Why can't they see my ovary on ultrasound?

Ovaries can be hard to see on ultrasound due to normal factors like menopause (shrinking ovaries), obesity, bowel gas, or misplaced ovaries, plus technical issues with the sonographer or equipment. In younger individuals, ovaries are often visualized better with a transvaginal ultrasound (TVS) because it gets closer than a transabdominal scan. If ovaries aren't seen, it often doesn't mean they're gone, but rather hidden by other structures or simply very small.

Why would an ovary be missing?

An ovary can "disappear" due to surgical removal (oophorectomy), severe damage from ovarian torsion (twisting cutting off blood supply) leading to tissue death, congenital absence from birth (embryological defect), or sometimes due to autoimmune destruction or certain genetic/metabolic conditions, though they often just shrink post-menopause, making them hard to see on imaging rather than truly gone.
 

What does "ovary obscured" mean?

Obscured by bowel: this means we couldn't see an ovary as the bowel was overlying it and casting acoustic shadows. This is very common and normal.

Can endometriosis hide ovaries on ultrasound?

Ultrasounds are very good at identifying endometriosis in your ovaries. But ultrasounds can't show tiny pieces of tissue which are the most common type of endometriosis. An ultrasound can show: Endometrial tissue that's turned into cysts (endometriomas), most commonly found on your ovaries.

Do ovaries show up on ultrasound?

Yes, ovaries are routinely visualized using ultrasound, especially transvaginal ultrasound (TVS) (internal), which provides detailed images of their size, shape, follicles (eggs), and any cysts or masses, helping diagnose issues like infertility or ovarian cancer. While abdominal ultrasounds can also see them, TVS offers better clarity for these reproductive organs, though visibility can be affected by factors like body weight.
 

Hot Tips - Locating the Ovaries on Transabdominal Ultrasound

Why would you not be able to see an ovary on ultrasound?

In individuals who have given birth multiple times, the ovaries may have moved slightly from their original position. The ovaries also shrink after menopause, so an ultrasound may not be able to detect them in older people.

Is it possible for ovaries to hide?

The older we get, the smaller they become but they never disappear. Sometimes imaging with ultrasound, MRI or CT can have a hard time identifying ovaries for a multitude of reasons, with the most common being menopausal ovaries or lots of gas in the bowel, which can hide the ovaries.

What is silent endometriosis?

Silent endometriosis, also called asymptomatic endometriosis, is the same disease where uterine-like tissue grows outside the uterus, but without the typical severe pain, often going undetected until infertility issues arise. While some people experience mild symptoms like slight bloating or fatigue, others have none, yet the condition still causes inflammation, scarring, and issues with fertility, making diagnosis difficult. 

What can a transvaginal ultrasound detect?

A transvaginal ultrasound uses sound waves to provide detailed images of the female reproductive organs (uterus, ovaries, fallopian tubes, cervix) and can detect issues like cysts, fibroids, polyps, infections (PID), signs of cancer, ectopic pregnancy, infertility causes, and monitor early pregnancy, IUD placement, or conditions causing abnormal bleeding. It offers clearer views than an abdominal scan for these pelvic structures.
 

What are three signs of endometriosis?

Symptoms

• Painful periods. Pelvic pain and cramping may start before a menstrual period and last for days into it. ...
• Pain with sex. Pain during or after sex is common with endometriosis.
• Pain with bowel movements or urination. ...
• Excessive bleeding. ...
• Infertility. ...
• Other symptoms.

Can a full bladder improve ovary ultrasound?

For female patients, a full bladder helps in obtaining high-quality images of the uterus and ovaries. It is particularly beneficial when evaluating conditions such as ovarian cysts, fibroids, or abnormalities in the uterine lining.

Can ovaries move out of place?

Dermoid cysts and cystadenomas can become large and move the ovary out of position. This increases the chance of painful twisting of the ovary, called ovarian torsion. Ovarian torsion may reduce or stop blood flow to the ovary.

What does an ovary with PCOS look like on ultrasound?

On ultrasound, PCOS ovaries often look enlarged with multiple small, immature follicles (2-9mm) lining the outer edge, creating a distinctive "string of pearls" appearance, along with increased central tissue (stroma) that appears denser. Instead of one dominant follicle, you see many small ones that don't mature, along with a larger ovarian volume (often >10 cm³) and sometimes brighter, denser stroma.
 

