Ruptured ovarian cysts and bilateral ectopic pregnancy complicating a case of severe ovarian hyperstimulation syndrome.

Ovarian hyperstimulation syndrome (OHSS), ruptured ovarian cysts and bilateral ectopic pregnancies are all well-recognized entities occurring in association with infertility treatment. We are reporting a case of severe OHSS which was complicated initially by ruptured ovarian cysts and later by bilateral ectopic pregnancy. Diagnosis of tubal pregnancy was obscured by stimulated ovaries, which prevented accurate ultrasound definition. The role of transvaginal ultrasound, serial beta human chorionic gonadotropin and the place of paracentesis in diagnosing these cases are discussed.