Clinical Characteristics and Management of Ovarian Endometrioma Complicated by Infertility Treatment‐Induced Tubo‐Ovarian Abscess: A Retrospective Study

ABSTRACT Aim To evaluate the incidence of tubo‐ovarian abscess (TOA) in patients with ovarian endometrioma (OE) undergoing infertility treatment and to describe treatment approaches and clinical outcomes, including transvaginal ultrasound‐guided drainage. Methods This retrospective study included 17 patients with OE‐associated infertility who developed infertility treatment‐related TOA and were treated at our hospital between January 2011 and December 2022. Patient characteristics, diagnostic findings, the incidence of TOA associated with assisted reproductive technology in patients with and without OE, treatment approaches, and clinical outcomes were analyzed. Results The incidence of TOA was higher in patients with OE than in those without OE following oocyte retrieval (1.07% vs. 0.03%, p = 0.0001) and frozen–thawed embryo transfer (1.09% vs. 0.00%, p = 0.0055). Transvaginal ultrasound‐guided drainage was performed in 14 patients, with a success rate of 78.6% (11/14), a relapse rate of 18.2% (2/11), and no procedure‐related complications. Conclusions Patients with OE are at increased risk of developing TOA during infertility treatment. Transvaginal ultrasound‐guided abscess drainage is a safe and minimally invasive method for infection control and may help avoid emergency surgery during the acute phase as part of a multidisciplinary treatment strategy.