The Uterine Peristaltic Pump
Uterine peristalsis, visualized by sonography, drives sperm transport to the fallopian tubes, with transport efficiency increasing with menstrual cycle progression and directed towards the dominant follicle.
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This paper studied uterine cervico-fundal peristaltic contractions and their role in rapid sperm transport across the female genital tract, using vaginal sonography and serial hysterosalpingoscintigraphy with labeled albumin macrospheres placed at the external cervical os across the follicular cycle. The authors found that contraction frequency (and presumably intensity) increases through the proliferative phase, with a greater proportion of inert macrospheres entering the uterine cavity and fallopian tubes at mid- and late follicular stages, and preferential transport into the tube ipsilateral to the dominant follicle without chemotaxis. They additionally reported that women with infertility and mostly mild endometriosis show uterine hyperperistalsis and midcycle dysperistalsis, which correlated with inert particle transport into tubes early in the follicular phase, and they explicitly propose a mechanical pathway for endometriosis development and possible sperm-transport disruption as a limitation of directed transport mechanisms. This paper is centrally about endometriosis — it directly examines uterine hyperperistalsis/dysperistalsis in women with mostly mild endometriosis and links these dysmotility patterns to potential retrograde transport of endometrial fragments.
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References (37)
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Cited by (13)
- Endometrial Microbiome and Women’s Reproductive Health – Review of the Problem Endometrial Microbiome and Reproductive Health 2021
- The study of endometriosis and adenomyosis related microbiota in female lower genital tract in Northern Chinese population 2021
- The role of gut and genital microbiota and the estrobolome in endometriosis, infertility and chronic pelvic pain 2021
- New Opportunities for Endometrial Health by Modifying Uterine Microbial Composition: Present or Future? 2020
- Assessing Peristalsis at the Endometrial–Myometrial Junctional Zone: A Reproducible Ultrasound Technique? 2020
- Molecular detection of microbial colonization in cervical mucus of women with and without endometriosis 2019
- Uterine peristalsis and fertility: current knowledge and future perspectives: a review and meta-analysis 2017
- Potential Etiologies of Unexplained Infertility in Females 2015
- Seminal Plasma Promotes Lesion Development in a Xenograft Model of Endometriosis 2015
- Adenomyosis and ‘endometrial– subendometrial myometrium unit disruption disease’ are two different entities 2008
- Oxytocin – a stimulator of directed sperm transport in humans 2007
- Control and function of uterine peristalsis during the human luteal phase 2006
- Anatomy and physiology of the female pelvis: MR imaging revisited 2001
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