Ovarian torsion is the twisting of the ovary on its ligamentous supports. The ovary is essentially tethered between the uterus and the pelvic sidewall by the uteroovarian ligament (between the uterus and ovary) and the infundibulopelvic ligament (between the ovary and the pelvic sidewall).
If the ovary becomes very large and irregular, there is an increased chance that the ovary will twist on these supporting structures. These ligaments that hold the ovary in place also contain the blood supply to the ovary, so that if the ovary twists there can be both a great deal of discomfort as well as an interruption in the ovarian blood supply. The torsed ovary can even sometimes become necrotic (“dead”) when torsed, which may require it to be removed. Fortunately, ovarian torsion with COH is very uncommon.
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