Evidence Hub

Heterotopic pregnancy following ovulation induction with clomiphene citrate therapy: A case report

Almeida A, Zambrano A, Rodriguez E, Raval V, Vinod J, Molina L, Hernandez HG, Abreu A

Case reports in women's health, 2025

Abstract

A heterotopic pregnancy is a rare, life-threatening condition in which an intrauterine and ectopic pregnancy occur simultaneously. The incidence of these pregnancies is increasing as the use of assisted reproductive technology and ovulation-inducing agents becomes more common and accessible. A 31-year-old woman with polycystic ovarian syndrome conceived following clomiphene citrate-induced ovulation and was later diagnosed with a heterotopic pregnancy at 10 weeks 2 days of intrauterine gestation and 9 weeks 2 days of ectopic gestation by transvaginal ultrasound following painless vaginal bleeding and rectal pain. The ectopic pregnancy was managed surgically, and the intrauterine pregnancy progressed to a full-term vaginal delivery. This case calls attention to the importance of physicians maintaining a high index of suspicion for heterotopic pregnancy in patients undergoing ovulation induction, despite reassuring imaging and nonspecific symptoms.

How strong is the evidence?

Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

Related studies

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free