The Hidden Danger in Endometriosis: Bilateral Pelvic Abscesses Following Fertility Treatment

This case report underscores the crucial role of imaging and radiology in the timely diagnosis of a rare but serious complication associated with assisted reproductive technology (ART). A 34-year-old woman with a long-standing history of endometriosis and secondary infertility developed bilateral tubo-ovarian abscesses (TOAs) following in vitro fertilization (IVF). Her presentation included nonspecific gastrointestinal and pelvic symptoms that delayed diagnosis. However, a multimodal imaging approach, combining transvaginal ultrasound, contrast-enhanced computed tomography (CT), and pelvic magnetic resonance imaging (MRI), proved critical in identifying a superimposed infection on chronic adnexal disease. Subsequent surgical exploration confirmed the diagnosis of TOA and hematopyosalpinx. This case illustrates the diagnostic complexity of differentiating infectious processes from endometriotic flare-ups in the post-ART setting and highlights the indispensable role of early and advanced imaging in guiding clinical management, preventing sepsis, and preserving fertility.