An unusual case of rebound ovulation during conservative management of an ectopic pregnancy following ovum donation.

Conservative medical management of ectopic gestations may be difficult in patients with elevated levels of beta-hCG and cardiac activity. This case highlights the difficulty of managing such patients. Doppler flow studies and serum P, if available, should be used and can help determine those patients requiring repeated dosing of methotrexate. Patients using donor gametes and hormonal supplementation who subsequently develop an ectopic gestation may experience "rebound" ovulation, which further clouds the clinical picture. Careful follow-up using serial blood testing and ultrasound study is essential in the correct interpretation of a potentially confusing clinical picture.