The Dangers of the HCG Diet & Ovarian Hyperstimulation Syndrome

Ovarian hyperstimulation syndrome, or OHSS, is a painful condition that causes the ovaries to swell and release fluid into the belly and chest. OHSS occurs in about 25 percent of women after receiving in vitro fertilization treatments; of those, 10 percent who receive HCG will develop the condition. HCG, or human chorionic gonadotropin, was approved by the U.S. Food and Drug Administration for the treatment of infertility. The HCG weight-loss diet, which was developed by an endocrinologist in the 1950s, combines the hormone and a very-low-calorie meal plan. Your doctor can prescribe HCG off-label for weight loss purposes, but it is not FDA-approved for that purpose.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

About the Diet

An HCG diet is a multiphase protocol. HCG is injected intermuscularly for 23 days while participants limit their calorie intake to about 500 calories. In “Pounds and Inches,” written by A.T.W. Simeons, the diet’s architect explains that the hormone redistributes excess fat in a more normal way, allows the body to burn the fat and suppresses hunger. Dieters are given 125 international units, or IU, of the hormone, which is a fraction of the amount dispensed to women for the treatment of infertility.

Ovarian Hyperstimulation Syndrome

For in vitro fertilization, women are given from 5,000 to 10,000 IU of the hormone. In nonpregnant women who are prescribed HCG off-label by their doctor for weight-loss purposes, the risk of OHSS is present but to a smaller degree since the dose is smaller, says Shelly Burgess, a spokesperson with the U.S. Food and Drug Administration.


OHSS symptoms can be mild or severe. Most women have mild OHSS, which can cause transient abdominal pain, tenderness and bloating, nausea, vomiting and diarrhea. Symptoms of severe OHSS include intense pain, persistent nausea or vomiting, dark urine, shortness of breath and dizziness.

What to Do

Non-pregnancy-induced OHSS usually clears up on its own after one or two weeks. There is no cure for the condition, but there are things you can do to ease symptoms, reduce ovarian activity and prevent complications. The Mayo Clinic website suggests that you take an antinausea medication and prescription painkillers, note all changes in abdominal bloating by weighing yourself each day and measuring your belly, keep track of your urine output, drink lots of fluids, stay active and wear anti-clot stockings. Also, be sure to see your doctor so she can track your progress. If your symptoms are severe, you may need to be monitored in an inpatient hospital setting. Complications of OHSS include ruptured ovarian cysts, blood clots, liver and lung damage.