Abstract

Heterotopic pregnancy is an infrequent condition in which both extra and intrauterine pregnancies occur concurrently. Its incidence is very low in spontaneously conceived pregnancies. However, the incidence of heterotopic pregnancy is very high in assisted reproductive techniques reaching up to 0.2 – 1 % after ovulation induction by clomiphene citrate. In our case report, we are going to discuss a patient with heterotopic pregnancy who conceived after ovulation induction by Letrozole, an anti-estrogen drug. In our case, extrauterine pregnancy in the fallopian tube presented in form of chronic tubo ovarian (TO) mass along with the complaint of pain in the lower abdomen and intermittent bleeding from the vagina which was managed laparoscopically. Here we concluded that heterotopic pregnancy should be highly suspected in all patients with pain in the lower abdomen even after confirmation of intact intrauterine pregnancy.