Bilateral simultaneous isthmic ectopic pregnancy after clomiphene induction

Area of Science:

• Reproductive Medicine
• Gynecology
• Obstetrics

Background:

• Ectopic pregnancies, particularly tubal pregnancies, pose significant risks.
• Ovulation induction agents like clomiphene citrate (CC) are commonly used to treat infertility.
• Simultaneous bilateral tubal pregnancies are exceptionally rare, with few documented cases.

Purpose of the Study:

• To report a rare case of simultaneous bilateral isthmic tubal pregnancy.
• To emphasize the importance of considering bilaterality in ectopic pregnancies following CC-induced ovulation.
• To raise clinical awareness regarding this unusual presentation.

Main Methods:

• Case report of a 32-year-old woman with primary infertility.
• Detailed patient history including last menstrual period and intrauterine insemination.
• Documentation of symptoms: light vaginal bleeding and mild abdominal pain.
• Review of treatment: ovulation induction with clomiphene citrate.

Main Results:

• The patient presented with symptoms consistent with ectopic pregnancy.
• Diagnosis confirmed as simultaneous bilateral isthmic tubal pregnancy.
• The pregnancy occurred after intrauterine insemination and CC-induced ovulation.

Conclusions:

• Clomiphene citrate-induced ovulation may increase the risk of bilateral ectopic pregnancies.
• Clinicians should maintain a high index of suspicion for bilateral ectopic pregnancy in patients with risk factors.
• Early diagnosis and prompt management are essential for favorable outcomes in rare ectopic pregnancy cases.