Document Detail


Sperm transport in the human female genital tract and its modulation by oxytocin as assessed by hysterosalpingoscintigraphy, hysterotonography, electrohysterography and Doppler sonography.
MedLine Citation:
PMID:  10027619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The transport function of the uterus and oviducts and its modulation by oxytocin has been examined using hysterosalpingoscintigraphy, recording of intrauterine pressure, electrohysterography and Doppler sonography of the Fallopian tubes. After application to the posterior vaginal fornix, a rapid (within minutes) uptake of the labelled particles into the uterus was observed during the follicular and during the luteal phase of the cycle in all patients. Transport into the oviducts, however, could only be demonstrated during the follicular phase. Transport was directed predominantly into the tube ipsilateral to the ovary bearing the dominant follicle; the contralateral oviduct appeared to be functionally closed. The proportion of patients exhibiting ipsilateral transport did increase concomitant with the increase of the diameter of the dominant follicle. That ipsilateral transport has biological significance is suggested by the observation that the pregnancy rate following spontaneous intercourse or insemination was significantly higher in those women in whom ipsilateral transport could be demonstrated than in those who failed to exhibit lateralization. Oxytocin administration was followed by a dramatic increase in the amount of material transported to the ipsilateral tube, as demonstrated by radionuclide imaging and by Doppler sonography following instillation of ultrasound contrast medium. Continuous recording of intrauterine pressure before and after oxytocin administration did show an increase in basal tonus and amplitude of contractions and a reversal of the pressure gradient from a fundo-cervical to a cervico-fundal direction. These actions of oxytocin were accompanied by an increase in amplitude of potentials recorded by electrohysterography. These data support the view that uterus and Fallopian tubes represent a functional unit that is acting as a peristaltic pump and that the increasing activity of this pump during the follicular phase of the menstrual cycle is reflected by an increased transport into the oviduct ipsilateral to the ovary bearing the dominant follicle. In addition, they strongly suggest a critical role of oxytocin in this process. Failure of this mechanism appears to be a cause of subfertility or infertility, as indicated by the low pregnancy rate following intrauterine insemination or normal intercourse in the presence of patent Fallopian tubes. It may be regarded as a new nosological entity for which we propose the term tubal transport disorder (TTD). Since pregnancy rate of such patients is normal when treated with in-vitro fertilization (IVF), hysterosalpingoscintigraphy seems to be useful for the choice of treatment modalities in patients with patent Fallopian tubes suffering from infertility.
Authors:
L Wildt; S Kissler; P Licht; W Becker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Human reproduction update     Volume:  4     ISSN:  1355-4786     ISO Abbreviation:  Hum. Reprod. Update     Publication Date:    1998 Sep-Oct
Date Detail:
Created Date:  1999-04-16     Completed Date:  1999-04-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9507614     Medline TA:  Hum Reprod Update     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  655-66     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Erlangen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Electrodiagnosis
Fallopian Tubes / drug effects,  physiology*,  radionuclide imaging,  ultrasonography
Female
Gamma Cameras
Humans
Male
Middle Aged
Oxytocin / pharmacology*
Pregnancy
Pressure
Reproducibility of Results
Sperm Transport / drug effects,  physiology*
Spermatozoa / drug effects,  physiology*
Tomography, Emission-Computed
Ultrasonography, Doppler
Uterus / drug effects,  physiology*,  radionuclide imaging,  ultrasonography
Chemical
Reg. No./Substance:
50-56-6/Oxytocin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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