Ovarian agenesis

Last revised by Craig Hacking on 13 Oct 2022

Ovarian agenesis refers to a situation where there is a congenital absence of the ovary.  

Unilateral ovary agenesis affects approximately 1 in 11,240 women while bilateral agenesis is even rarer 1.

Most patients with agenesis of the ovary are asymptomatic. Ovarian torsion with subsequent necrosis and resorption antenatally is asymptomatic while in the adults and children groups, ovarian torsion is associated with severe symptoms and needs surgical emergency 2.

Clearly, it is important to establish that the patient has not had their ovary removed surgically. 

It may be broadly classified as: 

  • unilateral ovarian agenesis
  • bilateral ovarian agenesis

This condition may be the result of a congenital malformation especially when the entire ipsilateral fallopian tube is missing or ischemic events because of mechanical alterations such as torsion and subsequent resorption of the ovary during fetal life or childhood 3.

Ovarian agenesis can be associated with a number of uterus and/or urinary tract malformations, such as the unicornuate uterus, unilateral renal agenesis, and other variations 4.

Ultrasound and MRI are useful imaging modalities and can provide a definitive diagnosis.

The diagnosis could be aided with a hysterosalpingogram as a contrast study to confirm the absence of an ipsilateral fallopian tube.

No treatment is needed if asymptomatic.

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Cases and figures

  • Case 1: ovarian agenesis - unilateral
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