Background: Ovarian pregnancy is a rare type of ectopic gestation and presents a diagnostic challenge to the clinician. It is often confused with tubal ectopic pregnancy, corpus luteal cyst, and hemorrhagic ovarian cyst. An intrauterine device (IUD) is a known risk factor for ovarian pregnancy. We report a case of primary ruptured ovarian pregnancy managed with conservative laparoscopic surgery. Case: A 33-year-old woman with an IUD in situ underwent laparoscopy for left adnexal ectopic pregnancy. Diagnosis of left ovarian ectopic pregnancy was made intraoperatively. She underwent a laparoscopic left partial ovariotomy with left salpingectomy. Conclusion: Ovarian pregnancy, even though ruptured, can be managed by conservative fertility-sparing laparoscopic surgery instead of traditionally described surgeries consisting of oophorectomy or adnexectomy. (J GYNECOL SURG 31:280)
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