What is a dead ovary?

An uncommon but serious condition called ovarian torsion (also known as adnexal torsion) occurs when the ovary, and sometimes the fallopian tube, twist on the tissues that support them. This cuts off the blood supply to the ovary, which if not treated promptly, can cause tissue in the organ to die.

At what age do ovaries disappear?

Menopause usually happens between 45 and 55

“Menopause occurs because the ovaries have stopped producing estrogen, and the egg follicles have stopped producing other hormones as well, including progesterone” he added. “Ovulation and hormone production have ceased.

What is a lazy ovary syndrome?

"Lazy ovary syndrome" isn't a formal medical term but often describes conditions like PCOS (Polycystic Ovary Syndrome) or Primary Ovarian Insufficiency (POI), where ovaries don't function properly, leading to irregular periods, trouble conceiving, excess hair, acne, or hot flashes, often due to hormonal imbalances preventing egg release (anovulation). Symptoms vary but center on menstrual disruption, fertility issues, and androgen excess, requiring medical diagnosis to manage symptoms like irregular cycles, infertility, weight gain, and excess hair.
 

How long do ultrasound results take if something is wrong?

If something is wrong on an ultrasound, you might get preliminary verbal results immediately or within hours from the technician/radiologist, but the detailed report to your doctor usually takes 24 hours to a few days (2-3 days) for urgent/standard cases, though it can stretch to a week or more depending on urgency, complexity (requiring second reads or more tests like MRI/CT), and facility backlog; in emergencies, results can be expedited. 

Will a sonographer tell you if something is wrong?

No, an ultrasound technician (sonographer) cannot give you a diagnosis or tell you definitively "if something is wrong," as they are not doctors; they capture detailed images and measurements for a radiologist or physician to interpret, though they might point out "areas of concern" or seem to react, they must remain professional and non-diagnostic, and only the ordering doctor can explain the full results and next steps. 

What cancers can a pelvic ultrasound detect?

A pelvic ultrasound can detect potential signs of cancers in pelvic organs like the ovaries, uterus (womb), fallopian tubes, bladder, and rectum, spotting abnormalities, masses, or thickened tissues that might suggest malignancies, but it's usually a first step, not a definitive diagnosis, requiring further tests like biopsies. It's particularly useful for identifying issues in reproductive organs, showing suspicious features like irregular masses, increased blood flow, or fluid, helping differentiate benign from potentially cancerous growths, say researchers at Macmillan Cancer Support and Not These Ovaries.
 

What could mimic endometriosis?

Endometriosis symptoms, like pelvic pain, bloating, and heavy periods, often overlap with conditions such as Irritable Bowel Syndrome (IBS), Ovarian Cysts, Pelvic Inflammatory Disease (PID), Fibroids, and Polycystic Ovary Syndrome (PCOS), leading to misdiagnosis, but also conditions like Appendicitis, UTIs, and even rare issues like Ectopic Pregnancy can mimic its severe pain, making proper diagnosis crucial. 

What lifestyle causes endometriosis?

Lifestyle factors such as alcohol/caffeine intake, smoking, and physical activity influence estrogen levels in the body and, therefore, may impact development of endometriosis. Caffeine intake has been hypothesized to be influential in the pathology of gynecological disease due to its ability to influence estradiol.

Can endometriosis be undetectable?

Yes. Endometriosis can be invisible both symptomatically and radiologically. Lesions may be too small or too subtle to appear on routine pelvic ultrasound. Some lesions—especially clear or white peritoneal lesions—are difficult to detect without specialized surgical techniques.

Should ovaries be visible on ultrasound?

A pelvic ultrasound is a noninvasive diagnostic exam that produces images that are used to assess organs and structures within the female pelvis. A pelvic ultrasound allows quick visualization of the female pelvic organs and structures including the uterus, cervix, vagina, fallopian tubes and ovaries.

Why is my left ovary missing?

Possible causes include torsion or vascular obstruction leading to loss of one ovary, and true agenesis where the ovary never formed during development. It is much more common than having no functional ovaries (XX gonadal dysgenesis).

Can things be missed on an ultrasound?

They help doctors monitor the baby's development, detect abnormalities early, and guide decisions throughout pregnancy. Unfortunately, ultrasound can sometimes tell the wrong story due to diagnostic errors. Studies show that diagnostic errors in radiology, including ultrasound, happen in about 3% to 5% of cases.