Abstract
Ovarian endometriosis increases the risk of development of an abscess within the ovary. Tubo-ovarian abscess within an endometrioma occurs when the infected tube serves as a portal of infection and the endometriotic blood serves as a culture medium. Pelvic Inflammatory Disease, Intra uterine contraceptive device (IUCD), ultrasound guided oocyte retrieval in IVF-ET and endometrioma aspiration are possible sources of infection. Primary ovarian abscess without involvement of the fallopian tube, is a rare complication of an underlying endometrioma and may be due to iatrogenic introduction of pathogen during transvaginal surgical procedures. De novo primary ovarian abscess within an endometrioma in the absence of a risk factor is even rarer. Weakened endometriotic cyst wall and hematogenous spread of infection are possible explanations for bacterial implantation. Infected ovarian endometrioma is a surgical emergency and preserving the fertility in a nullipara is a challenge which can be overcome by timely intervention.