The dynamics of rapid sperm transport through the female genital tract, evidence from vaginal sonography of uterine peristalsis and hysterosalpingoscintigraphy
Abstract
Vaginal ultrasonography of uterine peristalsis during the follicular phase of the menstrual cycle demonstrates an increasing frequency and intensity of subendometrial and myometrial peristaltic waves as the follicular phase progresses. During this time the numbers of contraction waves with a fundo-cervical direction decrease considerably in favour of waves of contraction with a cervico-fundal direction. There is evidence that rapid sperm transport through the female genital tract is passive and is provided by these uterine contractions. Using hysterosalpingoscintigraphy, rapid sperm transport was studied by placing technetium-labelled albumin macrospheres of sperm size at the external os of the uterine cervix and following their path through the female genital tract. Ascension of the macrospheres occurred immediately following deposition at the external os of the cervix. As early as 1 min thereafter, the macrospheres had reached the intramural and isthmical part of the tube. Quantitatively, the extent of ascension increased with progression of the follicular phase. While only a few macrospheres entered the uterine cavity and even fewer the tubes during the early follicular phase, the proportion of macrospheres that entered the uterine cavity increased dramatically during the mid-follicular phase despite continuing limited entry into the tube. During the late follicular phase there was considerable ascension of the macrospheres which was directed preferentially into the tube ipsilateral to the dominant follicle. These data indicate that rapid transport of the spermatozoa through the female genital tract is under the endocrine control of the dominant follicle, ensuring the preferential accumulation of spermatozoa at the site of fertilization.
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Uterine peristalsis is critical for sperm transport, and women with endometriosis exhibit hyperperistalsis and dysperistalsis.
“In a nutshell, they showed that uterine peristalsis is critical for sperm transport, and women with endometriosis exhibit hyperperistalsis and dysperistalsis [38,39,40,41].”
From The Pathogenesis of Adenomyosis vis-à-vis Endometriosis (2020) · cites this paper as [39]
The non-pregnant uterus is constantly active throughout the reproductive period of life and is subjected to mechanical strain.
“It became evident that the non-pregnant uterus is constantly active throughout the reproductive period of life and thereby, like other mechanically active organs of the body such as the skeletal and the cardiovascular systems, respectively, rather inevitably subjected to mechanical strain.”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [15]
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KISSLER, S., ZANGOS, S., WIEGRATZ, I., KOHL, J., RODY, A., GAETJE, R., DOEBERT, N., WILDT, L., KUNZ, G., LEYENDECKER, G., et al. (2007) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1389.036 · Cited by 89 · see citing works
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“Apart from direct diffusion, an active mechanism may be involved in progesterone transport, as demonstrated by means of hysterosalpingography of the uterus and uterine tubes (50).”
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“Myometrial contractions have the ability to transport and preferentially direct microspheres placed in the vagina to mimic spermatozoa, towards the peritoneal opening of the tubes on the side of the dominant follicle [25].”
BackgroundYeung, C. (2001) · Molecular Human Reproduction · doi:10.1093/molehr/7.9.819 · Cited by 86 · see citing works
“Effects of the ion-channel blocker quinine on human sperm volume, kinematics and mucus penetration, and the involvement of potassium channels”
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“They were transported from the uterus to the oviduct more rapidly in the late follicular phase (Kunz et al., 1996) which, along with other experiments, indicates that uterine contractions that transport sperm are under endocrine control.”
Mechanism of action of emergency contraception
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BackgroundThe Patterns of Uterine Contractility in Normal Menstruating Women: From Physiology to Pathology
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“There is experimental evidence that rapid and sustained sperm transport through the female genital tract into the tubes is provided by uterine peristaltic contractions (Lyons et al., 1991; Kunz et al., 1996).”
BackgroundInfluentialSelf-citationOptimizing natural fertility: a committee opinion
Penzias, A., Azziz, R., Bendikson, K. A., Falcone, T., Hansen, K., Hill, M., Jindal, S., Kalra, S., Mersereau, J., Reindollar, R., et al. (2021) · Fertility and Sterility · doi:10.1016/j.fertnstert.2021.10.007 · Cited by 69 · see citing works
- Authors
- Kunz, G., Beil, D., Deininger, H., Wildt, L., & Leyendecker, G.
- Affiliations
- Goethe University Frankfurt (DE)
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Corresponding author
- Leyendecker, G.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 1996-03-01
- Volume
- 11
- Issue
- 3
- Pages
- 627-632
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2171953969
- Cited by
- 408
- References
- 0
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 12 · 2023: 13 · 2022: 15 · 2021: 16 · 2020: 15 · 2019: 14 · 2018: 14 · 2017: 15 · 2016: 13 · 2015: 25 · 2014: 17 · 2013: 11 · 2012: 11
- FWCI
- 11.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- sperm transport, female reproductive tract, uterine peristalsis, follicular phase, follicle-stimulating hormone, dominant follicle, spermatozoa, vaginal ultrasonography
- MeSH terms
- Adult, Fallopian Tubes, Female, Follicular Phase, Humans, Male, Microspheres, Middle Aged, Radionuclide Imaging, Sperm Transport, Ultrasonography, Uterine Contraction, Uterus, Vagina
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