Bilateral ovarian abscesses following platelet-rich plasma injection for "ovarian rejuvenation": a case report

Vanessa Kalinowska; Haaris Mobin; Elnur Babayev

doi:10.1016/j.xfre.2025.12.009

General Gynecology · Infections

Bilateral ovarian abscesses following platelet-rich plasma injection for "ovarian rejuvenation": a case report

Kalinowska V, Mobin H, Babayev E

Published April 2026 F&S reports

DOI 10.1016/j.xfre.2025.12.009 PMID 42027662 PMC PMC13100835

RRM Academy Synopsis

Ovarian PRP injection was followed by abscesses in both ovaries

A 45-year-old woman developed abscesses in both ovaries after ovarian platelet-rich plasma (PRP) injections. This case report describes pain that continued despite antibiotics until the abscesses were drained with a needle. Four months later she reported full recovery.

Key Findings

The woman, 45 and with no prior pregnancy, had worsening pelvic pain, chills and decreased appetite after PRP injections into the ovaries at another facility. Imaging showed cystic structures in both ovaries.
Intravenous antibiotics brought improvement, and she was discharged on hospital day 3. At follow-up she still had debilitating pelvic pain, repeat imaging was unchanged, and she was readmitted.
On the second admission she developed a fever, and image-guided needle aspiration of both sides yielded purulent fluid. Cultures grew Streptococcus anginosus.
Four months later, she described no remaining pelvic pain, regular periods and a return to normal work and activities.
The authors state that the origin is unclear: the abscesses may be new infections or infected endometriomas (ovarian cysts caused by endometriosis) that were already present.

Interpretation

The paper is a case report, which describes the course of one patient. A single case gives no estimate of how often this happens. The authors had restricted access to outside records, including the injection protocol. They suggest the bacterium may have been vaginal or skin flora introduced during the injection. The authors cite a randomized trial in women younger than 38 with poor ovarian reserve that found no improvement in mature egg yield or other measures. They also cite an earlier case report of a bloodstream infection after the same procedure in a woman with endometriosis.

RRM Context

The paper describes ovarian PRP as an add-on to IVF. The authors think endometriosis is a reasonable suspicion, given her history of painful periods. They write that if she had endometriomas, she should have been cautioned against going ahead. Restorative reproductive medicine starts by asking which condition, in either partner, explains the pain or the trouble conceiving.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To describe a case of severe infectious complications following ovarian platelet-rich plasma (PRP) injections for ovarian rejuvenation.

Design

Case report.

Subjects

A 45-year-old nulligravid woman with a history of uterine fibroids and ovarian cysts presenting to an academic medical center.

Exposure

Ovarian PRP injections were performed at an outside facility. Following presentation, the patient was treated with intravenous antibiotics. Because of persistent symptoms and clinical deterioration, she subsequently underwent image-guided aspiration of bilateral tubo-ovarian abscesses.

Main Outcome Measures

Resolution of infection and resumption of baseline activity and menstrual cycles.

Results

The patient presented with persistent lower abdominal pain, leukocytosis, and complex bilateral adnexal masses on imaging several days after intraovarian PRP injection. Cultures from aspirated abscesses grew Streptococcus anginosus. After treatment, she achieved full clinical recovery, resuming normal menses and activity within four months.

Conclusion

Ovarian PRP injections, although increasingly marketed for "rejuvenation," carry risks of severe complications, including infection, such as tubo-ovarian abscess formation. This case underscores the need for caution and further investigation into the safety and efficacy of PRP for reproductive indications.

Topics

General Gynecology › Infections › Pelvic Inflammatory Disease · Infections and the Reproductive Microbiome › Systemic and Emerging Infections › Infection in Pregnancy

Vanessa Kalinowska, Haaris Mobin, Elnur Babayev

V Kalinowska, H Mobin, E Babayev

PMID 42027662 42027662 DOI 10.1016/j.xfre.2025.12.009 10.1016/j.xfre.2025.12.009 Kalinowska et al. 2026, Kalinowska 2026

Bilateral ovarian abscesses following platelet-rich plasma injection for "ovarian rejuvenation": a case report

Ovarian PRP injection was followed by abscesses in both ovaries

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

Oocyte mitochondrial function and reproduction

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