Bilateral ovarian pregnancy after intrauterine insemination and controlled ovarian stimulation.

OBJECTIVE

To report a case of bilateral ovarian pregnancy in a young patient who had previously undergone intrauterine insemination (IUI) and controlled ovarian stimulation (COS).

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 34-year-old woman who had previously undergone IUI and COS.

INTERVENTION(S): Emergency exploratory laparotomy for circulatory collapse. About 350 mL of bloody fluid was collected in the pelvic cavity. The left ovary was about 6 cm in diameter and was completely involved by a darkish hemorrhagic ovarian mass; the right ovary was involved by a 4-cm mass. A left ovariectomy and a partial resection of the right ovary with preservation of two-thirds of ovarian tissue was performed.

MAIN OUTCOME MEASURE(S): IUI and COS outcome.

RESULT(S): The pathologic diagnosis was considered, and bilateral ovarian pregnancy was confirmed according to the diagnostic criteria described by Spiegelberg.

CONCLUSION(S): Diagnosis of primary ovarian pregnancy is very difficult because of its rarity and asymptomatic state before rupture. However, early diagnosis is fundamental to avoid more serious complications and an emergency invasive procedure.