A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites, the probable cause is -

Ans. is 'd' Hyperstimulation syndrome (Ref : Shaws 13/e, p 304, 305 (12th/e, p. 242)). History of clomiphene citrate intake and the presence of ascites abdominal pain and distension strongly suggests ovarian hyperstimulation syndrome.Hyperstimulation syndrome results from clomiphene citrate intake.Other drugs which cause hyperstimulation syndrome:FSH/LH therapy (most commonly seen with this)*.GnRHC/F of hyperstimulation syndromeAscites, hydrothoraxGastrointestinal (abdominal pain, distension).Cerebrovascular accidentsRenal failureTorsion and hemorrhage in ovarian cyst.CoagulopathyLiver dysfunctionIt must be fairly obvious to you by now why I opted for hyperstimulation syndrome.Now lets see other options.Multifetal pregnancy - Clomiphene administration causes multiple pregnancy in about 10% cases. But the symptoms and signs of multiple pregnancy are altogether different from that of the patient.Ectopic Pregnancy - It's not mentioned anywhere that clomiphene administration causes ectopic pregnancy.Uterine rupture- Clomiphene administration has no effect on uterus. ' .