The left ovary is not visualized. Why are the ovaries not visualized on ultrasound. Possible reasons why the ovary is not visualized on ultrasound

Pelvic examination in postmenopausal women

Uterus. In postmenopausal women, the uterus becomes much smaller and more homogeneous in echostructure: the endometrium is not traced.
Postmenopausal ovaries. The ovaries are small and often very difficult or impossible to visualize on ultrasound. If they do appear, they appear hyperechoic, without follicles, and often nearly isoechoic to the surrounding tissue.

Position of the uterus

The uterus can be rotated so that the body of the uterus is defined behind the cervix (retroversio condition). The body of the uterus can be tilted anteriorly (anteversio).

If the body of the uterus is tilted towards the cervix, it is in antejlexio. If the body of the uterus is tilted back from the cervix, this condition is called retroflexio.

In cases where the uterus is not visualized, it is necessary to find out if there was a history of hysterectomy. If there is a history of surgery, carefully look for the cervical stump, as supravaginal amputation is not a hysterectomy.

When normal pelvic echostructures are not clearly visualized, give the patient more fluid to fill the bladder.

The ovaries can occupy a different position, but are always behind the bladder and uterus. Most often they are found at the site of the appendages, on the side.

The ovary may be located in the retrouterine space or above the fundus of the uterus. In postmenopausal women, the ovaries are small and often not visualized.

If it is difficult to visualize the uterus and ovaries, move the uterus manually through the vagina and continue scanning in different planes to refine the anatomical details. A similar technique can be used in the presence of low-lying pelvic formations.

In the absence of imaging of the ovaries, the following technique may be used:

Place the patient in the lateral position and scan the opposite ovary through a full bladder.
Decrease the sensitivity level of the device. If the sensitivity is too high, the ovary may be poorly identified against the background of the surrounding parametrium and may not be visualized.

If the ovaries are still poorly visualized, this may be due to overfilling or underfilling of the bladder. Adequate filling is considered such that the bladder covers the bottom of the uterus, if the bladder is not filled enough. give the patient more water. Repeat the study after 30 minutes, try to visualize the ovaries.

If the bladder is full, it will push the ovaries down from the uterus or laterally onto the psoas. Ask the patient to partially empty the bladder (give her a special measuring vessel for filling). Then repeat the study.

Even if the bladder is adequately filled, the ovaries may be poorly visualized due to shielding by intestinal gases. This often happens if the ovaries are located higher than usual.

If necessary, scan the patient in an upright position or in a vertical oblique view. This will help dislodge the gas-filled bowel loops, while making the ovaries more visible.

If the normal anatomy is still not clearly defined, gently inject 20 ml of body temperature water into the vagina and scan over the pubis. The fluid will surround the cervix and make it easier to identify the organs. This method is particularly useful in making a differential diagnosis between hysterectomy and supravaginal amputation in cases where clinical investigation is not possible.

If it is difficult to visualize the retrouterine masses, inject 200 ml of warm water into the rectum, then examine the area. Air microbubbles will be visualized as bright hyperechoic structures that clearly delineate the anterior rectal wall, which facilitates the recognition of formations in the intestinal lumen, such as fecal matter, which are the most common cause of diagnostic errors.

normal ovaries

When the ovaries are visualized, determine if there is any displacement of the surrounding structures. Determine the state of the internal structure of the ovaries and the presence or absence of acoustic pseudo-amplification. If anechoic structures are visualized in the thickness of the ovaries or along their periphery, it is possible that these are follicles. Decrease the sensitivity level when examining the ovaries, since normal ovaries are highly conductive and there is an increase in the deep sections. Take measurements for each ovary.

Examine the tissues around the ovary for cystic, solid, or fluid-containing masses. Look for fluid in the retrouterine space. Examine both ovaries.

The ovaries are normally never located in front of the uterus. In an atypical position, rotate the patient to look for adhesion fixation of the ovary and to determine if it is markedly enlarged.

The sensitivity of the instrument must be varied as different structures in the pelvis are examined in order to obtain an optimal image. The relationship of the pelvic organs can be better determined with a slow, steady scan over about 10 seconds.

Follicular apparatus of the ovary

Follicles are visualized as small cystic anechoic structures in the thickness of the ovary or along its periphery and are better visualized when a low sensitivity level of the device is set. Depending on the phase of the menstrual cycle, cystic structures can reach 2.5 cm in diameter. Simple cysts larger than 5 cm in diameter may be physiological and may change, become smaller or disappear).

If the presence of a cystic tumor formation is expected, dynamic observation is necessary - a study in the early and late phases of the menstrual cycle. Follicular cysts regress, while non-functional cysts do not change their size. If doubts remain, conduct a study next month.

