Anatomy.—The ovaries vary a good deal in size, within the limits of health, in different individuals. It is unusual to find the two ovaries in the same person exactly alike in size, shape, and appearance.

The size, shape, and appearance of the ovary change at the different periods of life. In the new-born child the ovary is elongated and lies parallel to the Fallopian tube (Fig. 158). In rare cases this infantile shape of the ovary may persist throughout life.

The general shape of the mature ovary is oval. The average measurements are—long axis, 3 to 5 centimeters; breadth, 2 to 3 centimeters; thickness, 12 millimeters; weight, 100 grains. These measurements are subject to great variations. Henning’s table of measurements shows that the ovary of the multipara is no larger than that of the virgin.

After the menopause the ovaries shrink a great deal in size, sharing in the general atrophy of all the reproductive organs. The ovary of an old woman may weigh but 15 grains.

The healthy ovary is of a pinkish pearly color. On its surface are seen small bluish areas that mark the position of unruptured or of recently ruptured ovarian follicles. The ripening follicles project somewhat from the surface of the ovary, and the old ruptured follicles are marked by scars which in time cover and render irregular the whole surface of the ovary (Fig. 159).

The surface of the ovary becomes more irregular and wrinkled after the menopause. The follicles disappear, until finally nothing is left but a mass of fibrous tissue and a few blood-vessels.

The ovary lies in the posterior layer of the broad ligament. It is attached by this connection with the broad ligament and by the ovarian and infundibulo-pelvic ligaments.

The ovarian ligament extends from the inner end of the ovary to the angle of the uterus immediately below the origin of the Fallopian tube. This ligament varies in length from 3 to 5 centimeters. It is shortest in the virgin, and longest in the multiparous woman. The ligament consists of a fold of peritoneum containing unstriped muscular fiber from the uterus.

The infundibulo-pelvic ligament is that part of the upper margin of the broad ligament lying between the distal end of the Fallopian tube and the pelvic wall. It is about 2 centimeters in length. The length is greatest in the multiparous woman.

The position of the ovary is maintained by its attachments and by its own specific gravity. The considerations that have been discussed in regard to the position of the uterus also apply here.

The blood-vessels are the utero-ovarian arteries and the ovarian arteries and veins. The ovarian artery is homologous to the spermatic artery in the male. The course of the ovarian veins has an important influence upon some pathological conditions of the ovaries.

The right ovarian vein enters the inferior vena cava at an acute angle, and at the junction of the two there is a very perfect valve.

The left ovarian vein enters the left renal vein at a right angle: there is no valve on this side. This anatomical difference affords a probable explanation of the greater tendency to congestion and prolapse of the left ovary.

The ovary is composed of connective tissue which surrounds the Graafian follicles, blood-vessels, lymphatics, nerves, and unstriped muscular fibers. The posterior portion, or the free portion of the ovary, is covered with the germinal epithelium, or modified peritoneum, which is continuous with the peritoneum of the broad ligament.

The ovary is divided into two portions, which present distinct anatomical, physiological, and pathological differences.

The oÖphoron is the egg-bearing portion of the ovary. It corresponds to the free border of the gland.

The paroÖphoron corresponds to the hilum of the ovary—that portion in relation with the broad ligament.

The paroÖphoron contains no ovarian follicles. It is composed of connective tissue and numerous blood-vessels. In the paroÖphoron of young ovaries remnants of gland-tubules—vestiges of the Wolffian body—may be found.

Accessory ovaries have been described by several writers, and their existence has often been assumed to account for the persistence of menstruation after a supposed complete salpingo-oÖphorectomy. It is very doubtful if a true accessory ovary has ever been found. Bland Sutton says: “As the evidence at present stands, an accessory ovary quite separate from the main gland, so as to form a distinct organ, has yet to be described by a competent observer.” It is probable that the bodies that have been described as accessory ovaries have been more or less detached portions of a lobulated ovary, or small fibro-myomatous tumors of the ovarian ligament. Abdominal surgeons have had opportunity of examining thousands of ovaries at operation, and yet I know of no one who has come across a third ovary.