Effect of peritoneal fluid supplemented with exogenous progesterone on sperm motility in vitro

Since progesterone has been claimed to induce acrosomal reactionand hyperactivated motility of human spermatozoa, the presentstudy was undertaken to determine if its presence at concentrationssimilar to those of peri-ovulatory follicular fluid could influencethe effect of peritoneal fluid on spermmotility in vitro. Tothis end, 11 sperm samples were incubated at 37°C with fiveperitoneal fluids with/without exogenous progesterone, and spermmotility was assessed using a computer-assisted analyser attime (t) = 0, 2.5, 5 and 24 h. Overall there was no observableconstant trend for enhancement or inhibition of sperm motility.Progesterone generally induced a negative effect on those spermsamples with high velocities in the native peritoneal fluidsand a positive effect on those sperm samples demonstrating lowmotility in the native peritoneal fluids. The incorporationof progesterone into the incubation medium seemed to resultin a ‘tuning’ of sperm velocity to around 30–50µm/s. However, a given sperm sample reacted differentlywhen incubated with various peritoneal fluids and, reciprocally,different semen samples incubated with the same peritoneal fluidshowed very variable motility patterns. The greater variabilityof the effects exerted by progesterone on sperm motility couldarise from the fact that each sperm sample may contain subpopulationsof gametes with different sensitivity to progesterone.     

The clinical role of interleukin-6 and interleukin-6 soluble receptor in human follicular fluids

In order to investigate the role of interleukin-6 (IL-6) and interleukin-6 soluble receptor (sR) in human ovulation, we evaluated the concentrations in human follicular fluid and analyzed the correlation of IL-6 and IL-6 sR with oocyte maturation. The oocytes were obtained from the follicular fluid of 45 women undergoing in vitro fertilization and embryo transfer. The concentrations of IL-6 and IL-6 sR in follicular fluid were measured by ELISA. In addition, granulosa cells obtained from the follicular fluid were cultured and treated with forskolin and 12-o-tetradecanoylphorbol 13-acetate for 24–48 h. The concentration of IL-6 was significantly higher in the follicular fluid than in the serum (P<0.01). In contrast, the concentration of IL-6 sR was significantly lower in the follicular fluid than in the serum (P<0.001). The concentrations of IL-6 and IL-6 sR were significantly higher in the follicular fluid containing mature oocytes than in fluid containing immature oocytes (P<0.05). The production of IL-6 was markedly increased over the basal level after 24 h of treatment with forskolin(P<0.001) and 48 h of treatment (P<0.01) with cultured granulosa cells. Our data suggest that IL-6 and IL-6 sR may play an important role in follicular growth and development in human preovulatory processes. It is possible that IL-6 in particular may be regulated by cAMP. IL-6 and IL-6 sR might also be valuable biochemical markers in the evaluation of oocyte maturation. Received: 6 July 2002 / Accepted: 18 December 2002 Correspondence to Y. Kawano     

A form of circulating interleukin-6 receptor component soluble gp130 as a potential interleukin-6 inhibitor in inflammatory bowel disease

The presence and the role of soluble gp130, the soluble form of a component of the interleukin (IL)-6 receptor complex, were investigated in inflammatory bowel disease. The serum concentrations of soluble gp130 were increased in ulcerative colitis (active disease, median, 93.5 ng/ml; interquartile range, 26-125 ng/ml; inactive disease, 81 ng/ml, 24.8-137.3 ng/ml) and to a lesser extent in Crohn's disease (active disease, 66 ng/ml, 44.4-87.6 ng/ml; inactive disease, 63 ng/ml, 43.5-82.5 ng/ml) compared to normal controls (43 ng/ml, 27-59 ng/ml). Paired analysis of serum samples showed a decrease of IL-6 and soluble IL-6 receptor concentrations in both diseases and an increase of soluble gp130 concentrations, especially in ulcerative colitis, just after the resolution of disease exacerbation. Size fractionation of the serum revealed that a part of the IL-6 co-eluted with soluble gp130 and soluble IL-6 receptor. The IL-6-induced proliferation of murine B9 hybridoma was enhanced by recombinant soluble IL-6 receptor, whereas the proliferation was inhibited by recombinant soluble gp130. These results indicate that soluble gp130 may function as a natural inhibitor of the IL-6 actions in inflammatory bowel disease.     

