Case Report: Ultrasound-guided continuous catheter drainage to facilitate ovarian access before in vitro fertilization in a patient with large pelvic cystic lesions

The article describes a case of a 35-year-old woman with secondary infertility, bilateral tubal occlusion, and severe pelvic adhesive disease with large multiloculated cystic lesions. These lesions obscured the left ovary and displaced the right ovary superiorly. Before ovarian stimulation, ultrasound-guided continuous drainage using a 12-Fr pigtail catheter was performed. Approximately 450 mL of clear fluid was drained over approximately 10 days, reducing the dominant lesion from 18.40 cm × 8.82 cm × 11.80 cm to approximately 3 cm × 2 cm. After drainage, the number of visualized antral follicles increased from two to eight and the previously obscured left ovary became accessible. Five metaphase II oocytes were retrieved, four from the left ovary and one from the right ovary. Four high-quality blastocysts were vitrified and a live birth followed a single frozen-thawed blastocyst transfer. Continuous catheter drainage provided temporary mechanical decompression that facilitated ovarian access and IVF treatment.