Background: Primary ovarian pregnancy is a relatively rare form of ectopic pregnancy with an incidence of 1/6,000-1/40,000 pregnancies.
Case Report: A 25-year-old woman, gravida 1, parity 0, presented with vaginal bleeding after 8 weeks of amenorrhea. Pelvic examination revealed a left adnexal mass and transvaginal ultrasound confirmed a left adnexal echocomplex mass with free fluid in the cul-de-sac. Serum β hCG was 3,441 mIU/mL. Emergency exploratory laparotomy was performed with a preoperative diagnosis of left ectopic pregnancy, suspected of ovarian pregnancy. Ruptured left ovarian pregnancy was intraoperatively diagnosed. Left salpingo-oophorectomy was performed. The histopathology confirmed ovarian pregnancy. She was well at discharge and throughout a 4-week period of follow-up.
Conclusion: Although primary ovarian pregnancy is rare and difficult to diagnose clinically and even intraoperatively, it can be detected early with the use of combined transvaginal ultrasonography and serum β hCG. The standard of care is conservative treatment in order to preserve the patient’s fertility.

Keywords: Ectopic pregnancy, Ovarian pregnancy, Primary