This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Contraceptives, Subject name: Gynaecology & Obstetrics
A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites, the probable cause is - 
Select and explain. 
A. Uterine rupture, B. Ectopic pregnancy rupture, C. Multifetal pregnancy, D. Hyperstimulation syndrome
D: Hyperstimulation syndrome
Answer: D: Hyperstimulation syndrome 
Explanation: Ans. is 'd' Hyperstimulation syndrome (Ref : Shaws 13/e, p 304, 305 (12th/e, p. 242)). History of clomiphene citrate intake and the presence of ascites abdominal pain and distension strongly suggests ovarian hyperstimulation syndrome.Hyperstimulation syndrome results from clomiphene citrate intake.Other drugs which cause hyperstimulation syndrome:FSH/LH therapy (most commonly seen with this)*.GnRHC/F of hyperstimulation syndromeAscites, hydrothoraxGastrointestinal (abdominal pain, distension).Cerebrovascular accidentsRenal failureTorsion and hemorrhage in ovarian cyst.CoagulopathyLiver dysfunctionIt must be fairly obvious to you by now why I opted for hyperstimulation syndrome.Now lets see other options.Multifetal pregnancy - Clomiphene administration causes multiple pregnancy in about 10% cases. But the symptoms and signs of multiple pregnancy are altogether different from that of the patient.Ectopic Pregnancy - It's not mentioned anywhere that clomiphene administration causes ectopic pregnancy.Uterine rupture- Clomiphene administration has no effect on uterus. ' .