Recurrent bilateral theca lutein cysts in association with normal pregnancy

We describe a case of a 28-year-old Saudi patient, gravida 6, para 5, at 14 weeks' gestation, who had recurrent bilateral theca lutein cysts during her last three pregnancies. The cysts were treated surgically during her fourth pregnancy because of acute abdomen at 20 weeks' gestation. Ovarian biopsy confirmed the diagnosis of theca lutein cysts and her pregnancy continued until term. In the last two pregnancies, the theca lutein cysts were managed conservatively by serial ultrasound examination and they resolved spontaneously. There was no history of molar pregnancy or use of ovulation-inducing drugs. The possibility that there was increased sensitivity of the ovarian tissue to human chorionic gonadotropin is discussed.