25 y/o/f received Ovulation induction and now complains of Lower abdominal pain

A 25 y/o female presented with lower ABDOMINAL PAIN. She was a case of primary infertility for 2 years and ultrasound findings of PCOD. HSG & her husband's spermogram were normal. She received ovulation induction with Clomiphene Citrate 100 mg/ day starting on day 2 of the cycle & continued with recombinant FSH on day 7. She presented with 6 weeks of amenorrhea with a c/o of lower abdominal pain. Pulse 108/min, BP 110/80 mmHg; mild tenderness was found on deep palpation of the right lower abdominal quadrant. Pelvic examination revealed an enlarged uterus corresponding to 6 weeks of pregnancy, with no bleeding. Transvaginal ultrasound attached below. What is the cause for her pain?


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- TVS image show intrauterine gestational sac( marked as IUP) - sac like structure seen marked as EP can't be assured what it may be? without real-time scanning But may be associated extrautrine pregnancy not said with assurance - OHSS may be the cause of pain
Ectopic pregnancy is identified with the widely-applied assisted reproductive technology In this case there is one intrauterine pregnancy and one ectopic pregnancy A rare complication of ovulation induction
Suggestive of "Heterotopic Pregnancy" A rare case. Intrauterine+Ectopic pregnancy at the same time.
It Seems Coincident pregnancy
Cont Same treatment
PID combination of confident choice is chandraprabha vati 2tds before food gokshuradi guggulu 2tds after food
Intrauterine and ectopic both pregnancy at a time. Due to complications of ovulation induction.
plz take a expert opinion on this as can't read sonography image..
No abnormality seen. Treatment to continue same

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