Fertility Outcomes Following Treatment of Tubo-Ovarian Abscess [ID 1134]

INTRODUCTION: Tubo-ovarian abscesses (TOA) commonly affect women of reproductive age. This study investigated fertility outcomes in patients treated for TOA. METHODS: A retrospective cohort study was conducted at a single academic medical center from 2015 to 2022. Sixty-two patients with TOA were identified. Background data was collected via the electronic medical record, and patients were contacted via email/phone to complete a fertility outcomes survey. Wilcoxon signed-rank tests were used to compare outcomes. RESULTS: Thirty-two patients were reached, and 25 completed the survey. Tubo-ovarian abscess management included parenteral antibiotics, interventional radiology-guided drainage, or laparoscopic surgery. Nine patients attempted conception following TOA. Five of nine (55.6%) conceived spontaneously, including one ectopic pregnancy. Six of nine (66.7%) achieved live birth. Of four patients unable to conceive spontaneously, two achieved pregnancies via in vitro fertilization (IVF); one had proven tubal occlusion on hysterosalpingography. Those who conceived spontaneously (n=5) had significantly lower body mass index (BMI) (26.2 versus 31.3, P =.02) and no fibroid history (0 versus 3 patients, P =.048) compared to those who did not (n=4, including those who conceived via IVF). Abscesses in patients who conceived spontaneously were smaller (77.9 versus 151.5 mL 3 , P =.71) and more likely bilateral (40% versus 0%, P =.44), although not significantly. Surgical management occurred only in patients who conceived spontaneously. One patient who conceived spontaneously and two who did not were readmitted. CONCLUSIONS/IMPLICATIONS: The pregnancy rate was 55.6%, and the live birth rate was 66.7%. Lower BMI and absence of fibroids were significantly associated with spontaneous conception. Further research is needed to evaluate fertility outcomes by treatment modality.