{"paper_id":"50037ed0-7009-4a54-a452-73398d5ae049","body_text":"Summary\nRapid as well as sustained sperm transport from the cervical canal to the isthmical part of the fallopian tube is provided by cervico-fundal uterine peristaltic contractions that can be visualized by vaginal sonography. The peristaltic contractions increase in frequency and presumably also in intensity as the proliferative phase progresses. As shown by placement of labeled albumin macrospheres of sperm size at the external cervical os and serial hysterosalpingoscintigraphy (HSSG) sperm reach, following their vaginal deposition, the uterine cavity within minutes. In the early follicular phase a large proportion of the macrospheres remains at the site of application, while a smaller proportion enters the uterine cavity with even a smaller one reaching the isthmical part of the tubes. In the mid-follicular phase of the cycle with increased frequency and intensity of the uterine contractions the proportion of macrospheres entering the uterine cavity as well as the tubes has significantly increased. In the late follicular phase with maximum frequency and intensity of uterine peristalsis the proportion of macrospheres entering the tube increases further at the expense of those at the site of application as well as within the uterine cavity. The transport of the macrospheres into the tube is preferentially directed into the tube ipsilateral to the dominant follicle, which becomes apparent in the mid-follicular phase as soon as a dominant follicle can be identified by ultrasound. Since the macrosphere are inert particles the directed sperm transport into the tube ipsilateral to the dominant follicle is not functionally related to a mechanism such as chemotaxis but is rather provided by uterine contraction of which the direction may be controlled by a specific myometrial architecture in combination with an asymmetric distribution of myometrial oestradiol receptors.\nWomen with infertility and mostly mild endometriosis display on VSUP a uterine hyperperistalsis with nearly double the frequency of contractions during the early and mid- as well as midluteal phase in comparison to the fertile and healthy controls. During midcycle these women display a considerable uterine dysperistalsis in that the normally long and regular cervico-fundal contractions during this phase of the cycle have become more or less undirected and convulsive in character. Hyperperistalsis results in the transport of inert particles from the cervix into the tubes within minutes already during the early follicular phase, and may therefore constitute the mechanical cause for the development of endometriosis in that it transports detached endometrial cells and tissue fragments via the tubes into the peritoneal cavity. Moreover, dysperistalsis may contribute to the infertility in these patients since it results in a break down of sperm transport within the female genital tract.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nAbramovicz JS & Archer DF 1990 Uterine endometrial peristalsis–a transvaginal ultrasound study. Fertility and Sterility 54: 451–454\nAdamson GD & Pasta DJ 1994 Surgical treatment of endometriosis-associated infertility: Meta analysis compared with survival analysis. 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New England Journal of Medicine 333: 1517–1521\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 1997 Springer Science+Business Media New York\nAbout this chapter\nCite this chapter\nKunz, G., Beil, D., Deiniger, Н., Einspanier, A., Mall, G., Leyendecker, G. (1997). The Uterine Peristaltic Pump. In: Ivell, R., Holstein, AF. (eds) The Fate of the Male Germ Cell. Advances in Experimental Medicine and Biology, vol 424. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5913-9_49\nDownload citation\nDOI: https://doi.org/10.1007/978-1-4615-5913-9_49\nPublisher Name: Springer, Boston, MA\nPrint ISBN: 978-1-4613-7711-5\nOnline ISBN: 978-1-4615-5913-9\neBook Packages: Springer Book Archive\nKeywords\nThese keywords were added by machine and not by the authors. 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