OVARIAN MALDESCENT

Objective: To describe and assess the incidence and impact of ovarian maldescent in infertile women. Design: Observational clinical study. S etting: Referral infertility practice. Patients: Women undergoing oper ative intervention as part of infertility evaluation or treatment. Int erventions: Anatomic observation at laparoscopy or laparotomy. Results : Failure of the gonad to descend into the true pelvis occurred in 5 o f 2,025 operative observations of patients evaluated and treated for i nfertility. Inappropriate descent of the ovary is associated with a sh ort infundibulopelvic ligament and attachment of the superior pole of the ovary above the pelvic brim adjacent to the fimbriated end of an e longated, ipsilateral fallopian tube. It may be bilateral or unilatera l and sometimes is associated with Mullerian duct abnormalities. Concl usions: The incidence of ovarian maldescent is low, its relationship t o infertility is unclear, and it does not necessarily preclude concept ion when other infertility factors are recognized and treated. Its rar ity and altered anatomy has the potential for therapeutic misadventure at laparoscopy, laparotomy, and IVF oocyte retrieval.