Reproductive system · Pelvis · Female
Ovaries !
The ovaries are two almond-sized organs on each side of the uterus; they hold the eggs, release one each cycle and make oestrogen and progesterone.
Official name: Ovary
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What it is
Two almond-shaped glands, about 3 x 2 x 1.5 cm, on the side walls of the pelvis beside the uterus.
What it does
Hold the eggs, release one each cycle (ovulation) and make oestrogen and progesterone.
Key facts
- Where
- Ovarian fossa on the lateral pelvic wall (between external and internal iliac vessels, ureter behind); attached by the mesovarium to the broad ligament
- Blood supply
- Ovarian artery (from aorta at L2) in the suspensory ligament; ovarian branches of the uterine artery
- Nerve
- Ovarian plexus (T10–T11 sympathetic; referred pain to the periumbilical region)
- Function
- Oogenesis and ovulation; oestrogen, progesterone and inhibin; lymph to para-aortic (lumbar) nodes
Relations
- Lateral
- Ovarian fossa: parietal peritoneum over the obturator nerve and vessels on the lateral pelvic wall
- Behind
- Ureters and the internal iliac artery
- In front
- Mesovarium, attaching its anterior border (hilum) to the back of the broad ligament
- Above
- Infundibulum and fimbriae of the tube, curving over its upper (tubal) pole, and the suspensory ligament of ovary
- Medial
- Uterine tube and loops of small bowel; on the left, the sigmoid colon
How to find it
Usually not felt, or felt as a small, mobile, slightly tender almond through a lateral fornix on bimanual examination; an ovary that can be felt after menopause is investigated. At laparoscopy it lies behind the broad ligament, below the tube, against the lateral pelvic wall.
On imaging
Transvaginal ultrasound shows follicles as small anechoic cysts, a dominant follicle near mid-cycle and a corpus luteum with a ring of flow on Doppler. In torsion the ovary is enlarged and oedematous with follicles pushed to the edge, sometimes with a whirlpool sign of the twisted pedicle.
Common problems
- Functional cysts (common, usually go away).
- Polycystic ovary syndrome (PCOS).
- Ovarian torsion (twisting): sudden severe pain, an emergency.
- Ovarian cancer, often found late.
How it is diagnosed
Pelvic ultrasound; hormone blood tests; tumour markers in selected cases.
Treatment
- Watchful waiting for simple cysts; hormonal treatment for PCOS.
- Surgery for torsion, large or suspicious masses.
Clinical notes
- Krukenberg tumours: metastases to the ovaries, often both, classically from the stomach
- A ruptured ovarian cyst can bleed into the rectouterine pouch and mimic an ectopic pregnancy
Development
The ovaries form on the posterior abdominal wall at upper lumbar level and descend into the pelvis: that is why the ovarian artery arises from the aorta near the kidneys and their lymph drains to para-aortic nodes.
Related conditions
- Hereditary breast and ovarian cancer syndrome (BRCA1/BRCA2)
- Endometriosis
- Polycystic ovary syndrome
- Pelvic inflammatory disease
- Ovarian torsion
- Ovarian cyst
- Ovarian cancer
- Menopause and climacteric syndrome
- Primary ovarian insufficiency
- Female infertility
- Premenstrual syndrome and premenstrual dysphoric disorder
- Functional hypothalamic amenorrhoea
- Ovarian germ-cell and sex cord–stromal tumours
- Ovarian hyperstimulation syndrome
- Turner syndrome
Test yourself
Think of the answer, then tap the question to see it.
Why can ovarian disease refer pain to the medial thigh?
The obturator nerve lies in the floor of the ovarian fossa, against which the ovary rests.
In ovarian torsion, which flow is blocked first, and can Doppler look normal?
Venous outflow first, then arterial inflow; Doppler flow can still look normal. An enlarged ovary is the usual lead point.
Where do the right and left ovarian veins drain?
The right into the inferior vena cava; the left into the left renal vein.
Why does lymph from the ovaries drain to the para-aortic nodes?
The ovaries form on the posterior abdominal wall at upper lumbar level and descend, so their vessels arise near the kidneys.
What is a Krukenberg tumour of the ovaries?
A metastasis to the ovaries, often both, classically from the stomach.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- ovarium TA2 3470
- Official Spanish (DeCS)
- Ovario DeCS D010053
- English (TA2)
- Ovary
- Also called
- oophoron
Related
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Abdomen and Pelvis, Ovary.
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Representative model, for educational purposes only.
