Conservative Management of Hemorrhagic Corpus Luteum During Ovulation Induction: A Case Report

Hemorrhagic corpus luteum (HCL) is a functional ovarian condition characterized by bleeding within the corpus luteum after ovulation, which may present with acute pelvic pain and risk of hemoperitoneum. In women undergoing ovulation induction, distinguishing HCL from other adnexal emergencies is challenging and requires careful clinical decision-making to avoid unnecessary surgical intervention, particularly in patients seeking fertility preservation. This study aims to describe the clinical presentation, diagnostic evaluation, conservative management, and follow-up outcomes of HCL occurring during letrozole-induced ovulation. This research used a descriptive case report design involving a 28-year-old nulliparous woman with infertility who developed acute right lower abdominal pain during a letrozole ovulation-induction cycle. Clinical data were obtained from medical history, physical examination, serial hemoglobin measurements, and repeated ultrasonographic evaluations. The patient was managed conservatively through close observation, analgesic therapy, tranexamic acid administration, laboratory monitoring, and follow-up imaging. The results showed that the patient remained hemodynamically stable, experienced improvement in pain severity, maintained relatively stable hemoglobin levels, and did not require blood transfusion or surgical intervention. Follow-up ultrasonography demonstrated spontaneous regression of the ovarian lesion. This case highlights that conservative management of HCL may be appropriate in selected stable patients when supported by continuous clinical assessment and imaging evaluation. Further studies are needed to establish standardized criteria for selecting patients suitable for conservative treatment during fertility management.