A Case of Pregnancy Complicated by the Development of a Tubo-ovarian Abscess Following In Vitro Fertilization and Embryo Transfer

Matsunaga Y, Yuko Matsunaga, Fukushima K, Kotaro Fukushima, Nozaki M, Masahiro Nozaki, Naoyuki Nakanami, Nakanami N, Kawano Y, Yoshiaki Kawano, Toshiyuki Shigematsu, Shigematsu T, Satoh S, Shoji Satoh, Nakano H, Hitoo Nakano
American journal of perinatology · 2003 · vol. 20(6) , pp. 277–282 · doi:10.1055/s-2003-42772 · PMID:14528395 · W147555711
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This case report describes a pregnancy complicated by a tubo-ovarian abscess after IVF-ET, which necessitated preterm delivery and salpingo-oophorectomy, highlighting a potential risk of assisted reproductive techniques.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This case report describes a pregnant patient who developed a tubo-ovarian abscess during pregnancy after in vitro fertilization with embryo transfer, with intravenous antibiotics used prior to delivery at 22 weeks of gestation. Following delivery, the patient underwent a left salpingo-oophorectomy, and the authors note that only 26 cases of tubo-ovarian or pelvic abscess during pregnancy had been reported in the literature. The paper discusses established risk factors such as pelvic inflammatory disease, prior laparotomy, and structural genital anomalies, and also cites prior reports of pelvic abscess after vaginal oocyte retrieval, including in patients with severe endometriosis and ovarian endometriomata. Relevance to endometriosis: the authors explicitly cite endometriosis and ovarian endometriomata as a context for pelvic abscess following oocyte retrieval, though the paper’s main focus is a single IVF-ET–associated tubo-ovarian abscess case rather than endometriosis itself.

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Abstract

Tubo-ovarian abscess is an uncommon complication in pregnant women. In this report, we present a patient who developed a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer (IVF-ET). Despite treatment with intravenous antibiotics she delivered at 22 weeks of gestation. After delivery, she underwent a left salpingo-oophorectomy. Review of the literature revealed only 26 reported cases of tubo-ovarian or pelvic abscess during pregnancy. Pelvic inflammatory disease, previous laparotomy, and structural genital anomalies are known risk factors for pelvic abscess during pregnancy. Pelvic abscess resulting as a complication of vaginal oocyte retrieval has been reported. Therefore, although enabling women with organic pelvic disease such as endometriosis and hydrosalpinx to achieve pregnancy, assisted reproductive techniques may potentially result in pelvic infection during pregnancy. This case suggests that a preconception evaluation and treatment for such conditions should be considered for women undergoing treatment for infertility.
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Abstract

Tubo-ovarian abscess is an uncommon complication in pregnant women. In this report, we present a patient who developed a tubo-ovarian abscess during pregnancy following in vitro fertilization and embryo transfer (IVF-ET). Despite treatment with intravenous antibiotics she delivered at 22 weeks of gestation. After delivery, she underwent a left salpingo-oophorectomy. Review of the literature revealed only 26 reported cases of tubo-ovarian or pelvic abscess during pregnancy. Pelvic inflammatory disease, previous laparotomy, and structural genital anomalies are known risk factors for pelvic abscess during pregnancy. Pelvic abscess resulting as a complication of vaginal oocyte retrieval has been reported. Therefore, although enabling women with organic pelvic disease such as endometriosis and hydrosalpinx to achieve pregnancy, assisted reproductive techniques may potentially result in pelvic infection during pregnancy. This case suggests that a preconception evaluation and treatment for such conditions should be considered for women undergoing treatment for infertility.

Keywords

IVF-ET - pelvic abscess - pregnancy

References

- 1 Jafari K, Vilovic-Kos J, Webster A, Stepto R C. Tubo-ovarian abscess in pregnancy. Acta Obstet Gynecol Scand . 1977; 56 1-4 - 2 Sherer D M, Schwartz B M, Abulafia O. Management of pelvic abscess during pregnancy: a case and review of the literature. Obstet Gynecol Surv . 1999; 54 655-662 - 3 Younis S, Ezra Y, Laufer N, Ohel G. Late manifestation of pelvic abscess following oocyte retrieval, for in vitro fertilization, in patients with severe endometriosis and ovarian endometriomata. J Assist Reprod Genet . 1997; 14 43-46 - 4 Stubbs R E, Monif G RG. Ruptured tubo-ovarian abscess in pregnancy: recovery of a penicillinase-producing strain of Neisseria gonorrhoeae. Sex Transm Dis . 1985; 12 235-237 - 5 Orr J W, Bull J, Younger J B. Infected Mullerian anomaly: unusual cause of pelvic abscess during pregnancy. Am J Obstet Gynecol . 1986; 155 368-370 - 6 Blanchard A C, Pastorec J G, Weeks T. Pelvic inflammatory disease during pregnancy. South Med J . 1987; 80 1363-1365 - 7 Dashow E E, Cotterill R, BeMiller D. Ruptured tubo-ovarian abscess in early gestation. J Reprod Med . 1990; 35 418-419

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Condition tags

endometriosisinfertility

MeSH descriptors

Abscess Oophoritis Pregnancy Complications, Infectious Pregnancy Outcome Salpingitis Staphylococcal Infections Abscess Abscess Abscess Adult Anti-Bacterial Agents Anti-Bacterial Agents Embryo Transfer Embryo Transfer Female Fertilization in Vitro Fertilization in Vitro Fertilization in Vitro Follow-Up Studies Gestational Age

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