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OVERDOSE AND TREATMENT: The effect of overdose is unknown, nevertheless one could expect ovarian hyperstimulation syndrome to occur, which is categorized as mild, moderate or severe. Symptoms usually appear 3~6 days after treatment with hCG.
1) Mild hyperstimulation: Symptoms: Abdominal swelling and pain, ovaries enlarged to about 5cm diameter.
Therapy: Rest, careful observation and symptomatic relief. Ovarian enlargement declines rapidly.
2) Moderate hyperstimulation: Symptoms: Pronounced abdominal distension and pain, nausea, vomiting, occasional diarrhea, ovaries enlarged up to 12cm diameter.
Therapy: Pelvic examination of enlarged ovaries should be gentle in order to avoid rupture of the cysts. Rest and close observation to detect any progression. Symptoms subside spontaneously over 2~3 weeks.
3) Severe hyperstimulation: Symptoms: Pronounced abdominal distension and pain, pleural effusion, ascites, decreased blood volume, reduced urine output, electrolyte imbalance and sometimes shock, ovaries enlarge to in excess of 12cm diameter.
Therapy: Hospitalization and treatment should be conservative and concentrate on restoring blood volume and preventing shock. Acute symptoms subside over several days and ovaries return to normal over 20~40 days if conception does not occur. But symptoms may be prolonged if conception occurs.
