Each ovary is held in place by three main structures: a ligament connecting it to the uterus, a ligament anchoring it to the pelvic wall, and a fold of tissue from the broad ligament that acts as its base of support. Together, these attachments keep the ovaries positioned in the pelvis while still allowing them some freedom to shift and move. The fallopian tubes also sit nearby, though they aren’t directly fused to the ovaries.
The Ovarian Ligament: Connection to the Uterus
A thin, rope-like band called the ovarian ligament runs from each ovary to the uterus. It attaches at the lower end of the ovary and connects to the side of the uterus, just below where the fallopian tube enters. This ligament keeps the ovary tethered relatively close to the uterus, but it doesn’t hold the ovary rigidly in one spot. Its length varies from person to person, and people born with longer-than-average ovarian ligaments have a higher risk of ovarian torsion, a painful condition where the ovary twists on itself.
The Suspensory Ligament: Anchor to the Pelvic Wall
On the opposite side, a structure called the suspensory ligament (also known as the infundibulopelvic ligament) extends from the upper end of the ovary outward to the lateral wall of the pelvis. This thin fold of tissue does more than provide structural support. It serves as the main highway for the ovary’s blood supply. The ovarian artery and vein travel inside this ligament to reach the ovary. Both the right and left ovarian arteries branch directly off the aorta, the body’s largest artery, which gives you a sense of how important blood flow to the ovaries is.
Because the suspensory ligament carries the ovary’s entire blood supply, it becomes a critical structure during any surgery involving the ovaries. If an ovary needs to be removed, this ligament must be carefully clamped and cut while making sure the nearby ureter (the tube draining urine from the kidney) stays safely out of the way.
The Mesovarium: Support From the Broad Ligament
The broad ligament is a wide sheet of tissue that drapes over the uterus, fallopian tubes, and ovaries like a curtain. The portion of the broad ligament that directly attaches to the ovary is called the mesovarium. It connects along the front border of the ovary to the back surface of the broad ligament, and it’s the point where blood vessels, lymphatic vessels, and nerves enter the ovary.
The mesovarium is relatively flexible. Its length gives the ovaries considerable room to shift position, sometimes moving above or settling between loops of intestine. This mobility is normal and explains why the ovaries don’t always sit in the exact same spot on imaging from one visit to the next.
How the Fallopian Tubes Relate to the Ovaries
The fallopian tubes sit very close to the ovaries, but they aren’t physically fused to them. Instead, each fallopian tube ends in a funnel-shaped opening lined with tiny finger-like projections called fimbriae. These fimbriae extend near the surface of the ovary and play an active role during ovulation.
When you’re not ovulating, the fimbriae sit a bit farther from the ovary. When an egg is about to be released, the fimbriae move in closer, extending over the ovary’s surface to catch the egg and sweep it into the fallopian tube. This isn’t a passive process. The fimbriae respond to the hormonal signals of ovulation, essentially reaching out to guide the egg on its path toward the uterus. The fact that there’s a small gap between the ovary and the tube opening is one reason ectopic pregnancies and certain fertility issues can occur.
How Hormones Affect These Attachments
The ligaments holding the ovaries in place aren’t static. Hormonal changes can alter their tension and flexibility. During pregnancy, hormones relax the body’s ligaments throughout the pelvis, making them more pliable. This increased flexibility is one reason ovarian torsion risk rises during pregnancy: softer, stretchier ligaments are more likely to allow the ovary to rotate on its support structures.
As the uterus grows during pregnancy, it can also shift the position of the ovaries by pulling on the ovarian ligament. After menopause, the ovaries shrink significantly, but their ligamentous attachments remain. The overall reduction in hormonal activity means the ligaments tend to become less elastic over time.
Why Ovarian Attachments Matter
Understanding what the ovaries are attached to helps explain several common gynecological issues. Ovarian torsion, for example, is directly related to the length and laxity of these ligaments. Cysts or tumors that enlarge the ovary add weight that can cause the organ to twist on the suspensory ligament and mesovarium, cutting off its blood supply. This is a medical emergency that causes sudden, severe pelvic pain, often with nausea and vomiting.
The attachments also explain why ovarian pain can sometimes feel like it’s radiating in different directions. Because the suspensory ligament connects to the pelvic sidewall and carries nerves alongside blood vessels, pain from an ovarian problem can be felt deep in the pelvis, in the lower back, or even down toward the inner thigh. The ovary’s flexible positioning means that the exact location of pain can vary depending on where the ovary happens to be sitting at the time.