A study of seven cases that underwent laparoscopic surgery for pelvic infection after fertility treatment

Mako Ueda, Tomoko Ando, Hajime Araki, Masafumi Kuroyanagi, Yoshiki Masahashi, Miho Suzuki, Nobuhiko Fukuhara, Ai Saito, Mioko Hando, Katsuhiko Hiromura
In: JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · 2024 · vol. 39(2) , pp. 21–27 · doi:10.5180/jsgoe.39.2_21 · W4390964488
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This study identified future issues arising from pelvic infection after fertility treatment and subsequent laparoscopic surgery through analysis of seven patient cases.

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

This retrospective study reviewed seven cases (ages 31–47) of pelvic infection occurring after fertility treatment and treated with laparoscopic surgery at one hospital between 2009 and 2022, focusing on backgrounds, surgical details, complications, and clinical course. One case had peritonitis only, while six had tubo-ovarian abscess; among those with TOA, five had ovarian endometriotic cysts and one had a mature teratoma, with infection triggered by intrauterine insemination, oocyte retrieval, or embryo transfer. The median interval from symptom onset to surgery was 16 days (7 days for emergency surgery), and while no complications were observed, three cases had reinfection after resuming fertility treatment. Four patients later became pregnant at subsequent embryo transfer with live births at term, and the paper reports that laparoscopic surgery was safely performed for these infections despite prolonged hospitalization and recurrence. This paper is centrally about endometriosis — it specifically reports that five of six tubo-ovarian abscess cases after fertility treatment involved ovarian endometriotic cysts treated laparoscopically.

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Abstract

Objective: The purpose of this study was to identify future issues brought about by pelvic infection after fertility treatment and laparoscopic surgery.
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Objective

The purpose of this study was to identify future issues brought about by pelvic infection after fertility treatment and laparoscopic surgery.

Methods

We retrospectively reviewed the background, surgical details, complications, and course of cases of pelvic infection that underwent laparoscopic surgery after fertility treatment at our hospital from January 2009 to April 2022.

Results

Seven patients aged 31-47 years were included in this study. One had peritonitis only, and the remaining six had tubo-ovarian abscess (TOA), of which five had ovarian endometriotic cysts and one had a mature teratoma. The infection was triggered by intrauterine insemination in two cases, oocyte retrieval in two cases, and embryo transfer in three cases. The median time from onset to surgery for the seven patients was 16 days, and the median time for the five patients who underwent emergency surgery was 7 days. Patients with peritonitis underwent drainage, those with teratoma underwent adnexectomy, and those with endometriotic cysts underwent cystectomy and cauterization. Four patients became pregnant at a later embryo transfer and had live births at term. Complications were not observed, but three cases had reinfection due to resumed fertility treatment.

Conclusions

Laparoscopic surgery can be safely performed for pelvic infections and TOA associated with fertility treatment, and in more than half of the cases, pregnancy was possible in the next cycle or later. However, prolonged hospitalization and recurrence in nearly half of the cases were observed. Earlier surgical intervention and infection prevention during fertility treatment need to be considered in the future. © 2024 日本産科婦人科内視鏡学会

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last seen: 2026-06-10T17:14:06.276822+00:00
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