A physiological cyst in the ovary can be up to 5 cm in diameter. Cysts of this size should be re-examined at the end of the menstrual cycle or during the next cycle.

The reproductive system is an important part of the body. For a woman, her main task is to provide conditions favorable for conception and the birth of a child. The ovaries are an important part of this system. Without their normal functioning, conception becomes impossible.

Modern examination methods allow you to quickly identify most types of pathologies, including the ovaries. Examination of the paired organ - the ovaries is recommended to take place every year, mainly for preventive purposes. Less commonly, ovarian ultrasound is performed to determine the effectiveness of the treatment, in this case, based on the data obtained, the necessary adjustment of the drugs used is carried out.

In rare cases, in the conclusion of the ultrasound, you can notice the wording that the left ovary is not varnished. What does this mean? The difficulty of finding the ovaries during the examination is due to the fact that they are located between the bladder and the uterus, and in some cases may be hidden under the uterine fundus.

Norm

The left ovary is not visualized - what does this mean, the patients are interested. There are a lot of reasons why an ovary becomes invisible during an ultrasound examination. And such a conclusion does not mean at all that there is no ovary.

Firstly, if the survey is carried out on old equipment, such an incident arises purely for technical reasons. In this case, it is enough to repeat the examination in another place and everything will fall into place.

Normally, on ultrasound, the ovaries have a very clear uneven contour, and in principle, if the patient is properly prepared for the procedure, then there are no difficulties in detecting the ovary. Before the examination, the woman should drink as much water as possible. This is necessary so that the ovary comes out from behind the uterus and becomes clearly visible.

In the presence of pathology, the ovary becomes the contours of the organ, lose their clarity and become blurred. This is what an ovary looks like, in which a cyst grows or an inflammatory process develops. Blurred contours are a sign of inflammation of the uterine appendages. If the ovary is significantly reduced in size, doctors talk about the onset of menopause.

The reasons

In the case when the ovary is not visible at all, it can be argued that the patient has an anatomical feature of the structure of the reproductive system, or endocrine disorders. Under the anatomical features of the structure is meant the absence of the ovaries or one of the ovaries at birth.

The most common reason that the left ovary ceases to be noticeable is a large accumulation of gases in the intestines or its fullness. The doctor conducting the diagnosis usually postpones the examination and recommends that the patient be more thoroughly prepared for the procedure.

When the intestines are filled with gases, it does not matter how full the bladder is or how sensitive the device is. During the diagnosis, the woman is laid on her side, then the doctor conducts an examination, if necessary, changing the sensitivity of the device.

After surgical treatment of the genital organs, the work of all organs related to this system is temporarily disrupted. So the ovaries can decrease several times, and for this reason they become invisible.

Another factor affecting the condition of the ovaries is the use of contraceptives, which are sometimes used to restore hormonal metabolism. The essence of contraception using pills is that they reduce the activity of hormones produced by the ovaries. Because of their intake, ovulation does not occur, and therefore pregnancy does not occur.

Under the influence of these drugs, the ovary can also become invisible on ultrasound. The same picture is observed in the physiological violation of ovulation. This condition can occur without the use of tablets, due to hormonal imbalance. Its effects disappear with the onset of the next menstruation. After that, the ovary again appears in the field of view and becomes visible on the monitor screen.

Polycystic can also affect ovulation. If the ovary is not detected during a second ultrasound examination, the woman is prescribed tests for female sex hormones in order to identify the source of the problem.

If there are adhesions in the genital area or in the abdominal cavity, then the ovaries are also not visualized. The ovaries can also become invisible against the background of an enlarged uterus, with an anatomical displacement of an organ or a displacement resulting from a previous disease.

What can be advised to a woman if one of the ovaries was not found in her during an ultrasound scan? First of all, you can not make hasty conclusions and worry too much about this.

The doctor should determine the cause of such an incident. In this situation, you need to contact a clinic equipped with more modern equipment and more experienced staff. Most of the time, the problem goes away on its own. For more serious reasons for the absence of an ovary during examination, it is necessary to consult a doctor and determine the cause.

The female reproductive system is a complex part of the human body, the main task of which is to provide normal conditions for the bearing and birth of a child. In this reproductive system, the ovaries play the main role, since, under the condition of abnormal functioning, a woman will not be able to conceive a child. What to do if the ovary is not visible on the ultrasound and does this affect the state of health?

The pelvis contains the following female organs:

the bladder, which, by virtue of anatomy, is located in contact with the uterus and vagina;
the vagina adjacent to the uterus and passing through the urogenital diaphragm;
rectum;
the uterus, which is shaped like a pear;
fallopian tubes;
ovaries, which produce female hormones and are responsible for the production of eggs.

