Undescended ovary and unicornuate uterus: Simplified diagnosis by the use of clomiphene citrate ovarian stimulation and magnetic resonance imaging (MRI)

Ombelet, Willem; Grieten, Martijn; DeNeubourg, Ph.; Verswijvel, G; Buekenhout, L.; Hinoul, Piet; deJonge, E.

doi:10.1093/humrep/deg191

Cited by 26 publications

(22 citation statements)

References 17 publications

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“…The ovarian ligaments and round ligaments of the uterus grow from the gubernaculum [5] . Maldescent of the ovaries may cause undescended or ectopic ovaries [6] . An ectopic ovary may also be secondary to an implantation of ovarian tissue which has been dislocated from its original position.…”

Section: Discussionmentioning

confidence: 99%

Surgical Transpositioning of Ectopic Ovarian Tissue and Pregnancy

Halil¹,

Küçük²,

Çepni

2009

Gynecol Obstet Invest

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Objective: Our objective was to report transpositioning an ectopic ovary, successfully using the assisted reproduction technique (ART), with the outcome of retrieving an oocyte from the transpositioned ovary during ART. Case Report: The couple, presenting with a history of 2 years of secondary infertility, was admitted to our hospital. Two years earlier, the patient had undergone a left salpingo-oophorectomy for a ruptured ectopic pregnancy. The right ovary had not been detected during the previous operation. During surgery, we observed that the right ovary was attached to the posterior abdominal wall near the hepatic flexura. It was repositioned, moved, placed and fixed to the posterior wall of the uterus. One follicle developed and was retrieved from the transpositioned ovary during in vitro fertilization. The patient now has a healthy ongoing singleton pregnancy. Conclusion: An ectopic ovary is an extremely rare gynecological entity. Transpositioning an ectopic ovary should be kept in mind as a possible procedure for the management of patients presenting with infertility where the other ovary is absent or does not respond to controlled ovarian hyperstimulation treatment.

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Section: Discussionmentioning

confidence: 99%

Surgical Transpositioning of Ectopic Ovarian Tissue and Pregnancy

Halil¹,

Küçük²,

Çepni

2009

Gynecol Obstet Invest

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“…Dabirashrafi found this disorder only in patients with congenital absence of the uterus or unicornuate uterus, but not in association with other congenital anomalies [4]. More recently, Ombelet [5] reported an undescended ovary in five out of eight patients with unicornuate uterus (62.5%). One of our patients had Rokitansky-Küster-Hauser syndrome type A, consisting in the absence of the uterus and cervix and associated with renal agenesis.…”

Section: Discussionmentioning

confidence: 99%

Ovarian maldescent

et al. 2004

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Undescended ovary is a rare disorder that can be associated with müllerian malformations. There is an unclear association with infertility and malignant disease. When an ovary is not in its normal location, it is sought in other locations above the pelvic brim. This is important in cases of undetermined cyclical abdominal pain, follicle aspiration and surgical castration. MRI has proven to be the best imaging method for finding an ovary in an anomalous position and for disregarding associated malformations. We report two patients with unilateral ovarian maldescent, one of them with Rokitansky-Küster-Hauser syndrome. A review of the literature is included.

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“…Owing to the potential of a pelvic mass, enlarged uterus or pregnancy to displace the ovaries, any such case was excluded from this series. Owing to the association between ovarian maldescent and congenital Mü llerian anomalies, these cases were also excluded [21,22]. In addition, owing to the risk of associated genitourinary malformations, plus the complication of skeletal distortion, cases with congenital spine abnormalities were excluded [23].…”

Section: Methodsmentioning

confidence: 99%

More harm than good? The anatomy of misguided shielding of the ovaries

Fawcett¹,

Gómez²,

Barter³

et al. 2012

The British Journal of Radiology

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Objective: Popular gonad shield designs aim to provide coverage of the true pelvis, which is presumed to be the probable location of the ovaries. Shields are frequently placed inaccurately, especially in children, obscuring important orthopaedic landmarks on pelvic radiographs. We aimed to identify the position of the ovaries and asses how this may vary with age and the degree of bladder filling. We aimed to identify the position of the ovaries and asses how this may vary with age and the degree of bladder filling. Methods: Using MRI examinations of the pelvis in women and children, we located 594 ovaries in 306 female patients aged from birth to 59 years. Results: This study provides new evidence that bladder filling affects ovary position. A lower than expected number of patients had both ovaries within the pelvis if the bladder contained more than a moderate volume of urine. Bladder emptying should be achieved wherever practical if a shield is used. In children under the age of 7 years, more than half (19/37) had at least one ovary outside the true pelvis. There was a significant association between age and ovary position, with the percentage of patients with one or both ovaries outside the true pelvis decreasing with age (x 2 , p,0.0001). Conclusion:The embryological descent of the ovaries into the pelvis would appear to continue after birth, well into childhood. Current popular shield designs are therefore inappropriate for use in young children. Given the high risk of obscuring critical landmarks, coupled with the new evidence that even accurate placement will not necessarily protect the ovaries, the use of pelvic shields in girls should be reconsidered.

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Undescended ovary and unicornuate uterus: Simplified diagnosis by the use of clomiphene citrate ovarian stimulation and magnetic resonance imaging (MRI)

Abstract: It is suggested that MRI after CC stimulation is an excellent non-invasive method to diagnose undescended ovaries in women with a unicornate uterus.

Cited by 26 publications

References 17 publications

Surgical Transpositioning of Ectopic Ovarian Tissue and Pregnancy

Surgical Transpositioning of Ectopic Ovarian Tissue and Pregnancy

Ovarian maldescent

More harm than good? The anatomy of misguided shielding of the ovaries

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