Anatomy, Abdomen and Pelvis, Ovary

Excerpt

The ovary is the female gonad. It is a paired intraperitoneal endocrine organ typically found in the lower left and right quadrants of the abdomen, respectively. The ovaries play a fundamental role in reproduction as well as the production of hormones. Granulosa cells and theca cells found in the ovary secrete multiple hormones, including estrogen and progesterone. It is here in the ovary the follicles will mature during the proliferation phase. Once the dominant follicle matures and Luteinizing hormone surges, the oocyte will be expelled and begin its journey through the fallopian tubes and into the uterus. The corpus luteum, a temporary endocrine organ will take its place in the ovary and will secrete large amounts of progesterone along with smaller amounts of inhibin A and estradiol. This hormonal production protects the oocyte and allows time for the sperm and egg to meet and implant before menstruation. If fertilization occurs, the newly formed blastocyst will secrete human chorionic gonadotropin hormone, which signals the corpus luteum to continue secreting progesterone. This function will be taken over by the placenta once it has matured. If fertilization does not occur, then the corpus luteum will degenerate into the corpus albicans, and the withdrawal of progesterone will start the process of menstruation. Problems within the complex feedback loops in the ovaries, such as those described above, can result in infertility, pain, or hormone imbalances.

On physical exam, healthy ovaries are palpable, but, depending on the anatomical variation and body habitus of the patient, it may not be easy to palpate them. Ovaries that contain cysts may be easier to feel. Ultrasound is one of the most common modes of evaluating ovaries. Laparoscopic procedures also provide valuable information if other modalities fail to provide answers. Multiple pathologic processes can occur in the ovaries, including ovarian cancer, ovarian torsions, ectopic pregnancies, ovarian abscesses, hormonal imbalances, or cysts. These conditions can have detrimental effects on the health of those affected.