Quadruplet pregnancy after ovarian stimulation: The role of the counseling program to avoid dangerous pregnancies

The incidence of high-order multiple gestation (HOM) (triplet and quadruplet pregnancies) has increased noticeably in the last few years due to the increase of medically assisted reproduction techniques. In order to reduce these generally unsafe pregnancies, different solutions are available such as embryo reduction. However, the best and most ethical method is prevention. It is strongly suggested to assign these procedures to a fertility specialist with experience in preconception counseling in order to establish a good relationship between the physician and the couple. When HOM occurs, identifying the optimal gestational age for delivery becomes a mandatory goal for its management. We describe a case of a woman with a history of infertility who had ovarian hyper stimulation and, as a consequence of an inadequate medical compliance, a quadruplet pregnancy.