From Hope to Infection: Tubo-Ovarian Abscess After Frozen Embryo Transfer-A Case Report and Review of the Literature.

Tubo-ovarian abscess is a rare but serious complication of assisted reproductive technologies, typically following oocyte retrieval. We report a case of a 41-year-old woman with endometriosis who developed a tubo-ovarian abscess 2 weeks after a hormonally prepared frozen embryo transfer. The procedure was uneventful and performed under sterile conditions with antibiotic prophylaxis. She later presented with pelvic pain and fever; imaging confirmed a right-sided multiloculated adnexal abscess. Given the patient's stable condition and abscess location, conservative management was chosen. Broad-spectrum intravenous and oral antibiotics led to complete resolution without the need for drainage or surgery. This case highlights that tubo-ovarian abscesses can occur even in low-risk frozen embryo transfer cycles and in the absence of procedural complications. A review of the literature suggests that underlying pelvic pathology, including endometriosis, may predispose patients to infection. Considerate post-transfer monitoring and individualized management strategies are essential to ensure favorable outcomes.