Gonadal Arteries (Testicular, Ovarian)

The gonadal arteries are paired branches of the abdominal aorta that supply the gonads — the testes in males and the ovaries in females. They arise below the level of the renal arteries and descend into the pelvis or inguinal region depending on the sex. Despite the difference in target organs, both arteries share the same embryological origin and structural pathway during development.

Structure

Each gonadal artery arises independently from the anterolateral aspect of the abdominal aorta, typically at the level of the L2 vertebra, slightly inferior to the renal arteries. From there, their courses diverge depending on whether the individual is male or female:

Both arteries are long and slender due to the embryological descent of the gonads from the posterior abdominal wall.

Location

The gonadal arteries are located in the retroperitoneal space and have sex-specific courses:

• In males: The testicular artery travels within the spermatic cord and reaches the testis via the inguinal canal.
• In females: The ovarian artery enters the suspensory ligament of the ovary and anastomoses with the uterine artery near the uterine tube.

Along their course, the gonadal arteries pass anterior to the psoas major muscle and ureter, which is clinically significant during pelvic or retroperitoneal surgery.

Function

The gonadal arteries provide the primary arterial blood supply to the gonads:

• Testicular artery: Supplies the testis and epididymis; supports spermatogenesis and hormone production.
• Ovarian artery: Supplies the ovary and part of the uterine tube; crucial for ovarian follicle nourishment and corpus luteum maintenance.
• Anastomoses: The ovarian artery anastomoses with the uterine artery; the testicular artery may anastomose with the cremasteric artery and artery to the ductus deferens.

Clinical Significance

The gonadal arteries are relevant in multiple clinical and surgical contexts:

• Varicocele: Dysfunction of venous drainage in the pampiniform plexus can affect testicular artery flow and temperature regulation, impairing fertility.
• Testicular torsion: A surgical emergency in which the arterial blood supply from the testicular artery is compromised due to twisting of the spermatic cord.
• Pelvic surgeries: The ovarian artery is at risk during oophorectomy, hysterectomy, and pelvic lymphadenectomy. Knowledge of its course prevents hemorrhage.
• Gonadal artery aneurysms: Rare but possible, more often seen in the ovarian artery during pregnancy; may present with abdominal or pelvic pain.
• Endovascular procedures: In embolization for certain tumors or varicocele, gonadal arteries may be selectively targeted.

The gonadal arteries, though slender and often overlooked, play a vital role in reproductive function. Their long descent, intimate associations with other retroperitoneal structures, and vulnerability during surgical interventions make them important vessels in both anatomy and clinical medicine.