High concentration of soluble interleukin-2 receptors in ejaculate with low sperm motility

The various cytokines are involved in infection and immunologicalreactions and thus may be involved in impairment of sperm function.The present study determined the concentrations of interleukin-1,interleukin-6 and soluble interleukin-2 receptors in ejaculatesof normal donors and patients suffering from pure asthenozoospermiaand patients suffering from oligoteratoasthenozoospermia. Ejaculatesof patients attending the fertility clinic in Hadassah MountScopus Hospital, Israel, were evaluated. The patients were dividedinto three groups: (i) controls (n= 20), (ii) pure asthenozoospermia(n= 30), (iii) oligoteratoasthenozoospermia (n= 36). Significantlyhigher concentrations of soluble interleukin-2 receptors werefound in the ejaculates of patients with pure asthenozoospermia2243.1 ± 473.6 µml (mean ± SE) as comparedwith controls 673.5 ± 281.3 µ/ml (P< 0.05) andoligoteratoasthenozoospermic patients 1012.3 ± 206.9µ/ml (P< 0.05). Interleukin-1 and interleukin-6 concentrationswere comparable in all the groups studied. Our results showthat human ejaculates contain interleukin-1, interleukin-6 andsoluble interleukin-2 receptors. High concentrations of solubleinterleukin-2 receptors in the ejaculates of asthenozoospermicpatients may be related to either infectious or immunologicalprocesses     

Endocytosis of interleukin-6—soluble interleukin-6 receptor complex and its intralysosomal degradation

Binding and internalization of interleukin-6—soluble interleukin-6 receptor complex by MDCK and MDCK-gp130 (transfected with gp 130 signal transductor) cells are studied. Binding of labeled complex depends on the concentration of interleukin-6; an effective internalization of the complex is shown. Binding and endocytosis of the complex are demonstrated in human hepatoma cells expressing interleukin-6 receptor and gp 130. These processes depend on the concentration of interleukin-6. The inhibitors of lysosomal functions ammonium chloride, monensin, and leupeptin suppress intralysosomal degradation of the complex, which confirms the important role of intralysosomal cleavage of the complex. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 124, No. 11, pp. 527–529, November, 1997     

Serum soluble interleukin-6 receptor in MRL/lpr mice is elevated with age and mediates the interleukin-6 signal

The characteristics of soluble interleukin-6 receptor (sIL-6R) in murine sera were examined. To investigate a relationship between serum sIL-6R level and autoimmune diseases, quantitative analysis of serum sIL-6R in MRL/lpr mice was performed by an enzyme-linked immunosorbent assay. The serum sIL-6R level in MRL/lpr mice of both sexes was below the detection limit (< 1.0 ng/ml) at 8 weeks of age, but it increased in accordance with age and reached 42 ± 9.3 ng/ml in female and 31 ± 13 ng/ml in male mice at 30 weeks of age. In MRL/+ mice, although an age-associated increase in serum sIL-6R level was observed, it was much less extensive than that in MRL/lpr mice. Elevated serum sIL-6R level at the age of 30 weeks was observed in female and male (NZB × NZW)F1 mice (32 ± 10 ng/ml and 17 ± 5.0 ng/ml, respectively), and male BXSB/Mpj Yaa mice (42 ± 18 ng/ml), suggesting that elevated serum sIL-6R in aged mice is one of the characteristics of autoimmune-prone mice. Quantitative analysis of serum IL-6 in MRL/lpr revealed that the serum sIL-6R level correlated well with the serum IL-6 level. We also showed that sIL-6R in the sera from MRL/lpr mice could mediate the IL-6 functions through the IL-6 signal-transducing receptor component gpl30, suggesting that elevated production of sIL-6R may partly contribute to development of autoimmune disease in MRL/lpr mice.     

Increased levels of interleukin-15 in the peritoneal fluid of women with endometriosis: inverse correlation with stage and depth of invasion

BACKGROUND: Interleukin (IL)-15 is a novel cytokine with immunoregulatory and angiogenic properties. We compared IL-15 levels in the peritoneal fluid (PF) of women with and without endometriosis. METHODS: PF samples were obtained from 55 women with endometriosis (23 with superficial peritoneal implants, 19 with deep endometriotic implants and 13 with ovarian endometriomas). Eighteen women with normal pelvic anatomy undergoing tubal sterilization served as controls. RESULTS: PF IL-15 concentrations were increased in women with endometriosis (2.7 +/- 0.5 pg/ml) versus controls (2.1 +/- 0.3 pg/ml; P < 0.001). However, IL-15 levels were higher in women with superficial peritoneal implants (2.9 +/- 0.5 pg/ml) than women with deep endometriotic implants (2.6 +/- 0.4 pg/ml; P = 0.01) or ovarian endometriomas (2.2 +/- 0.4 pg/ml; P < 0.001). IL-15 was also higher in women with deep implants than in those with endometriomas (P < 0.05). PF IL-15 correlated inversely with both depth of invasion (r = -0.52) and the stage of endometriosis (r = -0.42). PF IL-15 levels demonstrated little variation during the menstrual cycle, and did not discriminate between women with infertility or pelvic pain. CONCLUSION: PF IL-15 levels are increased in women with endometriosis. However, IL-15 levels are inversely correlated with the depth of invasion and disease stage, suggesting a possible role for this cytokine in the early pathogenesis of endometriosis.     

