Ovarian Hyperstimulation Syndrome (OHSS) is a potential complication following egg retrieval, often during in vitro fertilization (IVF). It is characterized by swollen ovaries and a shift of fluid from the bloodstream into the abdominal and chest cavities. This fluid shift, caused by hormonal changes increasing blood vessel permeability, leads to symptoms like bloating, abdominal pain, and nausea. While medical oversight is required, dietary choices support recovery by mitigating symptoms and helping the body rebalance its internal chemistry. The primary goal of nutritional support is to counteract the loss of fluid and proteins from the blood.
Optimizing Fluid and Electrolyte Balance
The core physiological problem in OHSS is that leaky blood vessels cause plasma fluid to exit the circulation, leading to hemoconcentration, or blood thickening. This causes dehydration within the blood vessels and disrupts the balance of salts. Therefore, strategic hydration is paramount to restore fluid volume.
Drinking plain water alone is insufficient because it can dilute remaining electrolytes, potentially worsening the imbalance. The most effective approach involves consuming beverages containing sodium and potassium, the main electrolytes lost in the fluid shift. These electrolytes help pull the fluid back into the bloodstream, counteracting the effects of vascular permeability.
Recommended sources of fluid include electrolyte-rich drinks like sports beverages, coconut water, or specialized electrolyte powders. Broths, such as chicken or vegetable soup, and savory juices like V8, are also excellent because they provide both fluid and sodium. The American Society for Reproductive Medicine (ASRM) suggests maintaining an intake of around 2 to 3 liters of fluid daily, preferably with electrolytes. Pairing these beverages with slightly salty foods, such as crackers, also increases the sodium intake needed to maintain proper fluid balance.
Focusing on High-Protein Intake
A second component of managing OHSS is increasing dietary protein intake. Proteins, specifically albumin, are large molecules that circulate in the blood and exert oncotic pressure. This pressure draws fluid from surrounding tissues back into the blood vessels.
When fluid leaks out of the blood vessels, it takes proteins with it, reducing the blood’s oncotic pressure and perpetuating the fluid shift into the abdominal cavity. Consuming extra protein provides the building blocks to replenish protein stores, helping to restore oncotic pressure. This mechanism reverses the “third-spacing” of fluid that causes uncomfortable bloating and swelling.
A general recommendation is to aim for a protein intake constituting 25% to 30% of daily calories, or roughly 100 to 120 grams per day. Practical, easily digestible sources of high-quality protein are best, especially since nausea and discomfort are common symptoms. Incorporating protein into every meal and snack provides a steady supply of amino acids to support recovery.
Recommended Protein Sources
- Eggs
- Greek yogurt
- Lean meats like chicken and fish
- Protein powders mixed into smoothies
Foods and Substances to Strictly Limit
It is important to limit or avoid certain substances that can exacerbate OHSS symptoms or interfere with recovery. Substances with diuretic properties, such as caffeine and alcohol, should be strictly avoided. These increase urine production, accelerating fluid loss from the depleted bloodstream and worsening dehydration and hemoconcentration.
The intake of high-sugar beverages and foods should also be minimized during recovery. High sugar consumption can lead to gastrointestinal distress or contribute to fluid shifts that are counterproductive to rehydration. Additionally, foods known to produce gas and bloating, such as beans, broccoli, and carbonated sodas, can intensify abdominal discomfort caused by enlarged ovaries and fluid accumulation.
It is also advisable to limit the consumption of fatty or greasy foods, including highly processed snacks. These foods slow down the digestive process, potentially increasing feelings of heaviness, nausea, or abdominal fullness. Avoiding these items reduces stress on the digestive system, allowing the body to focus on restoring fluid and electrolyte balance.