OBJECTIVE To report infection and pyometra after ovum retrieval for IVF. METHODS Case report. METHODS Community hospital. METHODS A 43-year-old woman with a recent history of ovum retrieval presented with high fever, chills, and no gynecologic symptoms. The patient was admitted to the medical intensive care unit due to septicemia. After an extensive workup for fever, the patient was diagnosed with pyometra, and biopsy of the endometrial cavity revealed vancomycin-resistant enterococci. METHODS The patient was treated with antibiotics and then discharged home. Two weeks later she presented with unrelenting fever and abdominal pain and underwent hysterectomy. METHODS Unrelenting infection despite antibiotic treatment resulting in hysterectomy, which showed autolyzed endometrium, subserosal and intramural abscess. RESULTS Infection resolved after hysterectomy. CONCLUSIONS Pyometra should be considered in the differential diagnosis of fever after ovum retrieval as it may result in serious consequences and can be life threatening.