EP13.03: Association between vascular obstetrical events and bilateral medullary ovarian calcifications: a rare finding

Ovarian calcifications, which manifest as echogenic foci within the ovary on sonography, pose uncertainties regarding their clinical significance, potentially being associated with conditions such as mucinous cystadenoma, dermoid cysts, and ovarian malignancies. We present the case of a 34-year-old woman with a history of idiopathic adrenal insufficiency. Despite being clinically stable under corticotherapy, she sought medical attention for secondary infertility. Her obstetric history revealed six prior miscarriages before 10 weeks and an intrauterine fetal demise at seven months due to severe pre-eclampsia. Notably, she had a normal previous hysterosalpingogram and denied thyroid or prolactin disorders. Assessment of ovarian reserve through antral follicular count showed normal results bilaterally (8 follicles each side). The patient was also previously tested for cardiovascular disease panel which revealed a heterozygocy state for factor V leiden and MTHFR C677T. Vaginal ultrasound revealed a normal uterus but bilateral ovarian medullary calcifications with preserved cortex. Approximately 10 calcifications were observed on the right side and 14 on the left side, characterised by linear shape, 4-5mm in length, and 1mm in width, all displaying a peripheral halo and lacking distal acoustic artifacts. In conclusion, this case presents a unique observation of ovarian calcifications in association with adrenal insufficiency, a connection not previously reported. Further investigation is warranted to elucidate potential shared pathophysiology. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.