Clinical Characteristics and Management of Ovarian Endometrioma Complicated by Infertility Treatment-Induced Tubo-Ovarian Abscess: A Retrospective Study

Yukiko Okada, Mari Kitade, Yasuho Yanagihara, Shiori Takeuchi, Mutsumi Kobayashi, Asako Ochiai, Yu Kawasaki, Keisuke Murakami, Kazuhiro Kawamura, Atsuo Itakura
Journal of Obstetrics and Gynaecology Research · 2026 · vol. 52(4) , pp. e70262 · doi:10.1111/jog.70262 · PMID:41905746
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective study found a higher incidence of TOA in ovarian endometrioma patients undergoing infertility treatment, with transvaginal ultrasound-guided drainage showing a high success rate.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This retrospective study evaluated incidence, clinical characteristics, treatment approaches, and outcomes of infertility treatment–related tubo-ovarian abscess (TOA) in 17 patients with ovarian endometrioma (OE) associated with infertility, treated at one hospital from 2011 to 2022. Compared with patients without OE, the incidence of TOA was higher after oocyte retrieval (1.07% vs. 0.03%, p = 0.0001) and after frozen–thawed embryo transfer (1.09% vs. 0.00%, p = 0.0055). Transvaginal ultrasound-guided drainage was used in 14 patients with a 78.6% success rate, 18.2% relapse among successes, and no procedure-related complications; the main limitation is the small sample size and retrospective design. This paper is centrally about endometriosis—specifically ovarian endometrioma complicated by infertility treatment–induced tubo-ovarian abscess.

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Abstract

AIM: To evaluate the incidence of tubo-ovarian abscess (TOA) in patients with ovarian endometrioma (OE) undergoing infertility treatment and to describe treatment approaches and clinical outcomes, including transvaginal ultrasound-guided drainage. METHODS: This retrospective study included 17 patients with OE-associated infertility who developed infertility treatment-related TOA and were treated at our hospital between January 2011 and December 2022. Patient characteristics, diagnostic findings, the incidence of TOA associated with assisted reproductive technology in patients with and without OE, treatment approaches, and clinical outcomes were analyzed. RESULTS: The incidence of TOA was higher in patients with OE than in those without OE following oocyte retrieval (1.07% vs. 0.03%, p = 0.0001) and frozen-thawed embryo transfer (1.09% vs. 0.00%, p = 0.0055). Transvaginal ultrasound-guided drainage was performed in 14 patients, with a success rate of 78.6% (11/14), a relapse rate of 18.2% (2/11), and no procedure-related complications. CONCLUSIONS: Patients with OE are at increased risk of developing TOA during infertility treatment. Transvaginal ultrasound-guided abscess drainage is a safe and minimally invasive method for infection control and may help avoid emergency surgery during the acute phase as part of a multidisciplinary treatment strategy.
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Abstract

Aim To evaluate the incidence of tubo-ovarian abscess (TOA) in patients with ovarian endometrioma (OE) undergoing infertility treatment and to describe treatment approaches and clinical outcomes, including transvaginal ultrasound-guided drainage.

Methods

This retrospective study included 17 patients with OE-associated infertility who developed infertility treatment-related TOA and were treated at our hospital between January 2011 and December 2022. Patient characteristics, diagnostic findings, the incidence of TOA associated with assisted reproductive technology in patients with and without OE, treatment approaches, and clinical outcomes were analyzed.

Results

The incidence of TOA was higher in patients with OE than in those without OE following oocyte retrieval (1.07% vs. 0.03%, p = 0.0001) and frozen–thawed embryo transfer (1.09% vs. 0.00%, p = 0.0055). Transvaginal ultrasound-guided drainage was performed in 14 patients, with a success rate of 78.6% (11/14), a relapse rate of 18.2% (2/11), and no procedure-related complications.

Conclusions

Patients with OE are at increased risk of developing TOA during infertility treatment. Transvaginal ultrasound-guided abscess drainage is a safe and minimally invasive method for infection control and may help avoid emergency surgery during the acute phase as part of a multidisciplinary treatment strategy. Disclosure An earlier version of this article was presented in abstract form at the 44th Annual Meeting of the Japan Society of Endometriosis, held in Kochi, Japan, on January 21–22, 2023, and at the 75th Annual Congress of the Japan Society of Obstetrics and Gynecology, held in Tokyo, Japan, on May 12–14, 2023. Conflicts of Interest The authors declare no conflicts of interest. Data Availability Statement Data supporting the findings of this study are available in the Supporting Information of this article.

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Condition tags

endometriosisendometriomainfertility

MeSH descriptors

Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess Abscess

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