654 REPRODUCTIVE ORGANS. 



probably for several days and sometimes longer, after which they 

 undergo disintegration. Diihrssen found living spermatozoa in a 

 tube which he removed from a woman whose statement, if true, 

 would show that they had been there for fully a month. 



Ovarian and Abdominal Pregnancy. The portion of the 

 female generative passages in which the spermatozoa and the 

 ovum ordinarily meet is probably the Fallopian tube in the major- 

 ity of instances. It may, however, also be the uterus. 



That the place of meeting may also be the ovary is proved by 

 the occurrence of ovarian pregnancy, which is one form of ectopic 

 gestation. The proportion of ectopic to uterine gestations is vari- 

 ously estimated ;* some writers placing it at 1 in 500, and others at 

 1 in 10,000. Of ectopic pregnancies, Edgar thinks 4.8 per cent, are 

 ovarian. Williams regards only 5 reported cases of primary ova- 

 rian pregnancy as having been conclusively demonstrated, 30 cases 

 as highly probable, and 25 as fairly probable. Four cases are 

 reported by such competent authorities as Leopold, Patenko, and 

 Martin. It may be interesting in this connection to say that in 

 Patenko's case the right ovary, which was about the size of a hen's 

 egg, contained a cyst within which was a yellow body consisting of 

 cylindrical and flat bones, which upon examination were found to 

 be fetal, and not such as are found in dermoid cysts. In the wall 

 around the cyst were found corpora lutea and Graafian follicles, 

 showing that the tissue was true ovarian tissue. Martin reports 2 

 cases which he regards as undoubtedly primary ovarian pregnancies ; 

 1 of these is shown in Fig. 439. He believes that in cases of ova- 

 rian pregnancy the spermatozoon finds its way through the fimbri- 

 ated extremity of the Fallopian tube into one of the small, recently 

 ruptured, cysts so often seen on the surface of the ovary, and there 

 fertilizes the contained ovum. 



As to the occurrence of primary abdominal or peritoneal preg- 

 nancy, there is great difference of opinion. Some writers, while 

 recognizing its possibility, doubt that it has ever actually occurred. 

 When the impregnated ovum is implanted upon the fimbria oVarica 

 the subsequent growth would make it appear to be a peritoneal or 

 abdominal pregnancy. SchlechtendahPs case would, however, 

 appear to have been an instance of primary abdominal pregnancy. 

 In this case a fetus 15 cm. long was found attached to the abdomi- 

 nal wall, near the spleen, of a woman who had died from hemor- 

 rhage. Should this form of pregnancy occur, it would be explained 

 by the meeting of the spermatozoa and the ovum at the time of the 

 escape of the latter from the Graafian follicle, which, instead of 

 entering the Fallopian tube, falls into the peritoneal cavity, where 

 it would subsequently become developed. 



Webster, in his Ectopic Pregnancy, in which he considers the 

 subject most exhaustively, states it as " extremely probable that 



