Anti-ovary antibodies (AOAs) are autoantibodies directed against proteins within the ovary. Their presence may suggest that the immune system is recognizing ovarian tissue as a target. Although testing is not part of the standard infertility evaluation and the assays have not yet been standardized, ovarian autoimmunity is increasingly recognized as a potential contributor in a subset of women with reproductive challenges. In Functional Medicine, we view anti-ovary antibodies as one piece of a larger immune assessment, rather than a stand-alone diagnostic test.