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Spontaneous Disappearance of a Normal Adnexa Associated With a Contralateral Polycystic-Appearing Ovary

The Assisted Conception Unit, Birmingham Women’s Hospital, Birmingham, United Kingdom

Address reprint requests to: Olufemi Olufowobi, MRCOG, Birmingham Women’s Hospital, Assisted Conception Unit, Metchley Park Road, Birmingham B15 2TG, United Kingdom; E-mail: femi.olufowobi{at}bham-womens.thenhs.com.

ABSTRACT

BACKGROUND: Absence of the adnexa may be congenital or acquired. However, the etiology is often uncertain.

CASE: A 27-year-old woman presented with a 3-year history of subfertility. Her irregular menstruation was associated with acne vulgaris, alopecia, and elevated body mass index. Transvaginal ultrasonography of the pelvis showed a normal uterus, a normal right ovary, but a polycystic-appearing left ovary. A hysterosalpingogram demonstrated a normal uterine cavity, prompt filling and spilling of contrast material from the left fallopian tube, but no filling on the right. Subsequent laparoscopy showed an unexpected absence of right adnexa and presence of a solitary rounded free-floating mass enshrouded in the omentum. She did not have a history of abdominal pain or surgery.

CONCLUSION: The evidence suggests that the patient might have had an asymptomatic infarction of the right adnexa.