Endometriosis in the tract of transvaginal ovum pick up, a rare and late complication of in vitro fertilisation

Endometriosis is a common and painful condition. We present a case of a 33-year-old woman who had delivered triplets after in vitro fertilisation (IVF) for male factor infertility. She did not have any clinical features suggestive of endometriosis before the IVF treatment. The patient presented 7 years after conception, with premensural and postmenstrual abdominal pain and intense pain on defecation. The patient was diagnosed to have endometriosis in the tract of transvaginal ovum pick up in the right pouch of Douglas and right distal uterosacral ligament. The patient underwent excision of a nodule of endometriosis. The patient is asymptomatic 1 month after surgery. Histopathology analysis revealed features suggestive of endometriosis. The needle ovum pick up tract must have implanted the endometriotic tissue near the pararectal tissue. This is an unreported and late complication of IVF treatment.