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Park, Song, Kim, Lee, Kim, Kim, Yoon, Seong, and Shim: Tuboovarian abscess in pregnancy after in vitro fertilization and embryo transfer
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2012; 55(11): 894-898.

Published online: 16 November 2012

DOI: https://doi.org/10.5468/KJOG.2012.55.11.894

Tuboovarian abscess in pregnancy after in vitro fertilization and embryo transfer

Seoyeon Park, MD1, Taejong Song, MD1, Young Ju Kim, MD1, Jee Eun Lee, MD1, Mi Kyoung Kim, MD1, Mi-La Kim, MD, PhD1, Bo Sung Yoon, MD1, Seok Ju Seong, MD, PhD1, Jeong Yun Shim, MD2

1Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.

2Department of Pathology, CHA Gangnam Medical Center, CHA University College of Medicine, Seoul, Korea.

Corresponding author: Taejong Song, MD. Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, CHA University College of Medicine, 566 Nonhyeon-ro, Gangnam-gu, Seoul 135-913, Korea. Tel: +82-2-3468-3677, Fax: +82-2-558-1112, songtaejong@naver.com

Received 9 July 2012       Revised 24 August 2012       Accepted 4 September 2012

Copyright © 2012. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tuboovarian abscess occurred in pregnancy is a rare disease, especially which occurs after in vitro fertilization and embryo transfer (IVF-ET) is extremely rare. It is also difficult in diagnosis, because of its low incidence and nonspecific symptoms. Most of diagnosis is made in surgery. Although IVF currently is considered an effective treatment in women with endometriosis, there is the risk causing the infection of the endometrioma after oocyte retrieval. A case of tuboovarian abscess in IVF-ET pregnancy was presented and reviewed briefly.

Keywords: Tuboovarian abscess, Pregnancy, In vitro fertilization and embryo transfer, Oocyte retrieval

Figures and Tables

Fig. 1
Transabdominal sonography. A 12.5 cm-sized right ovarian cyst.
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Fig. 2
Magnetic resonance imaging findings. Right ovarian cyst and intrauterine pregnancy (T2 weight image).
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Fig. 3
Laparoscopic image of right ovarian cyst. There was a 10 cm-sized right ovarian cyst including pus, which made severe adhesion with surrounding pelvic organs and peritoneum. It also had endometriotic lesion.
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Fig. 4
Microscopic findings. (A) The specimen consisted of many fragmented pieces of tissue showing fibrinous necrotic exudate, infiltration of acute and chronic inflammatory cells and fibrosis (H&E, ×40). (B) High power view showed infiltration of many neutrophils, lymphocytes and plasma cells (H&E, ×200).
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Table 1
Clinical features of 9 cases of tuboovarian abscess in pregnancy after IVF-ET
kjog-55-894-i001

IVF, in vitro fertilization; ET, embryo-transfer; OP, operation; WBC, white blood cell count (/mm3); BT, body temperature; GA, gestational age; CDS, cul-de-sac; IUP, intrauterine pregnancy; NA, not available; IV, intravenous; LSO, left salpingo-oophorectomy; PO, per oral.

aIt contains vaginal irrigation method in oocyte retrieval and use of peri-retrieval antibiotics; bIt is time of 1st operation for tuboovarian abscess; cAll data are in time of diagnosis; dSymptom was developed 45 days after Cesarean section at 38 weeks; eOperation was done 15 days after delivery at 22 weeks; fShe had only painless vaginal discharge at the first time; gThe second operation was done 24 hours after delivery at 21 weeks.

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