Reference values
In the University of Kentucky Ovarian Cancer Screening Program (Pavlik et al., 2000), 58,673 transvaginal ultrasound measurements in 13,963 women aged 25–91 years were analyzed using the prolate ellipsoid formula (L × H × W × 0.523); this calculator uses π/6 ≈ 0.5236.
| <30 years | 6.6 cm³ |
|---|---|
| 30–39 | 6.1 |
| 40–49 | 4.8 |
| 50–59 | 2.6 |
| 60–69 | 2.1 |
| ≥70 | 1.8 |
Mean ovarian volume was 4.9 cm³ in premenopausal women and 2.2 cm³ in postmenopausal women. The authors reported an upper limit of normal of 20 cm³ in premenopausal women and 10 cm³ in postmenopausal women.
Use of exogenous estrogens was associated with smaller ovarian volume in women aged 40–59 years, but not in women 60 or older.
In an earlier ultrasound study of 1,157 ovaries in 725 patients (Cohen et al., Radiology 1990), average ovarian volumes were 9.8 cm³ in menstruating, 5.8 cm³ in postmenopausal, and 3.0 cm³ in premenarchal patients, with no significant difference between right and left ovaries.
Pavlik 2000 reference limits come from women aged 25–91 years; enter age ≥25 and menopausal status to compare.
Polycystic ovarian morphology
The 2023 international evidence-based guideline for polycystic ovary syndrome recommends follicle number per ovary of 20 or more as the threshold for polycystic ovarian morphology in adults. An ovarian volume of 10 mL or more in at least one ovary can be used as the threshold when older technology or image quality does not allow accurate follicle counts.
Not recommended in adolescents (Teede 2023).
Worked example
An ovary measuring 3.0 × 2.0 × 1.5 cm has a volume of 3.0 × 2.0 × 1.5 × π/6 ≈ 4.71 mL.
Frequently asked questions
How is ovarian volume calculated?
Ovarian volume is usually estimated with the ellipsoid formula: length × width × height × 0.5236 (π/6). For example, 3.0 × 2.0 × 1.5 cm gives about 4.71 mL.
What is the upper limit of normal ovarian volume?
In a study of 13,963 women, Pavlik et al. reported an upper limit of normal of 20 cm³ in premenopausal women and 10 cm³ in postmenopausal women.
What ovarian volume is used for polycystic ovarian morphology?
The 2023 international PCOS guideline recommends a follicle number per ovary of 20 or more as the threshold for polycystic ovarian morphology in adults, and an ovarian volume of 10 mL or more in at least one ovary when older technology or image quality does not allow an accurate follicle count.
References
- Pavlik EJ, DePriest PD, Gallion HH, et al. Ovarian volume related to age. Gynecol Oncol. 2000;77(3):410-412. doi:10.1006/gyno.2000.5783. PMID 10831351.
- Cohen HL, Tice HM, Mandel FS. Ovarian volumes measured by US: bigger than we think. Radiology. 1990;177(1):189-192. doi:10.1148/radiology.177.1.2204964. PMID 2204964.
- Teede HJ, Tay CT, Laven J, Dokras A, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2023;38(9):1655-1679. doi:10.1093/humrep/dead156. PMID 37580037. PMC10477934.