Increased and highly stable levels of functional soluble interleukin-6 receptor in sera of patients with monoclonal gammopathy

Soluble human interleukin-6 receptor (sIL-6R) was measured in the serum of 30 healthy individuals, 32 individuals with monoclonal gammopathy of undetermined significance (MGUS), 20 patients with early multiple myeloma (MM) and 54 patients with overt MM. The serum activity recognized by an immunoradiometric assay was determined to be sIL-6R, because of its binding capacity to IL-6 and its molecular mass of 55 kDa. All sera of healthy individuals contained sIL-6R (mean value: 89 ng/ml, range 17-300 ng/ml). Serum sIL-6R levels were increased by 51% in patients with MGUS (mean value: 135 ng/ml, p<0.005), by 44% in patients with early myeloma (mean value: 128 ng/ml, p<0.001) and by 116 % in patients with overt MM (mean value: 193 ng/ml, p<0.001). In patients with MM, a complete lack of correlation (p>0.7) was found between serum sIL-6R levels and other previously recognized prognostic factors in this disease, particularly serum IL-6 levels and those factors related to tumor cell mass. The independence of serum sIL-6R levels on tumor cell mass was directly demonstrated by studying four patients with MM treated with autologous bone marrow transplantation for periods of between 320 and 760 days. These levels were found to be remarkably stable and constant, independent of whether patients relapsed or achieved complete remission. Finally, physiological concentrations of sIL-6R were found to increase by tenfold the sensitivity of human myeloma cell lines to IL-6. These observations suggest a high control of the sIL-6R level in vivo, and, possibly, an important functional role of this circulating protein in patients with monoclonal gammopathies.     

Ionized calcium in human male and female reproductive fluids: relationships to sperm motility

The levels of ionized calcium in seminal plasma were - 20% ofthe serum levels. In contrast, cervical mucus contained a levelof ionized calcium similar to both serum and follicular fluid.Titration of seminal plasma and serum with increasing concentrationsof calcium chloride indicated a 10-fold higher calcium-bindingcapacity for seminal plasma. In a random group of men undersemen investigation, concentrations of ionized calcium and citratein semen were inversely correlated (r = 0.732; P > 0.001),an observation which was confirmed by studies of split ejaculates.These findings supported the contention that citrate is themajor regulator of the levels of ionized calcium in seminalplasma and primarily responsible for maintaining the calciumgradient between the seminal plasma and cervical mucus. No significantrelationship could be demonstrated between the levels of ionizedcalcium in the ejaculates and any of the motility characteristicsof the spermatozoa in the same sample. Furthermore, the additionof increasing quantities of calcium chloride (0.16-20.00 mM)to washed spermatozoa had no major effects on their progressivemotility. These data suggest that human spermatozoa are effectivein maintaining an appropriate level of internal ionized calcium,necessary for normal motility, despite fluctuations in externalcalcium.     

The remedial effect of soluble interleukin-1 receptor type II on endometriosis in the nude mouse model

Objective

Recent studies have shown that the local expression of soluble interleukin (IL) -1 receptor type II (sIL-1 RII) in endometrial tissue of women with endometriosis is decreased, and the depression of IL-1 RII was more significant in infertile women than that in fertile women with endometriosis. In this research, we investigated the remedial effect of sIL-1-RII administration on endometriosis in the nude mouse model.

Methods

Nineteen nude model mice with endometriosis were randomly divided into three groups: group A was treated by intraperitoneal administration with only sIL-1 RII for two weeks, group B was similarly treated with only IL-1, and group C (control) was administered saline . After 2 weeks, the size of the ectopic endometrial lesions was calculated, and the expression of vascular endothelial growth factor (VEGF) and B-cell lymphoma leukemia-2 (Bcl-2) were detected by immunohistochemistry. The IL-8 and VEGF levels in the peritoneal fluid (PF) and serum were also measured by enzyme-linked immunosorbent assay (ELISA).

Results

The mean size of ectopic endometrial lesion did not differ between the three groups (P > 0.05). Compared with the control, the expression of VEGF and Bcl-2 was significantly lower in group A, and higher in group B. In the three groups, the levels of IL-8 in the PF and serum were highest in group A, and lowest in group B.

Conclusion

sIL-1 RII may suppresse hyperplasia of ectopic endometriosis, perhaps by reducing the expression of certain cytokines, such as VEGF, IL-8, and Bcl-2, which could provide a new clinical strategy for the treatment of endometriosis.     

