Tubo-Ovarian Abscess (TOA) Due to Bilateral Ovarian Endometriomas: Conservative Treatment to Retain Fertility-A Case Report

Yumiko Goto, Takahiro Suzuki, Atsuya Narita, Sungsil Kim, Eri Nakamura, Kenichi Goya, Shun‐ichiro Izumi, Mikio Mikami
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2010 · vol. 26(2) , pp. 585–588 · doi:10.5180/jsgoe.26.585 · W2329755086
article OA: bronze CC0
🔓 Open OA copy Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This case report describes the successful fertility preservation and subsequent IVF conception in a patient with a tubo-ovarian abscess stemming from bilateral ovarian endometriomas, managed with aspiration and conservative surgical techniques.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This 2010 case report describes a 37-year-old woman with stage IV endometriosis on initial laparoscopy, who had bilateral ovarian endometriomas associated with long-standing infertility, repeated failed IUI attempts, and later developed pelvic inflammatory disease followed by a tubo-ovarian abscess picture. The patient underwent multiple ultrasound-guided transvaginal endometrioma aspirations, received antibiotics when PID occurred, and ultimately had laparoscopic intervention with transvaginal ultrasound-guided aspiration to withdraw pus; after recovery, 10 poststimulatory eggs were harvested for IVF, resulting in delivery of a healthy baby. The report emphasizes that ovarian endometriomas are present in up to 25% of infertility patients and notes that while antibiotics are indicated for PID, drainage may still be required, but the main limitation is that these findings are from a single patient case. This paper is centrally about endometriosis — specifically, tubo-ovarian abscess due to bilateral ovarian endometriomas and conservative fertility-preserving management.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Objective: To report a case of TOA from bilateral ovarian endometriomas and discuss how fertility may be preserved.Case: A 37-year-old gravida 1/para 0 female underwent treatment for infertility for seven years. Her initial laparoscopy, at age 31, disclosed bilateral ovarian endometriomas (stage IV endometriosis according to the revised classification of the American Society for Reproductive Medicine [r-ASRM]). Ultrasound-guided transvaginal endometrioma aspirations were done on four occasions, and more than 10 attempts at intrauterine insemination (IUI) failed. At age 35, she also developed pelvic inflammatory disease (PID) two days following an IUI procedure. Antibiotics were given and the infected ovarian cysts aspirated. However, the condition became episodic, so laparoscopic intervention with transvaginal ultra-sound guided aspiration was elected to withdraw pus. Once recovered, 10 poststimulatory eggs were harvested. She subsequently conceived with in vitro fertilization (IVF), and a healthy baby was finally delivered vaginally.Conclusions: Up to 25% of infertility patients have ovarian endometriomas. If PID develops, antibiotics are clearly indicated; but surgical drainage of pus may still be needed. We routinely give preservation of fertility high priority, using minimally invasive laparoscopy and transvaginal, ultrasound-guided aspiration. Ovarian function was thus retained for this patient, despite TOA and repeated endometrioma infections.
Full text 3,157 characters · extracted from oa-doi-fallback · 3 sections · click to expand

Abstract

Objective: To report a case of TOA from bilateral ovarian endometriomas and discuss how fertility may be preserved. Case: A 37-year-old gravida 1/para 0 female underwent treatment for infertility for seven years. Her initial laparoscopy, at age 31, disclosed bilateral ovarian endometriomas (stage IV endometriosis according to the revised classification of the American Society for Reproductive Medicine [r-ASRM]). Ultrasound-guided transvaginal endometrioma aspirations were done on four occasions, and more than 10 attempts at intrauterine insemination (IUI) failed. At age 35, she also developed pelvic inflammatory disease (PID) two days following an IUI procedure. Antibiotics were given and the infected ovarian cysts aspirated. However, the condition became episodic, so laparoscopic intervention with transvaginal ultra-sound guided aspiration was elected to withdraw pus. Once recovered, 10 poststimulatory eggs were harvested. She subsequently conceived with in vitro fertilization (IVF), and a healthy baby was finally delivered vaginally.

Conclusions

Up to 25% of infertility patients have ovarian endometriomas. If PID develops, antibiotics are clearly indicated; but surgical drainage of pus may still be needed. We routinely give preservation of fertility high priority, using minimally invasive laparoscopy and transvaginal, ultrasound-guided aspiration. Ovarian function was thus retained for this patient, despite TOA and repeated endometrioma infections. Case: A 37-year-old gravida 1/para 0 female underwent treatment for infertility for seven years. Her initial laparoscopy, at age 31, disclosed bilateral ovarian endometriomas (stage IV endometriosis according to the revised classification of the American Society for Reproductive Medicine [r-ASRM]). Ultrasound-guided transvaginal endometrioma aspirations were done on four occasions, and more than 10 attempts at intrauterine insemination (IUI) failed. At age 35, she also developed pelvic inflammatory disease (PID) two days following an IUI procedure. Antibiotics were given and the infected ovarian cysts aspirated. However, the condition became episodic, so laparoscopic intervention with transvaginal ultra-sound guided aspiration was elected to withdraw pus. Once recovered, 10 poststimulatory eggs were harvested. She subsequently conceived with in vitro fertilization (IVF), and a healthy baby was finally delivered vaginally.

Conclusions

Up to 25% of infertility patients have ovarian endometriomas. If PID develops, antibiotics are clearly indicated; but surgical drainage of pus may still be needed. We routinely give preservation of fertility high priority, using minimally invasive laparoscopy and transvaginal, ultrasound-guided aspiration. Ovarian function was thus retained for this patient, despite TOA and repeated endometrioma infections. © 2010 Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy Favorites & Alerts Recently viewed articles

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosisendometriomainfertility

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (8)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK