Histologic features, pathogenesis, and long-term effects of viral oophoritis

Oophoritis, or inflammation of the ovaries, occurs as a result of certain viral infections and may impair ovarian function. Oophoritis has been attributed to cytomegalovirus, mumps virus, Zika virus, hepatitis B virus, and hepatitis C virus due to isolation of these viruses from the ovaries, histologic evidence of ovarian inflammation, and/or signs of ovarian dysfunction in infected people or animal models. These viruses cause inflammation of the ovaries by hematogenous spread, ascending infection of the female reproductive tract, or vascular changes in the ovary, including virus-induced vasculitis. Viral oophoritis has been studied as a potential cause of irregular menstruation, premature menopause, infertility, and ovarian cancer, although evidence of these associations remains limited and inconclusive. Risk factors for developing oophoritis with resultant ovarian dysfunction have additionally been investigated and may include sexual transmission, infection during pregnancy, and peripubertal infection depending on the virus. Despite the potential adverse effects of viral oophoritis, relatively little research has been performed on this condition, perhaps because of its rarity and underdiagnosis. This review summarizes the current literature regarding the most common histologic features of viral oophoritis, its pathogenesis, and its reported or suspected consequences on reproductive function. Furthermore, it highlights gaps in knowledge and areas requiring deeper investigation to inform future research.