From the Guidelines
Aspirin is not recommended for patients with Ovarian Hyperstimulation Syndrome (OHSS) who are planning to fly, as it provides minimal benefit in preventing blood clots while potentially increasing bleeding risk. OHSS already increases the risk of blood clots, and air travel further compounds this risk due to immobility and cabin pressure changes. Instead, patients with OHSS should consider low molecular weight heparin (such as enoxaparin 40mg daily via subcutaneous injection) before flying, especially for flights longer than 4 hours, as suggested by the LONFLIT-3 study 1.
To minimize the risk of venous thromboembolism (VTE), patients with OHSS should also:
- Stay well-hydrated during the flight
- Move regularly (at least every hour)
- Wear compression stockings (15–30 mmHg) to reduce the incidence of asymptomatic DVT and leg oedema 1
- Avoid alcohol or sedatives that might increase immobility OHSS causes fluid shifts and increased blood viscosity, creating a hypercoagulable state. Adding aspirin, which primarily affects platelet function rather than addressing the clotting cascade most relevant in OHSS, provides minimal benefit while potentially increasing bleeding risk. If travel is non-essential, consider postponing flights until OHSS symptoms resolve, typically within 7-10 days for mild cases or 2-3 weeks for moderate cases. The American Society of Hematology guideline panel suggests not using graduated compression stockings, LMWH, or aspirin for VTE prophylaxis in long-distance travelers without risk factors for VTE, but patients with OHSS are at increased risk of VTE 1.
From the Research
OHSS and Aspirin in Flight
- There is no direct evidence in the provided studies regarding OHSS (Ovarian Hyperstimulation Syndrome) and aspirin in flight.
- However, the studies do discuss the use of aspirin in preventing venous thromboembolism (VTE) in various situations, including air travel 2.
- One study calculated the potential benefit of aspirin in preventing VTE in air travelers and found that it would be necessary to treat 17,000 people with aspirin to prevent 1 additional VTE 2.
- Other studies discuss the use of low-molecular-weight heparin (LMWH) and compression stockings in preventing VTE in patients undergoing surgery, including knee arthroscopy 3, 4, 5 and neurosurgery 6.
- These studies suggest that LMWH and compression stockings can be effective in preventing VTE, but the use of aspirin is not directly addressed in the context of OHSS and flight.
- There is no evidence to suggest that aspirin would be beneficial or harmful in preventing OHSS in flight, as OHSS is not discussed in the provided studies.