Heterotopic pregnancy following ovulation induction by clomiphene citrate and timed intercourse: a case report

Abstract

We report a combined intra-uterine and unruptured tubal pregnancy following ovulation induction by clomiphene citrate (CC) and timed intercourse. The diagnosis of heterotopic pregnancy (HP) is the major problem until occurrence of tubal rupture. Because HP is a life-threatening condition, the diagnosis should be made as soon as possible. In a spontaneous conception, HP is a rare event. The risk of HP significantly increases after ovulation induction. Clomiphene itself could be associated with a high HP rate. We present a case with normally developing intra-uterine singleton pregnancy successfully managed by salpingectomy of synchronous tubal pregnancy following ovulation induction by CC and a review of the literature.

Heterotopic pregnancy with superfetation following ovarian stimulation: A case report

“…However, information about the association between CC and HP is limited and mainly restricted to case reports [ 6 , 7 ]. As far as we know, there is no association between the dosage, and duration of CC in women suffering from HP after using CC [ 7 , 11 ]. However, the majority of these cases had no previous risk factors for HP [ 6 , 7 ].…”

Successful treatment of a heterotopic tubal pregnancy by gasless laparoscopic surgery

“…5 The risk factor in our case was clomiphene citrate use, which was similar to previous reports. 10 Clomiphene citrate induction can cause multiple follicular development, ovarian hyperstimulation, multiple pregnancy and heterotopic pregnancy. 11 The preoperative diagnosis of heterotopic pregnancy requires a high index of suspicion.…”

Heterotopic triplet pregnancy (twin tubal) in a natural cycle with tubal rupture: Case report and review of the literature

“…Usually, tubal heterotopic pregnancy is diagnosed after developing acute abdominal syndrome which can lead to maternal shock or death. Very few cases (<10) have been reported in patients without tubal rupture or acute abdominal syndrome 17,18 . Typically, vaginal bleeding is absent in heterotopic pregnancy.…”