Infertility can be influenced by several factors, including the presence of leiomyomas and tubal abnormalities like a tubal abscess or tubo-ovarian abscess which can cause adhesions of the tubes and surrounding tissues or obstruction of the tubes. A 35-year-old woman is diagnosed with primary infertility of 8 years with intramural uterine leiomyoma, right tubo-ovarian abscess, and left tubal abscess with tubal obstruction. Laparotomy myomectomy and salpingostomy surgery were carried out. There were no complications during or after the surgery. The management of infertile patients with leiomyoma and tubo-ovarian abscess who wish to preserve reproductive function requires special attention.