INTRAFOLLICULAR OVARIAN PREGNANCY AFTER OVULATION INDUCTION INTRAUTERINE INSEMINATION - PATHOPHYSIOLOGICAL ASPECTS AND DIAGNOSTIC PROBLEMS

Ovarian pregnancy is a rare variant of ectopic implantation. A case of an intrafollicular ovarian pregnancy after ovulation induction/intrau terine insemination is presented. The woman had primary infertility of 4 years. Diagnostic laparoscopy revealed endometriosis and adhesions. After adhesiolysis and laser vaporization of endometriotic implants, the patient underwent ovulation induction with artificial insemination by husband/intrauterine insemination; she conceived at her second att empt. The pregnancy proved to be an ovarian intrafollicular one. She n as treated by right partial ovariectomy. Three months later she concei ved spontaneously with an intrauterine pregnancy which is still ongoin g. The diagnostic problems resulting from the coexistence of ovarian h yperstimulation and the intrafollicular development of pregnancy are d iscussed. A re-evaluation of the criteria for the diagnosis of ovarian pregnancy based on the currently available diagnostic methods is prop osed. Moreover, the pathophysiology of ovarian and especially intrafol licular implantation is reviewed.