Received May 22, 2018
Accepted November 22, 2018

In vitro fertilization procedures are nowadays more than 1 million cycles per year. The incidence of serious complications associated with this technique is low, but this is not a risk-free procedure. Risks are inherent to the method of introducing a thin needle and cutting edge through the vaginal wall and ovarian capsule to access the ovaries. Case Description: The 45 year–old patient reported urinary discomfort and difficulty urinating on her second cycle, 12 hours after the oocyte pick-up, with macroscopic blood in urine and small blood clots. In 24 hours post pick-up, without fever and maintaining good general condition, a transvaginal sonography showed a heterogeneous intra bladder image of 23 x 19 mm, suggestive of a clot. Expectant behavior, with increased fluid intake lead to the expelling of the clot in few hours. This episode of bladder hematoma was unique in 21 years of clinic functioning, all guided by ultrasonography with a clear visualization of the needle tip sonographically throughout the 15 to 20 minute procedure. Given the elective nature of transvaginal ultrasound retrieval in IVF cycles, patients should be informed about these potential, albeit rare, risks and complications.