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Gynécologie Cochin Paris : chirurgie, PMA et cancers
Gynécologie Cochin Paris : chirurgie, PMA et cancers

Low risk of endometrioma infection after oocyte retrieval.

Auteurs : Parpex G, Bourdon M, Marcellin L, Sorel M, Maignien C, Bordonné C, Charlier C, Patrat C, Santulli P, Chapron C

Date de publication : 03/2026

Résumé vulgarisé

Cette étude analyse le risque d’infection d’un endométriome après une ponction ovocytaire chez des femmes prises en charge en AMP. Sur plus de 1600 procédures, les infections nécessitant un drainage chirurgical sont très rares (0,36 %), y compris lorsqu’une ponction de l’endométriome est réalisée. Une seule infection a été observée après ponction transkystique, et aucune complication grave de type sepsis n’a été rapportée. La plupart des infections ont pu être traitées simplement par drainage échoguidé, avec très peu de recours à la chirurgie. Ces résultats confirment que la ponction ovocytaire, même en présence d’un endométriome, est globalement sûre avec un risque infectieux faible.

DOI

Abstract
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RESEARCH QUESTION: What is the incidence of endometrioma infections requiring surgical drainage following oocyte retrieval in women with ovarian endometrioma? DESIGN: This retrospective observational cohort study included women aged 18-43 years with a confirmed radiological diagnosis of ovarian endometrioma who underwent ovarian stimulation and oocyte retrieval for IVF/intracytoplasmic sperm injection (ICSI) or fertility preservation between January 2018 and December 2023 at a single tertiary academic centre. All procedures were performed under standardized aseptic conditions with antibiotic prophylaxis. Transcystic puncture was performed when deemed necessary. The primary outcome was the incidence of endometrioma infections requiring surgical drainage within 30 days after oocyte retrieval. RESULTS: Oocyte retrievals were performed in 1102 out of 1668 cycles (66.1%) for IVF/ICSI and in 566 cycles (33.9%) for fertility preservation. Bilateral endometriomas were present in 322 of 880 patients (36.6%), with a mean cyst (SD) diameter of 31.5 ± 22.7 mm. Endometriomas larger than 30 mm accounted for 295 of 649 cases (45.5%). Intentional transcystic puncture was performed in 76 of 1148 applicable procedures (6.6%), and endometrioma drainage during oocyte retrieval occurred in 52 cases (4.5%). Endometrioma infections requiring surgical drainage occurred in 6 of 1668 procedures (0.36%). Only one infection was reported following transcystic puncture (1.3%). No cases of sepsis or septic shock occurred. Five infections were managed with ultrasound-guided transvaginal drainage; one required laparoscopic surgery. CONCLUSIONS: The incidence of endometrioma infection requiring surgical intervention after oocyte retrieval, including after transcystic puncture, is low. These findings support the safety of assisted reproductive techniques in women with endometriomas.