Professionals by Lisa Hendrickson-Jack, FAE, HRHP

Fertility Friday | Fertility Awareness Mastery for Women's Health Professionals

795 Listeners

Pregnancy Podcast by Vanessa Merten

Pregnancy Podcast

922 Listeners

40 Weeks Pregnancy Podcast by Vanessa Merten of the Pregnancy Podcast

40 Weeks Pregnancy Podcast

459 Listeners

The Skinny Confidential Him & Her Show by Lauryn Bosstick & Michael Bosstick / Dear Media

The Skinny Confidential Him & Her Show

14,944 Listeners

The mindbodygreen Podcast by mindbodygreen

The mindbodygreen Podcast

2,039 Listeners

The Egg Whisperer Show by Dr. Aimee Eyvazzadeh

The Egg Whisperer Show

237 Listeners

As a Woman by Natalie Crawford, MD

As a Woman

1,092 Listeners

The Kick Pregnancy Podcast by Dr Patrick Moloney and Brigid Moloney

The Kick Pregnancy Podcast

49 Listeners

Fertility Docs Uncensored by Various

Fertility Docs Uncensored

279 Listeners

What To Expect by iHeartPodcasts

What To Expect

197 Listeners

Mind Your Hormones by Corinne Angelica

Mind Your Hormones

235 Listeners

Fertility Confidence Podcast by Dr. Kelsey Duncan ND

Fertility Confidence Podcast

88 Listeners

Pursuit of Wellness by Mari Llewellyn & Pursuit Network

Pursuit of Wellness

2,726 Listeners

The Dr. Brighten Show by Dr. Jolene Brighten

The Dr. Brighten Show

58 Listeners