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OHSS is a clinical condition resulting from overstimulation of ovaries. Most cases of OHSS are mild and can include symptoms such as nausea and abdominal bloating, but in rare cases the condition can become severe and lead to hospital admission and can be potentially fatal. Lower doses of Clomid should be used initially to avoid the risks of OHSS and multiple births, and then cycles should be monitored with ultrasound scans to assess the response of ovaries and lining of womb at least for the first cycle and day 21 blood tests for progesterone.
Other causes for anovulation should be excluded before Clomid is used. These can include bodyweight issues and other hormonal disorders. In particular, women with PCOS who are overweight are advised to lose weight before treatment. Clomid is not useful in women who are ovulating naturally or those who have unexplained infertility. Success rates for those with unexplained infertility are not higher when using Clomid, so alternative treatment pathways should be sought.
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