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Tubo-ovarian abscess treatment often preserves fertility

NEW YORK (Reuters Health) – Treatment of tubo-ovarian abscess with ultrasound-guided drainage and antibiotics lets about half of women who wish to become pregnant conceive naturally, Norwegian researchers have found.

“The high pregnancy rate following ultrasound-guided drainage of turbo-ovarian abscess is very encouraging,” Dr. Erling Ekerhovd of Telemark Hospital, Porsgrunn told Reuters Health by email.

In a May 14th online paper in Fertility and Sterility, he and his colleagues wrote that there’s been little reported about natural fertility in women who were managed with this regimen, rather than surgery.

Their report covers 100 women who were treated in this manner between 1986 and 2003. Altogether they had 131 drainages, as the procedure was repeated if a substantial amount of pus was still visible with ultrasonography.

Thirty-eight women expressed a wish to become pregnant, and 20 subsequently did become pregnant naturally and gave birth. Another two did so following in vitro fertilization.

Of the 62 women who did not wish to become pregnant, 14 were not on birth control. Seven of these women became pregnancy; four terminated the pregnancies and three went on to give birth.

The researchers say it would be interesting to conduct a prospective trial of ultrasound-guided drainage vs laparoscopic conservative treatment.

In the meantime, Dr. Ekerhovd said, “Since ultrasound-guided drainage of tubo-ovarian abscess is easy to perform, inexpensive, minimally invasive, and does usually not require general anesthesia, it could be a first-line treatment in women of reproductive age.”


Fertil Steril 2012.