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Cited by 149Gynecological conditions and treatmentsReproductive Health and TechnologiesReproductive Health and Contraception

Sperm transport in the human female genital tract and its modulation by oxytocin as assessed by hysterosalpingoscintigraphy, hysterotonography, electrohysterography and Doppler sonography

Wildt, L·1998·Human Reproduction Update
DOI 10.1093/humupd/4.5.655
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Abstract

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.

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Crossref · 10.1093/humupd/4.5.655

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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 [41]

  • 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 [16]

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Authors
Wildt, L.
Affiliations
Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
Corresponding author
Wildt, L
ORCID
Wildt, L
Venue
Human Reproduction Update
Publisher
Oxford University Press (OUP)
Published
1998-09-01
Volume
4
Issue
5
Pages
655-666
ISSN
  • 1355-4786 (ISSN-L)
  • 1460-2369
DOI
10.1093/humupd/4.5.655
OpenAlex
W2136012920
Cited by
149
References
45
Citations by year
2026: 2 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 3 · 2017: 4 · 2016: 8 · 2015: 2 · 2014: 7 · 2013: 8 · 2012: 3
FWCI
2.19
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction Update (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords
female reproductive tract, uterus, oviduct, oxytocin, electrohysterography, Doppler ultrasound, intrauterine pressure, uterine peristalsis, dominant follicle, follicular phase, luteal phase, subfertility, infertility
MeSH terms
Adult, Electrodiagnosis, Fallopian Tubes, Female, Humans, Male, Middle Aged, Oxytocin, Pregnancy, Pressure, Sperm Transport, Spermatozoa, Tomography, Emission-Computed, Uterus, Reproducibility of Results, Gamma Cameras, Ultrasonography, Doppler

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