I just spent 10 days in the hospital for ovarian hyperstimulation. For eight days they tried Hespan. Finally when I could no longer take the pain, they tapped me and removed seven liters of fluid from my abdomen. Is this a common procedure? Does this happen often to women going through IVF? --Faith

Ovarian hyperstimulation is a relatively rare condition. Cases severe enough to require hospitalization occur in about 1 out of 200 ovulation induction cases. For those undergoing IVF, the risk factors include the number of eggs retrieved and the peak estradiol level. As retrieving a large number of eggs is one of the goals in IVF, this is a risk associated with this procedure. Some physicians believe that the use of intravenous albumin at the time of retrieval may reduce the risk, but research data have provided conflicting results.

With severe hyperstimulation, the ovaries enlarge and result in abdominal pain, and fluid leaks into the abdomen and the chest cavity. This can result in bloating, pressure, nausea and shortness of breath, as well as blood chemistry abnormalities and a thickening of the blood. The important thing to remember is that if you have undergone an ovulation induction treatment and experience any of these symptoms, you must check with your reproductive endocrine physician. Ovarian hyperstimulation syndrome can be a life-threatening condition if not recognized and treated in a timely fashion. Some women assume that as the symptoms do not appear to be related to their ovaries, they should go to an emergency room or see an internist or family physician. This can be a grave mistake.

Despite the severity of this situation, there is often a silver lining to the cloud. First, removal of the fluid often provides rapid and dramatic relief. Rarely, a repeat 'fluid tap" is necessary to remove a reaccumulation of fluid. More important, hyperstimulation is frequently associated with pregnancy, and resolution of the symptoms will usually proceed without adverse effects on the pregnancy.