The authors report a case of ovarian hyperstimulation leading to 6 endo-uterine pregnancies and one extra-uterine pregnancy. After embryonic reduction, and salpingectomy, a twin pregnancy was carried through, in a bifid uterus. Review of the literature enables to emphasize the difficulties in diagnosing heterotopic pregnancies, and to discuss the indications and techniques of selective embryonic reduction, along with the ethical and legal problems it raises.