Treatment of anovulatory patients with gonadotropim significantly increased the incidence of multifetal gestation. Quintuplet gestation after ovulation induction with HMG and HLH is described. This is the first reported pregnancy after HLH. All infants survived and developed normally. Management of these cases poses special problems for the obstetrician, anesthesiologist, pediatrician and premature infant unit. Early diagnosis is imperative to achieve favorable results. Early hospitalization and complete bed rest for the mother are mandatory. Advance organization of an alert and adequately staffed emergency team will improve fetal salvage. Prolonged hospital stay of mother and infants may create a severe economic burden and steps have to be taken to relieve it. The public interest in plural birth and the involvement of news media may create a complicated situation for family, physicians and hospital. Planning and coordination with the institutional administration may prevent embarrassment and protect the patient's interests and privacy.