All these organs, functioning without anomalies, provide a woman with the possibility of childbearing.

As an independent procedure, ultrasound is rarely performed, it is usually prescribed in conjunction with an examination of organs. But sometimes it can be prescribed in order to check the functionality of the ovaries. More often this procedure is prescribed to find out the reason for the impossibility of conception.

The main indications for ultrasound examination of the reproductive organs are the following diseases and symptoms:

pain during intercourse;
change in the regularity of the menstrual cycle or its absence;
constant pain in the lower abdomen;
pregnancy;
heavy or scanty periods, in which there is severe pain;
suspicion of infertility;
inflammatory process of the appendage;
preparation in IVF and standard pregnancy;
prevention.

With the help of ultrasound, the following pathologies can be detected:

A cyst is a benign formation in the form of a protrusion filled with fluid, which often causes a delay in menstruation. This pathology is dangerous because at any time it can degenerate into a malignant tumor and cause infertility.
Polycystic ovary, which is a hormonal pathology, when the ovaries enlarge and a large number of cysts form on them. This pathology also provokes infertility, as it simply does not allow ovulation to occur, that is, the egg cannot leave the ovary.
Cancer tumors of various sizes.
Torsion of the ovary, when its nutrition is disturbed, as a result of which pathological processes begin to develop in it.
Salpingo-oophoritis, when there is infection and inflammation in the fallopian tubes and the ovaries themselves. It occurs due to the penetration of chlamydia, streptococcus and other infections from the vagina.

But sometimes it is not possible to see the ovaries, and then other methods of examination can come to the rescue.

If an ultrasound scan cannot reveal some pathologies, then alternative studies can come to the rescue, which include the following:

Laparoscopy with smears.
Computed and magnetic resonance imaging.
Puncture of the Douglas space with further cytological analysis of the washout.

Ultrasound examination of the ovaries is the most versatile examination method.

Among the undeniable advantages are the following:

painlessness;
non-invasiveness;
availability;
when using it, there is no ionizing radiation;
visualization of soft tissues;
the ability to see the processes occurring in the body in real time.

In addition, this technique is the most convenient for monitoring the intrauterine development of a child, allowing you to visualize all the processes and changes in the female body during the period of bearing a child.

An important characteristic of ultrasound is its affordability, which allows you to monitor the state of the body at any time, especially since it is completely safe.

This terminology implies not the fact that this organ does not exist, but the fact that it is not defined, that is, the structure and contour cannot be determined. Often this can happen due to the incompetence of a doctor who could not properly set up the sensors.

This situation may arise when the examination was carried out on old equipment, here you can correct the situation by doing another study in another clinic.

But before a transvaginal ultrasound, it is necessary to empty, otherwise the liquid during the movement of the sensor inside the vagina will interfere with seeing the organs.

Normally, the ovaries have an uneven and clear contour. If the woman is properly prepared for the procedure and the equipment is appropriate, then there should be no problems with imaging.

If there are pathologies, then the contours lose their clarity. It will look like an ovary with a cyst or inflammation. If the ovary has decreased, then the onset of menopause takes place. When the right or left ovary is not determined, this may indicate problems with the endocrine system or simply features of the body.

Intestinal disorders

The main and most common reason that the ovary is not visible is the accumulation of gases in the intestines or a full stomach. If these factors take place, then the organ should be visible on the next ultrasound.

Anovulatory cycle

It happens that the ovary is not visualized due to the fact that there is no ovulation, and this can happen for the following reasons:

temporary hormonal failure, when the normal state returns in a further cycle;
serious pathologies in the pelvis or hormonal disorders.

When both cycles in a row give an abnormal result in ultrasound diagnostics, there is no ovulation, then it is necessary to investigate the endocrine system.

Hormonal disorders

If all other reasons are absent, and the ovary is still not visualized on ultrasound, then you need to take tests for hormones, which include the following:

Estrogens.
Prolactin.

With an insufficient or excessive amount of the above hormones, it is necessary to check all the organs of the female body that are responsible for their production.

Reasons for not visualizing the ovary

In addition to the listed pathologies and factors, problems with the visibility of the organ can occur for the following reasons:

the presence of adhesions in the peritoneum or in the reproductive organs themselves;
after surgery on the ovaries or fallopian tubes;
congenital absence;
high density of the peritoneum;
anomalies in development;
due to the deformation of the uterus, which arose due to the presence of myomatous nodes;
menopause;
the presence of scars on the anterior abdominal wall;
the period before the onset of menopause;
during severe polyetiological pathology of the uterus;
due to enlargement of the uterus;
the presence of too dense fat layer;
organic shifts.

