The use of hormones to stimulate egg production in the ovaries has given new hope to women who are having difficulty becoming pregnant. Possible side effects of these hormone treatments include increased risk of ovarian cysts, and the risk of developing ovarian hyperstimulation syndrome.
The ovaries are the organs in a woman’s reproductive system that produce eggs. In a normal month, hormones trigger a woman’s body to prepare and release one egg for possible fertilization. In vitro fertilization, also known as IVF, is a procedure that removes eggs from a woman’s body so they can be fertilized in a laboratory then returned to the woman to help her become pregnant. Sometimes the eggs used belong to the woman hoping to become pregnant. Other times, the eggs are from a donor – a woman who makes her eggs available to another woman to help her get pregnant. In either case, the woman providing the eggs will be given injections of hormones to stimulate egg production so multiple eggs can be harvested in one procedure.
Ovarian cysts can develop when eggs mature in the ovaries but are not released correctly. Normally, the follicle holding an egg ruptures to release the egg. If the follicle does not rupture, it can become a fluid-filled sac that continues to grow inside or on the surface of the ovary. Hormones used in preparing women for egg donation can increase the risk of ovarian cysts. In most cases, ovarian cysts go away on their own in the course of a woman’s monthly cycle.
Ovarian Hyperstimulation Syndrome
A more serious side effect of hormones to stimulate eggs production is ovarian hyperstimulation syndrome or OHSS. This condition, which affects up to 10 percent of women who go through IVF, is caused by certain hormones commonly used to prepare a woman for egg donation. Initial symptoms of OHSS include bloating or swelling of the abdomen along with mild pain in the abdomen and weight gain. OHSS can also cause the ovary to twist, which can cut off the supply of blood and require emergency surgery to remove the ovary.
In serious cases of ovarian hyperstimulation syndrome, a woman can gain more than 10 pounds in just three to five days as fluids collect in her tissues and abdomen. This can cause severe swelling and pain as well as shortness of breath. Women who become pregnant while they have OHSS may have increased symptoms that can last for weeks. The most severe cases of OHSS can cause blood clots, kidney failure, fluid in the lungs, and even death.
For women who develop OHSS in the process of preparing for egg donation, the doctor may be able to let the body “coast” for several days before the next injection while still continuing with the planned egg donation. Mild cases of the condition usually resolve themselves within a month. More serious cases may require hospitalization and careful monitoring.
If you are considering becoming an egg donor, talk to your doctor or clinic staff about the risk of OHSS. Other hormone treatments to stimulate egg production without the risk of OHSS are being developed. If you have received hormone injections to prepare for egg donation and you develop swelling in the abdomen or sudden, unexplained weight gain, talk to your doctor to rule out complications from the hormone treatments.