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Tubal transport of gametes and embryos: a review of physiology and pathophysiology

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Abstract

With the advent of assisted reproductive technology in the past three decades, the clinical importance of fallopian tubes has been relatively overlooked. However, successful spontaneous conception requires normal function of the tube to provide not only a conduit for the gametes to convene and embryo to reach the uterine cavity, but also a physiologically optimized environment for fertilization and early embryonic development. In this review, after a brief description of normal human tubal anatomy and histology, we will discuss tubal transport and its principal effectors, including ciliary motion, muscular contractility and tubal fluid. Furthermore, we will discuss the ciliary ultrastructure and regulation of ciliary beat frequency by ovarian steroids, follicular fluid, angiotensin system, autonomic nervous system and other factors such as adrenomedullin and prostaglandins. In the last section, we describe the adverse impact of various pathological conditions, such as endometriosis, infection and smoking on tubal function and ciliary motility.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9032, USA

    Mohammad Ezzati & Bruce R. Carr

  2. Center for Reproductive Medicine, St. Bartholomew’s Hospital, London, UK

    Ovrang Djahanbakhch

  3. Department of Obstetrics, Gynecology and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, TX, USA

    Sara Arian

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  1. Mohammad Ezzati
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  2. Ovrang Djahanbakhch
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  3. Sara Arian
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  4. Bruce R. Carr
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Correspondence to Mohammad Ezzati.

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Capsule Tubal transport of gametes and embryo requires coordinated actions of ciliary movement, tubal peristalsis and tubal fluid. Ciliary movement is controlled by many different signals and can be adversely affected by a variety of conditions such as endometriosis, infection and smoking.

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Ezzati, M., Djahanbakhch, O., Arian, S. et al. Tubal transport of gametes and embryos: a review of physiology and pathophysiology. J Assist Reprod Genet 31, 1337–1347 (2014). https://doi.org/10.1007/s10815-014-0309-x

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  • DOI: https://doi.org/10.1007/s10815-014-0309-x

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