Sir, We have encountered the rare occurrence of the ovary virtually exploding during preparation for in vitro fertilization and wish to call attention to this possibility. The patient was a 31-year-old nulligravida with primary infertility for nine years. Controlled ovarian hyperstimulation was undertaken with a short antagonist protocol using recombinant follicle-stimulating hormone and gonadotrophin-releasing hormone antagonist followed by intramuscular injection of human chorionic gonadotrophin. Thirty-six hours later, seven oocytes were picked up under general anesthesia and ultrasound guidance from both ovaries. After intracytoplasmic sperm injection, three embryos were transferred to the uterus. Three days later, she presented to the emergency ward after three hours of sudden, sharp, right lower quadrant abdominal pain, nausea and vomiting. Her heart rate was 81beats/minute and blood pressure 110/80mmHg. There was rebound and direct tenderness in the lower abdomen and mild abdominal distension. Abdominal ultrasound revealed fluid in the cul-de-sac and abdomen. The ovaries were enlarged and included four or five luteinized follicles. The right ovary was larger than normal with enhanced echogenicity. The hematocrit value was 35.9%, a white blood cell count 21.9 × 103/uL with 75% polymorphonuclear cells. The patient was immediately sent to the operating theatre for laparoscopic evaluation. Blood pressure dropped just before operation, with a tachycardia of 120beats/min and because of the patient's shock status and abdominal distension, we changed to laparotomy. Severe bleeding was detected coming from a severed ovarian artery and vein. The right ovary could not be seen in its normal site, but the left one was normal with multiple follicles. First, the bleeding was controlled. Many small ball-shaped follicles were found between the bowel loops, under the liver and in the pelvic cavity (Figure 1). When the material that was dispersed from the pelvis up to the liver was aspirated and collected, it appeared as if the ovary had exploded. The patient received two units of packed cells. The postoperative recovery was uneventful, and she was discharged 24hours later. The histopathology report was consistent with follicles, ovarian capsule (germinal epithelium), ovarian stroma and hemorrhagic cystic corpus luteum. After two weeks, a pregnancy test was negative and ultrasound was normal for the left ovary and uterus, with no sign of residual ovarian hyperstimulation. Consent was obtained from the patient for this report. Follicles that distributed in the abdomen. To the best of our knowledge this is the first report of explosion of the ovary after induction of ovulation with gonadotrophins. The possible explanation for that, based on the sudden abdominal pain and enhanced ovarian ultrasound echogenicity on admission, could be hyperstimulation followed by possible torsion with increasing intra-ovarian pressure. Ovarian hyperstimulation syndrome is a serious complication that sometimes accompanies the use of exogenous gonadotrophins and occurs usually during the luteal phase or early pregnancy. Predisposed individuals are young women, those with polycystic ovaries and in cycles where conception occurs, particularly multiple pregnancies (1). The increased weight and volume of the ovary predisposes to adnexal torsion. The presence of sigmoid colon on the left and the larger right utero-ovarian ligament could explain why the right adnexa is more often affected (2). This case underscores the need for expeditious diagnosis and surgical intervention to prevent harmful consequences of ovarian torsion.