Before getting upset about a possible disappointing diagnosis, it is necessary to find out why the ovary cannot be located, because often the reason for this is inappropriate preparation, researcher error, or excess gases in the intestines.

The patient should be aware that ultrasound will be less informative if the woman is taking contraceptives.

Content

Ultrasound diagnosis of the ovaries allows you to quickly identify the existing pathology, assess the size and structure of the tissues of the organ without additional preparation on the part of the patient. However, sometimes the ovary is not visualized, what this means is the main issue that worries patients. Without additional examinations, it is difficult to answer why the gland is not visible, however, the most likely causes are the onset of menopause, hormonal failure, and disturbances in the work of neighboring organs.

Ovaries are not located: what does it mean

If, as a result of the diagnosis, the doctor made an entry: "The ovaries are not located" or "The ovaries are not visualized" - this means that they are not visible. The reason may be not only a developing pathology, but also poor-quality equipment, flatulence that prevents the visualization of the gland, and inaccuracies in the doctor's actions. Finding it is not so easy due to the location of the pelvic organs.

The glands may not be visible because they are located behind the uterus, the bladder. Often they are blocked by the intestines. It is especially difficult to see the ovaries during menopause, when the size of the organs decreases naturally and they are not visualized.

Why is the left ovary not detected on ultrasound

The left ovary is not detected on ultrasound when the bladder is empty. Patients underestimate the importance of following the doctor's recommendations for preparing for the examination. The reason is a misunderstanding of the essence of the process.

During ultrasound, the glands, like other organs of the small pelvis, may not be visible. They are blocked by intestinal loops. Filled with air, they reflect ultrasound waves, preventing image transmission, which is why the glands are not visualized. There is a need to create an "acoustic window" - a zone through which it would be possible to freely conduct an examination. A full bladder becomes just such a zone. If it is not full enough, you need to drink water, take a diuretic and return to the examination in half an hour. The diagnostician will have the opportunity to assess the structure of glands that were not previously visible.

Why is the right ovary not visualized on ultrasound

During the ultrasound diagnostics of the pelvic organs, it is required to adjust the sensitivity of the sensor. If the sensitivity level is exceeded, the readings of the device may be unreliable, the ovary is not visualized. Often, the right ovary is not determined on ultrasound, access to which is blocked by parametric tissues (peripheral tissue), bone structures.

Attention! The reasons why the right or left gland is not visible are identical.

Ovaries are not located on ultrasound during menopause

Approaching menopause causes a number of changes in a woman’s body:

the number of follicles in the glands decreases;
decreased production of the hormone estrogen;
connective tissue develops, gradually replacing the cortical substance with numerous follicles.

As a result of changes, the size of the organs decreases, they are not visualized during the examination.

Ovarian volume depending on age

In a woman of reproductive age, the average volume of the ovary is 8 cm 3, however, during the premenopausal period, an enlarged organ is a deviation from the norm. Its volume should not be more than 5 cm 3, such a condition is regarded as pathological, and the difference between paired organs should not exceed 1.5 cm 3.

During menopause, the scan must be performed with a transvaginal probe, otherwise the ovaries cannot be seen. When choosing a transabdominal approach, the risk of the absence of an image of the glands on the monitor increases by 30-50%, the gland is not visualized.

Possible reasons why the ovary is not visualized on ultrasound

In addition to menopause, flatulence, improper preparation for diagnosis, there are other reasons why the ovary is not located:

congenital features of the structure of internal organs;
the development of an adhesive process after inflammation of the appendages, surgical intervention;
enlarged uterus;
displacement of other organs.

Common reasons why the gland is not visible on ultrasound include:

Taking oral contraceptives.
Intestinal disorders.
Hormonal disbalance.
anovulatory cycle.
Operational interventions.

Taking oral contraceptives

If the ultrasound did not find the ovary, you need to tell the doctor about taking birth control pills. The hormones that make up their composition contribute to the inhibition of the functions of the gland. It is not visible on the monitor, and diagnostics cannot be considered an informative examination method.

Bowel disorders

Do not overload the intestines before the examination. Overeating, eating gas-forming food is a common reason for the unreliability of the examination results and the reason why the gland is not visible.

Hormonal disbalance

If the ovary is not visualized on ultrasound, the reasons may be hormonal failure caused by stress, disruption of the endocrine system, and other concomitant diseases. The examination includes the delivery of a number of hormones:

follicle-stimulating and luteinizing;
antimullerian hormone;
prolactin;
estrogen;
"male" hormones.

