title: Ruptured tubo-ovarian abscess as a complication of IVF treatment: clinical, ultrasonographic and histopathologic findings. A case report.
abstract: Tuboovarian abscess is a rare complication of IVF treatment, which can be lethal on rupture. Hereby, we present a case of a ruptured tubo-ovarian abscess, following transvaginal ultrasound-guided oocyte retrieval for IVF and transcervical embryo trasfer in a 38-year-old white female patient with five years of primary infertility who underwent aspiration of bilateral hydrosalpinges at the time of oocyte retrieval. This case suggests that the reactivation of latent pelvic infection due to a previous pelvic inflammatory disease (PID) was the possible route of infection after transvaginal ultrasound-directed follicle aspiration--transcervical embryo transfer. We conclude that physicians should consider the diagnosis of tubo-ovarian abscess in the differential diagnosis of abdominal pain, fever and leukocytosis after ovum retrieval and transcervical embryo transfer for IVF treatment. Preservation of the uterus and unaffected uterine adnexa should be attempted in such cases if future pregnancy is desired.
authors.affiliation: Department of Gynaecology, G. Gennimatas General State Hospital of Athens, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Varras
authors.forename: D
authors.initials: D
authors.lastname: Polyzos
authors.forename: A
authors.initials: A
authors.lastname: Tsikini
authors.forename: E
authors.initials: E
authors.lastname: Antypa
authors.forename: D
authors.initials: D
authors.lastname: Apessou
authors.forename: M
authors.initials: M
authors.lastname: Tsouroulas
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D007710:Klebsiella Infections / Q000188:drug therapy / Q000209:etiology; D010049:Ovarian Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D010052:Ovariectomy; D000292:Pelvic Inflammatory Disease / Q000150:complications; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012422:Rupture, Spontaneous; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D014463:Ultrasonography