written by

Dr. Rebecca Angelica Miscioscia

Fertility Clinic Medical Director


The Ovary: your Sex Hormones and Egg Cells Factory

Understanding what the ovary is, what it does and in what way it contributes to your fertility.

What is the ovary?

The ovaries are part of the female reproductive system and they have a huge role in determining its correct function.

We always refer to them in the plural because the ovaries are 2: the right ovary and the left ovary.

ovaie donna
Both ovaries are located inside the pelvis (lower abdomen), one on each side of your uterus (the organ where pregnancy develops).

The 2 ovaries are small, but very powerful organs and are capable of regulating your menstrual cycle, your fertility, and your general well-being.

Ovary and Hormones

The ovaries produce various hormones, of which the most famous are estrogens and progesterone.

These hormones, also called “female sex hormones” allow the development of the so-called “secondary sexual characters”.
Breast development and the onset of menstruation in puberty.

During your reproductive years they regulate your menstrual cycle, but also have an important influence on your mood and memory, your bones´health and your immune system.

Just like diamonds, the ovary’s worth to women’s health is immense.

ovaie diamanti

Ovary and Fertility

The ovary, however, can also be seen a small “fertility bank”. In fact, your ovaries store your entire egg reserve … from before you were even born!

When you were still in your mom's womb, around the fifth month of pregnancy, your ovaries already possessed the total number of eggs available to you in your life!

At birth, depending on our genetics, our ovaries store about a few million eggs, but already by the onset of puberty this number will have greatly reduced falling to about 400,000.

Every month, your brain sends instructions to your left and right ovary and regulates their hormone production to trigger the start of the menstrual cycle.

At the beginning of each new cycle, the ovaries will “take out” from their “egg bank” a variable number of ovarian follicles (the “houses” of the egg cells).

The selected follicles will then compete with each other, fighting like gladiators in the Colosseum, to make the oocyte they have inside of them grow. 

ovaie follicoli

Only one of the follicles will become the biggest of all and will be chosen by the ovary to produce ovulation, which is nothing more than the rupture of the “dominant follicle” with the release of its oocyte in the abdomen (i.e. inside the belly).

The egg cell released with ovulation will be then taken up from one of the two tubes. Once in the fallopian tube, if sperm meets the oocyte, the egg cell can be fertilized. In the meantime, the follicle that broke during ovulation, is transformed into a small scar on the ovary, known as “corpus luteum”, which disappears with the next cycle.

ovaie corpo luteo

All the other developing “gladiator-follicles” and their egg cells, on the other hand, will die, being lost.

ovaie cellule perse

This is the reason why, as the years go by, women´s fertility potential progressively decreases making it more difficult for us to get pregnant.

Throughout our fertile life, which ranges from menarche (our very first menstruation) to menopause, it is estimated that we will ovulate approximately 400-500 egg cells, equivalent to only 0.05% of all primordial oocytes with which we are born.

Ovaries in Men

The male equivalent of the female ovaries are the testicles. The testes, like the ovaries, produce sexual hormones and gametes (the cells used for reproduction), but in this case both will be of “the male type”.

The most famous male sex hormone is undoubtedly testosterone and the male reproductive cells are the small tadpoles-looking cells known as sperm.

The Gynecologist and the Ovaries

Even if they are located inside the abdomen, the gynecologist can check the health of your ovaries through:

  • the bi-manual gynecological examination (palpation of the abdomen associated with the internal examination)

  • pelvic ultrasound, which can be done trans-abdominally (ie with the ultrasound probe placed on the lower belly) or transvaginally (i.e. with the ultrasound probe inserted into the vagina)

  • other radiological methods, such as magnetic resonance or CT scans, in selected cases

Ovarian Problems

There are many medical conditions that can affect ovarian function causing hormonal issues and a decreased fertility.


Menopause marks the natural end of female fertility.

When it occurs before the age of 40 it is due to a premature exhaustion of the ovarian function defined as POI (Premature Ovarian Insufficiency), POF (Premature Ovarian Failure), or premature menopause.

Once menopause is reached, the only possibility of a pregnancy is through heterologous assisted fertilization (egg donation).

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome, or PCOS, is the most frequent hormonal disorder in women.

It is a syndrome, therefore not a single symptom but a collection of symptoms, which, amongst other things, can make the journey of trying to conceive more difficult.
It does so by causing irregular menstrual cycles, by preventing ovulation and worsening the quality of our beloved egg cells.

Ovarian Cysts

We can also have ovarian cysts!
These can be of many types depending on their origin and their size which can range from a few millimeters to several centimeters.

Most ovarian cysts are caused by the normal functioning of your ovaries and generally disappear with your following menstrual cycle.

In case of endometriosis, this chronic condition can cause the formation of ovarian cysts called endometriomas. The “craziest” ovarian cysts of all are those called “dermoids” inside of which sebum, hair and even teeth can be found.

ovaie denti

Depending on the characteristics and size of each cyst, the gynecologist will tell you if no treatment is required or if a pharmacological or surgical treatment should be carried out.

Ovarian Cancer

The most dreadful ovarian disease is without any doubt cancer.

There are many types of ovarian cancer and unfortunately, to date, there are no screening tests allowing the early diagnosis of these tumors which rank 10th among the most common female cancers.

Most cases of ovarian cancer occur in menopausal women, but familial forms due to inheritable genetic mutations also exist causing the onset of this malignant disease even at a young age.


Our ovaries surely play a great role in our lives, however, our lifestyle also has a huge impact on the natural function of the ovaries.

For example, prolonged periods of stress, intense physical exercise, super restrictive diets, or a combination of the 3 can cause your menstrual period to stop, also preventing you from getting pregnant.

ovaie allenamento
ovaie dieta

This condition is known as “hypothalamic amenorrhea” and it is a protection mechanism through which the body signals the brain to block the menstrual cycle when it feels deprived of the energy and resources to face a pregnancy.

So, as in all things, moderation is key also when performing something universally recognized as “good” such as physical exercise and our diet must always be balanced and full of nutrients.

Precious Ovary

Your ovary is a real nuclear powerhouse of hormones necessary to maintain a state of physical and mental well-being.

It is also your fertility goldmine, guarding your egg cells and promoting ovulation to allow pregnancy.

It can thus be said that the miracle of life starts right here…from the ovary!



The information contained in this website is presented for informational purposes only. In no case can the information presented constitute the formulation of a diagnosis or the prescription of a treatment. All content presented in this website is not intended to, and must not in any way, replace the direct doctor-patient relationship or the medical specialist evaluation. It is recommended to always seek the advice of your doctor and / or specialists regarding any indication reported. In case of any doubts or questions about the use of a drug, you should contact your doctor. Read the Disclaimer »

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Hi, I’m Rebecca, I’m the Medical Director of an LGBTQ+ friendly fertility clinic and in my free time I create simple content to make obstetrics and gynecology no longer a mystery.
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