Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation, but fertilized within the ovary where the pregnancy implants. Such a pregnancy usually does not proceed past the first four weeks of pregnancy. An untreated ovarian pregnancy causes potentially fatal intra-abdominal bleeding and thus may become a medical emergency. Cause and pathology
The cause of ovarian pregnancy is unknown, specifically as the usual causative factors – pelvic inflammatory disease and pelvic surgery – implicated in tubal ectopic pregnancy seem to be uninvolved. There appears to be a link to the intrauterine device (IUD), however, it cannot be concluded that this is causative as it could be that IUDs prevent other but not ovarian pregnancies. Some have suggested that patients who undergo IVF therapy are at higher risk for ovarian pregnancy.An ovarian pregnancy is usually understood to begin when a mature egg cell is not expelled or picked up from its follicle and a sperm enters the follicle and fertilizes the egg, giving rise to an intrafollicular pregnancy. It has also been debated that an egg cell fertilized outside of the ovary could implant on the ovarian surface, perhaps aided by a decidual reaction or endometriosis. Ovarian pregnancies rarely go longer than 4 weeks; nevertheless, there is the possibility that the trophoblast finds further support outside the ovary and thus may affect the tube and other organs.
In 1899, Catharine van Tussenbroek finally settled the question of the existence of ovarian pregnancy, by providing the first accurate clinical and histological description of a case. Though doubted, her results were confirmed three years later in a case by Thompson. References
Citations
Sources
Jacobson, Sidney D. (1908). "True Primary Ovarian Pregnancy: Operation; Recovery". In Brooks, Henry T. (ed.). Contributions to the Science of Medicine and Surgery: In celebration of the twenty-fifth anniversary, 1882-1907, of the founding of the New York Post-Graduate Medical School and Hospital. New York: Jacobson New York Post-graduate Medical School and Hospital Faculty / Royal College of Physicians of Edinburgh. McDonald, Ellice (1914). Studies in gynecology and obstetrics. New York: American Medical Publishing Co. OCLC 11339026. Ray, Henry M. (June 1921). "Primary Ovarian and Primary Abdominal Pregnancy: Their Morphological Possibility". Surgery, Gynecology & Obstetrics. Chicago: Journal of the American College of Surgeons / Franklin H. Martin Memorial Foundation. 32. Retrieved 21 March 2016. Rizk, Botros R. M. B. (2010). Ultrasonography in Reproductive Medicine and Infertility. Cambridge, England: Cambridge University Press. ISBN 978-1-139-48457-2. Thorek, Max (February 1926). "Case of Ovarian Pregnancy with Histological Findings". The Illinois Medical Journal. Chicago: Illinois State Medical Society. 49: 106–111. Retrieved 6 April 2016. "Obstetrical Society of London". The British Medical Journal. London: Royal Medical and Chirurgical Society. 2 (2081): 1442. 17 November 1900. PMC 2463948.