Two patients with endometriosis require peripregnancy surgical treatment for pelvic abscesses after egg collection and embryo transfer

Abstract

Assisted reproductive technology procedures infrequently cause pelvic abscesses, but the risk is higher in patients with endometriosis. If antibiotic treatment of a pelvic abscess is unsuccessful, surgery is required—even during pregnancy. We report two patients with endometriosis who suffered from pelvic abscesses formed after egg collection and embryo transfer. Patient 1 underwent laparoscopic resection of the left adnexa and right ovarian cystectomy after diagnosis of the implantation failure. Surgical findings showed severe adhesions in the pelvis due to endometriosis. Patient 2 underwent open drainage surgery at 11 weeks of pregnancy due to pan-peritonitis caused by a pelvic abscess. The patient delivered at 36 weeks of gestation. We conclude that egg collection and embryo transfer in patients with endometriosis confers a high risk for pelvic infection. An accurate diagnosis and appropriate treatment, including surgery, are mandatory in case of severe pelvic abscesses during pregnancy to save both mother and fetus.