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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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“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]
In the citing paper
“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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“CF waves appear to play a role in sperm transport (9, 10).”
BackgroundAltered innervation of the fallopian tube in adenomyosis
Zhang, X., Xu, H., Huang, X., et al. (2014) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443615.2014.948396 · Cited by 5
“…radiological evidence of dyspolar uterotubal contractility in adenomyosis and endometriosis using magnetic resonance studies (Kissler et al. 2006; Kunz et al. 1996), although there are no studies of potential structural abnormalities of the fallopian tube to account for these radiological…”
BackgroundWånggren, K., Wramsby, H., Bremmer, S., Lundberg, S., & Jacobsson, H. (2010) · Gynecologic and Obstetric Investigation · doi:10.1159/000321795 · Cited by 5
A Uterine Motion Classification in MRI Data for Female Infertility
Mori, K., Tokunaga, Y., Sakumoto, T., Nakashima, A., Komesu, I., & Hata, Y. (2018) · Current Medical Imaging Formerly Current Medical Imaging Reviews · doi:10.2174/1573405614666180917123654 · Cited by 5
Cyclic changes in T2* relaxometry of human uterus during the menstrual cycle using BOLD MR imaging
Li, Y., Lai, M., Li, Q. X., et al. (2022) · European Journal of Radiology · doi:10.1016/j.ejrad.2022.110563 · Cited by 5
Meylaerts, L., Wijnen, L., Bazot, M., et al. (2017) · Magnetic Resonance Imaging · doi:10.1016/j.mri.2016.12.026 · Cited by 5
Women with one ovary in assisted reproduction technologies: a review of the literature
Sofía, B., Panagiotis, T., Beniamin, R., et al. (2012) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-012-2477-1 · Cited by 5
Short-duration insemination with frozen semen increases fertility rate in nulliparous dairy goats
Houdeau, É., Furstoss, V., Forgerit, Y., et al. (2008) · animal · doi:10.1017/s1751731108002425 · Cited by 5
Tubal transport of spermatozoa does not appear to be dependent on normal cilia function
Ott, H. W., Schmiedehausen, K., Kat, S., Binder, H., Gall, C., Kuwert, T., Heute, D., Virgolini, I. J., & Wildt, L. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.12.079 · Cited by 5
Self-citationCicinelli, E., Einer‐Jensen, N., Alfonso, R., et al. (2005) · Human Reproduction · doi:10.1093/humrep/dei179 · Cited by 5
“Radiolabelled sperm were found after a few seconds in the ipsilateral tube side (Kunz et al., 1996).”
BackgroundWira, C. R., Fahey, J. V., Schaefer, T. M., Pioli, P. A., Sentman, C. L., & Shen, L. (2008) · Reproductive medicine and assisted reproductive techniques series · doi:10.3109/9780203091500.034 · Cited by 4
An update on pacemaking in the myometrium
Wray, S., & Taggart, M. J. (2024) · The Journal of Physiology · doi:10.1113/jp284753 · Cited by 4
“It is reported as chaotic in terms of orientation and frequency and altered by stages of the menstrual cycle, effects attributable to changes in progesterone and oestrogen signalling in this region (Ijland et al., 1996; Kunz et al., 1996; Little et al., 1995).”
Alberola-Rubio, J., Diaz‐Martinez, A., Mira‐Tomas, J. M., Faubel, P. A., Sanz, S. C., Cortés, G. C., de Arriba-Garcia, M., Aparicio, J. L., & Garcia‐Casado, J. (2025) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2025.03.042 · Cited by 5
“Uterine peristalsis is a physiological phenomenon potentially relevant to human reproduction as it is believed to be partially responsible for actively transporting spermatozoa from the vaginal fornix to the oviduct [1] and providing a suitable environment for implanting the embryo [2 – 4].”
Electrical wave generation and spatial organization in uterine tissue
Means, S., Hussan, J. R., Garrett, A. S., Cheng, L. K., & Clark, A. R. (2025) · Journal of The Royal Society Interface · doi:10.1098/rsif.2024.0638 · Cited by 4
“Aside from menstruation, activity is mostly at relatively shallow depths of uterine muscle tissue (the myometrium; figure 1B) with low frequencies and magnitude so as to not inhibit implantation [3,5,6].”
The effect of GnRH on in vitro bovine myometrial activity
Giammarino, A., Manera, M., Robbe, D., Perugini, M., & Amorena, M. (2008) · Animal Reproduction Science · doi:10.1016/j.anireprosci.2008.05.011 · Cited by 4
Pelvic Imaging in Reproductive Endocrinology
Porter, M. B., & Goldstein, S. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-47912-7.00035-4 · Cited by 4
Sperm Capacitation, the Acrosome Reaction, and Fertilization
Šutovský, P. (2010) · Springer eBooks · doi:10.1007/978-1-4419-1436-1_25 · Cited by 5
Physiology of Sperm Maturation and Fertilization
Cooper, T. G., & Yeung, C. (2001) · Andrology · doi:10.1007/978-3-662-04491-9_4 · Cited by 4
Metadata
- 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 › Reproductive Medicine › 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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