Tag: ovarian torsion

Ovarian Torsion: A Medical Emergency Every Woman Should Know About

When it comes to women’s reproductive health, certain conditions require immediate attention — and ovarian torsion is one of them. While not as commonly discussed as PCOS or endometriosis, ovarian torsion is a serious and potentially fertility-threatening condition that demands swift medical intervention. Understanding what it is, why it happens, and how it’s treated can make a crucial difference in outcomes.

What is Ovarian Torsion?

Ovarian torsion occurs when an ovary twists around the ligaments that hold it in place. This twisting can cut off blood flow to the ovary and sometimes the fallopian tube. If left untreated, it can lead to the death of ovarian tissue and loss of the ovary, impacting hormonal balance and fertility.

Ovarian torsion is considered a gynecologic emergency. Though it is relatively rare — accounting for around 2.7% of gynecologic emergencies — it tends to affect women of reproductive age, particularly those undergoing fertility treatments or with ovarian cysts.

What Causes Ovarian Torsion?

The most common cause is an enlarged ovary, often due to:

• Ovarian cysts or masses

• Ovarian hyperstimulation, especially during fertility treatments like IVF

• Polycystic ovary syndrome (PCOS)

• Pregnancy, particularly in the first trimester

• Congenital abnormalities or elongated ligaments

When the ovary becomes heavier or imbalanced due to a mass or swelling, it is more likely to rotate, cutting off the blood vessels supplying it.

Who Is at Risk?

While ovarian torsion can happen to any woman, certain groups are more vulnerable:

• Women undergoing fertility treatments involving ovulation induction drugs (e.g., Clomid, gonadotropins)

• Pregnant women, especially in early pregnancy when the corpus luteum cyst is active

• Teenagers or premenopausal women with active ovarian function

• Women with previous pelvic surgeries or adhesions

Recognizing the Symptoms

The symptoms of ovarian torsion can come on suddenly and may mimic other abdominal or pelvic issues. Key signs include:

• Sudden, severe pelvic pain, usually on one side

• Nausea and vomiting

• Abdominal tenderness or swelling

• Fever (in later stages, if the ovary becomes necrotic)

• Pain during intercourse or bowel movements

The pain may come and go if the ovary twists and untwists temporarily, which can delay diagnosis. However, persistent or worsening pain should never be ignored.

How is Ovarian Torsion Diagnosed?

Prompt diagnosis is critical to preserve ovarian function. A doctor will typically perform:

• Pelvic examination

• Transvaginal or abdominal ultrasound, often using Doppler imaging to assess blood flow to the ovary

• CT or MRI scans (in uncertain cases)

It’s important to note that Doppler ultrasound is not 100% reliable. Blood flow may still appear normal in early torsion, so clinical suspicion and symptoms are key to deciding the next steps.

Treatment: Time is of the Essence

Once ovarian torsion is suspected, surgical intervention is necessary — usually via laparoscopy (a minimally invasive keyhole procedure). The surgeon will attempt to:

1. Untwist (detorse) the ovary to restore blood flow

2. Remove any cyst or mass causing the torsion

3. In some cases, remove the ovary if it is no longer viable

If treated early, the ovary can often be saved, even if it appears discolored during surgery. In the past, some surgeons removed the ovary due to fear of embolism (clots), but recent evidence supports detorsion even in these cases, as the ovary often recovers.

Can Ovarian Torsion Affect Fertility?

Yes — if the ovary or fallopian tube is damaged or removed, it may reduce the number of eggs available and affect natural fertility, especially if the remaining ovary is compromised. This is particularly relevant for women undergoing fertility treatments.

However, many women go on to conceive naturally or with assisted reproductive technologies (ART) after recovering from ovarian torsion. If you have one healthy ovary, your body can often compensate hormonally and reproductively.

Preventing Ovarian Torsion

While not always preventable, the risk of ovarian torsion can be reduced by:

• Monitoring ovarian size during fertility treatments

• Surgical removal of large cysts when necessary

• Discussing any prior pelvic pain or ovarian history with your doctor, especially before starting IVF or ovulation induction

For women undergoing IVF, doctors may recommend “coasting” (delaying ovulation trigger) or adjusting medication to reduce ovarian swelling and minimize the risk of torsion.

Final Thoughts

Ovarian torsion is a rare but serious condition that every woman — especially those in fertility treatment — should be aware of. If you experience sudden, intense pelvic pain, don’t delay seeking medical attention. Early diagnosis and treatment can mean the difference between preserving your ovary or losing it.

By staying informed and acting quickly, you can protect not only your reproductive health but your long-term well-being.

For any of your fertility problems, please do not hesitate to contact us. At Fertility Solutions we pride ourselves with the excellent tailored personal care we provide to our patients for their specific needs. A team member will contact you as soon as we get your message, and construct a personal treatment plan for your fertility problems in the country of Cyprus. You can also contact our clinics directly through the links below.