What would cause the ovaries to be unseen on ultrasound and not found in exploratory surgery?

Possible causes for ovaries not being seen on ultrasound and not found in exploratory surgery:

1. Small ovaries: In some cases, the ovaries may be too small to be clearly visualized on ultrasound. This can be especially true in young girls or women who have not yet reached puberty.

2. Dense tissue: The ovaries may be obscured by dense tissue, such as uterine fibroids or scar tissue. This can make it difficult to see the ovaries on ultrasound.

3. Ovarian cysts: Ovarian cysts can sometimes fill the space where the ovaries would normally be located, making it difficult to see the ovaries on ultrasound.

4. Prior surgery: Surgery in the pelvic area, such as a hysterectomy, can make it difficult to locate the ovaries during exploratory surgery. This is because the ovaries may have been removed or their location may have been altered by the surgery.

5. Congenital anomalies: In some cases, women may be born with one or both ovaries missing. This is a rare condition called ovarian agenesis. Women with ovarian agenesis will not have ovaries that can be seen on ultrasound or found during exploratory surgery.

6. Ectopic ovaries: Rarely, the ovaries may be located outside of their normal position. This is called ectopic ovaries. Ectopic ovaries can be difficult to find during exploratory surgery, especially if they are located in an unusual location.

7. Ovaries retracted into the abdomen due to adhesions or other surgical changes.