Ovary Preservation: A Practice in Preserving Your Future

On each side of a female’s uterus are two ovaries. Though small in size, they play an important role. Ovaries are where eggs develop and mature and where female hormones are made. Each month during a female’s childbearing years, an egg is released and, if fertilized, can grow and eventually develop into a baby. Ovaries are a significant factor in a female’s general and reproductive health.

Unfortunately, there are conditions that can threaten ovarian health:

Ovarian cysts are fluid-filled sacs. Cysts are common, fluid filled, benign, and most of the time they present little to no cause for concern.

Ovarian torsion is the twisting of an ovary which may cause it to move and/or cut off the blood supply. This can sometimes be caused by a cyst or mass, but it can also happen to normal ovaries.

Ovarian rupture is a cyst that ruptures, releasing fluid into the abdomen and pelvis, and may cause severe pain or lead to internal bleeding.

Ovarian cancer is when cells grow out of control in an ovary or ovaries and threaten the health of a female’s reproductive system and/or life.

Many times there are no symptoms present, but ruptured cysts and torsions may yield symptoms such as:

• Abdominal pressure
• Bloating
• Swelling or pain in the lower abdomen
• Nausea or vomiting

These symptoms are cause for concern and should be evaluated immediately.

Ovarian surgery is not always necessary and carefully choosing which patients need surgery is actually the first step in protecting the ovaries. If surgery is needed and the risk of the cancer is low, the ovary can be spared by removing only the mass or the cyst—this procedure is called ovarian sparing surgery or ovarian cystectomy.  

It is important to review each patient, collaboratively, with other departments who may be able to assist with decision making and help improve outcomes. These measures, or what we call an algorithm, look at radiologic imaging and serum tumor markers to estimate the risk of cancer and provide heightened opportunities for saving and preserving ovaries, rather than removing them.

Outcomes prove that ovarian preservation is higher in institutions with a gynecology department. Nationwide Children’s multi-team algorithm helps us work together to minimize unnecessary removal of ovaries in the absence of concern for cancer as well as make sure the correct surgery is done to spare ovarian function.

No matter the complicated nature of the surgery, the goal is that fewer ovaries are removed unnecessarily; improving the lives and reproductive outcomes in girls and young women.