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Maternal ovaries

The maternal ovaries are paired female gonads located on either side of the uterus in the pelvis. They serve as both reproductive organs and endocrine glands. Each ovary is ovoid, approximately 3 × 2 × 1 cm in reproductive age, though size and appearance change with age, hormonal state, and pregnancy.

During pregnancy, the ovaries typically reduce in ovulatory activity due to suppression of the hypothalamic–pituitary–ovarian axis, but the corpus luteum persists in early pregnancy to maintain progesterone secretion until the placenta takes over hormonal support.

Synonyms

  • Female gonads

  • Ovarian glands

  • Reproductive ovaries

Structure

  • Cortex: Contains ovarian follicles at various stages of development (primordial, primary, secondary, Graafian)

  • Medulla: Contains connective tissue, blood vessels, lymphatics, and nerves

  • Surface: Covered by simple cuboidal epithelium (germinal epithelium)

  • Supporting structures: Suspensory ligament of ovary (infundibulopelvic ligament) and ovarian ligament connect ovaries to uterus and pelvic wall

Relations

  • Medially: Uterus (connected by ovarian ligament)

  • Laterally: Pelvic wall and infundibulopelvic ligament (with ovarian vessels)

  • Superiorly: Uterine tubes (fimbrial ends)

  • Inferiorly: Broad ligament and peritoneum

Function

  • Reproductive: Production and release of oocytes (ova)

  • Endocrine: Secretion of sex hormones (estrogens, progesterone, inhibin, relaxin)

  • Pregnancy role: Early maintenance of pregnancy by corpus luteum progesterone secretion until placental takeover (~10–12 weeks gestation)

Clinical Significance

  • Corpus luteum cyst: Common in early pregnancy, usually regresses spontaneously

  • Ovarian torsion: Increased risk during pregnancy due to enlarged corpus luteum

  • Endometrioma, dermoid cysts, neoplasms: May complicate pregnancy

  • Hormonal disorders: Polycystic ovary syndrome (PCOS) may affect fertility before conception

  • Imaging relevance: MRI helps differentiate benign from malignant ovarian pathology in pregnancy when ultrasound is inconclusive

MRI Appearance

T2 HASTE (T2 GRE):

  • Ovarian stroma: intermediate signal intensity

  • Ovarian follicles: very bright hyperintense fluid signal (multiple small round hyperintense foci)

  • Corpus luteum: variable — usually intermediate-to-hyperintense, with possible hypointense wall and surrounding edema

T1 GRE:

  • Ovarian stroma: intermediate signal intensity

  • Simple follicles: low (dark) signal intensity

  • Corpus luteum or hemorrhagic cyst: bright hyperintense signal due to blood/proteinaceous content

  • Fat-containing lesions (dermoid): bright signal, suppressed on fat-sat

MRI image

maternal ovaries MRI coronal anatomy image-img-00000-00000