Anovulatory cycle

Do not be surprised if the ultrasound does not visualize the ovary during the anovulatory cycle. The absence of the natural process of maturation of the egg indicates an imbalance of hormones. If anovulation is accompanied by weight gain, there is a deterioration in the condition of the skin and hair, and the gland is not visible for 2 months in a row, you should contact a gynecologist-endocrinologist.

Operational interventions

Removal of the ovaries is a forced necessity, and the patient, as a rule, is aware of the surgical procedures performed. In this case, the gland is not visualized, but this should not arouse suspicion.

Another reason why the organs are not visible is the stress suffered during the operation. Even if the ovary is not removed, it may decrease and be no more than 0.5 cm in diameter.

What to do if the ovary is not visible on the ultrasound

If the appendages are not determined, this means either a more serious change in the hormonal background, which happens when taking contraceptives, during menopause, or features of the current state of the internal organs.

When re-examination with an abdominal sensor, it is necessary:

3 days before the manipulation, give up carbonated drinks, as well as products that cause flatulence (legumes, black bread, cabbage, fresh pastries, sweets);
a few hours before the examination, take a sorbent;
in the evening, take a laxative or cleanse the intestines with an enema.

Attention! 2 hours before visiting the doctor, it is worth drinking at least 1 liter of water and not urinating before the ultrasound diagnostic procedure (the ovaries are not visible with an empty bladder).

Assessment of the state of the glands using a vaginal sensor does not require special training.

The only obstacle to obtaining a clear picture may be gases in the intestines, due to which the ovaries are not visible, therefore it is recommended to take the drug "Espumizan" a day before the examination (2 tablets three times a day, and 2 tablets an hour before the procedure) .

Conclusion

If the ovary is not visualized, what does this mean - the doctor will tell you. It is recommended to re-diagnose, preparing for the process. In most cases, following all the recommendations for preparing for the examination has a positive effect. If the gland is not visualized again, it is necessary to take tests to check the hormonal background.

The ovaries are the paired organ of the female reproductive system. The onset of pregnancy and the health of the woman as a whole depend on their normal functioning. Therefore, it is necessary to regularly undergo preventive examinations for ultrasound. If a woman has symptoms of a gynecological disease, then an ultrasound examination is necessary for diagnosis. To date, this is the most accessible and informative method of examination for diagnosis.

Why is an ovarian ultrasound prescribed?

For prevention, it is enough to undergo an ultrasound examination 1 or 2 times a year. This approach will help to avoid many serious female diseases. In addition, it will be possible to diagnose them at an early stage of development and prescribe treatment in time. As a rule, most diseases in gynecology are much easier to cure at the initial stage than in the acute stage.

If the woman has already applied to medical Center about various symptoms and have already been treated, the doctor prescribes ultrasound for diagnostics. The following symptoms should be the reason for contacting a specialist and undergoing an examination:

Menstrual cycle of different duration or its absence;

Painful periods and long cycles;

Painful sensations in the suprapubic part of the abdomen and pulling pains;

Infertility;

The appearance of discharge with an admixture of blood in the intervals between menstruation.

Also, the doctor prescribes an ultrasound examination, if you need to determine the duration of pregnancy. During treatment infertility Ultrasound diagnostics shows how the corpus luteum in the ovary matures and whether it is there at all: it depends on whether pregnancy occurs.

Indications for ultrasound

Ultrasound allows you to accurately determine the gestational age and the number of embryos in the uterus, to control their development. In addition, the doctor can confirm or refute the development of the following diseases:

All types of pathology of the endometrium of the uterus;

Tumors and other neoplasms on the ovaries and near them;

salpingitis;

Inflammatory processes in the pelvic organs, including the ovaries;

Various pathologies of the cervix;

Since at the same time as the ovaries, the doctor can also examine other organs of the small pelvis, such a diagnosis is complex and helps to detect violations of the hormonal background and the functions of the genitourinary system.

Features of ultrasound of the ovaries

The examination can be carried out in several ways - transvaginally and transabdominally. This makes it possible to visualize the organ most fully. The first method is that the patient is injected with a special sensor into the vagina. No preparation is required, and the guide gel is applied directly to the scanner.

A transabdominal examination is a scan of the pelvic organs through the wall of the abdominal cavity. Before this, it is necessary to fill the bladder in order to better visualize the ovaries. However, it happens that ovary not detected on ultrasound. This could be for several reasons:

The ovary was removed by surgery;

This is a congenital pathology, and it happens that two organs are missing at once;

The ovaries are reduced in size due to malnutrition and are difficult to visualize;

There are myomatous nodes in the uterus and from this it is enlarged and closes the ovaries;