Severe ovarian hyperstimulation syndrome, selective embryo reduction and heterotopic pregnancy.

Ovarian hyperstimulation syndrome is common (21.4%) in patients with polycystic ovarian disease, treated by gonadotrophins. It is much frequent (50%) in conceptual cycles. We report a case associated with a quadruplet pregnancy that underwent selective embryo reduction at 8 weeks' gestation to a twin pregnancy and was subsequently found to have an unruptured ectopic pregnancy at 11 weeks' gestation. After laparotomy and partial salpingectomy a successful twin pregnancy ensued.