Ovarian hyperstimulation syndrome associated with clomiphene citrate

Ovarian hyperstimulation is a recognized complication of ovulation inductio n with gonadotrophins. The syndrome is becoming more common as the number o f women undergoing in-vitro fertilization increases. It is rarely seen in c onjunction with clomiphene citrate usage. This case report is of moderate t o severe ovarian hyperstimulation in a patient who was treated with clomiph ene citrate because of infertility secondary to anovulation. She presented with amenorrhoea for five weeks, lower abdominal pain and a positive urinar y human chorionic gonadotrophin (hCG) test. Pelvic ultrasonography was sugg estive of a possible ectopic pregnancy with a differential diagnosis of a r uptured ovarian cyst. Diagnostic laparoscopy was done followed by laparotom y. Oophorectomy was performed because the ovary was thought to be complex w ith solid areas. However, conservative management with avoidance of laparot omy is the recommendation in confirmed cases of ovarian hyperstimulation bu t this requires a high level of suspicion inpatients who have ovulation ind uction.