IL-6 and soluble IL-6 receptors (sIL-6R and sgp130) in human pleural effusions: massive IL-6 production independently of underlying diseases

IL-6, soluble IL-6 receptor (sIL-6R) and soluble gp130 (sgp130) levels were measured in sera and pleural effusions from 42 patients with metastatic carcinoma, non-Hodgkin's lymphoma, tuberculosis, cardiac failure and miscellaneous diseases. Pleural IL-6 levels measured by ELISA were very high in all patient groups (mean 34.8 ± 15.3 ng/ml) without significant difference according to diseases. IL-6 was shown to be biologically active in a proliferative assay. Serum IL-6 levels were low (0.049 ± 0.014 ng/ml) and did not correlate with pleural fluid levels. Pleural IL-6 levels correlated with the number of polymorphonuclear cells in pleural fluid (P< 0.03). Pleural sIL-6R levels (76 ± 8 ng/ml) were always lower than serum levels (196 ± 12 ng/ml; P< 0.0001) but correlated with them (P< 0.01). Pleural sIL-6R and albumin levels correlated (P< 0.01), suggesting a transudation of sIL-6R from the serum. Pleural sgp130 levels (10.9 ± 1.0 ng/ml) were lower than serum levels (24.6 ± 2.8 ng/ml; P< 0.002). After gel filtration of pleural fluid, the bulk of IL-6 (>90%) was recovered in a 15 000–30 000 fraction, corresponding to the expected mol. wt of free IL-6. These results suggest a production and a sequestration of IL-6 in the pleural cavity in all studied conditions.     

The cytokine receptor gp130 and its soluble form are under hormonal control in human endometrium and decidua

The transmembrane protein gp130 plays a central role in cytokine action as a signal transducing receptor subunit common to all interleukin-6 type cytokines. Endometrial tissue obtained from women with a normal menstrual cycle and decidua obtained from women in the first or second trimester of pregnancy were assessed for gp130 by western blotting, immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) analysis. By immunoblotting, two forms of gp130 were detected: one-the soluble form-of approximately 100 kDa and a larger membrane-bound form of approximately 150 kDa. The latter became clearly visible in the mid to late secretory phase and was more pronounced in decidual tissue of second trimester compared to first trimester. Immunohistochemically, gp130 was located in glandular epithelial cells during the mid to late secretory phase, whereas staining in the proliferative phase was rather weak. In first and second trimester decidua, glandular cells were also positively stained. In addition, the invading trophoblast cells were gp130 positive. Soluble gp130 release was measured in the supernatants from primary endometrial and decidual cell cultures by ELISA and reached maximum values in cell cultures without addition of hormones. In cultured endometrial epithelial cells obtained during the proliferative phase of the cycle, the soluble gp130 release increased significantly under combined estradiol/progesterone supplementation which mimics the secretory phase conditions compared to estradiol supplementation alone. In cultured epithelial cells derived from decidual tissue of first trimester of pregnancy, similar effects of hormonal regulation were observed. Our results suggest that the balance between soluble gp130 and its membrane-bound form may play an important role in regulating cytokine action necessary for blastocyst implantation and for further interaction between the decidualized endometrium and the invading trophoblast.     

急性颅脑损伤后脑脊液中IL-6和IL-8的变化及临床意义

目的研究急性颅脑损伤后脑脊液中白细胞介素-6（IL-6）和白细胞介素-8（IL-8）含量的变化规律,探讨其含量变化与损伤程度、预后的关系。方法对54例急性颅脑损伤患者以GCS评分分组,分别检测不同时段脑脊液中IL-6、IL-8的含量。结果急性颅脑损伤后第1天脑脊液中IL-6、IL-8含量显著升高,第3天降至最低（P〈0.01）。轻、中型颅脑损伤组脑脊液中IL-6含量与重型颅脑损伤组相比无显著差异（P〉0.05）;而脑脊液中IL-8含量在两组间有显著性差异（P〈0.01）。脑脊液中IL-6、IL-8含量在存活组和死亡组间有显著性差异（P〈0.01）。结论IL-6、IL-8参与了颅脑损伤的病理生理过程,对指导治疗、判断伤情和预后有重要意义。     

Endeometriosis: The influence of peritoneal fluid from patients with minimal stage or treated endometriosis on sperm motility parameters using computer-assisted semen analysis

The aim of this study was to determine the influence of peritonealfluid from patients with minimal stage or treated endometriosison sperm motility parameters. Peritoneal fluid aspirated atdiagnostic laparoscopy for unexplained infertility from womenduring the luteal phase of the menstrual cycle (days 20–23)was incubated for 5 h with fresh semen samples obtained frommen of recently proven fertility. Spermatozoa were preparedby a swim-up technique from unprocessed semen. Using computer-assistedsemen analysis (Hamilton-Thorn Research, MA, USA), sperm motilityand motion parameters were observed at 0, 120, 180 and 300 min.Compared with spermatozoa incubated in Earle's balanced saltsolution/human serum albumin, the percentage motility, percentageprogressive motility and progressive velocity of spermatozoaincubated in peritoneal fluid from patients without visibleendometriosis were significantly higher (P< 0.05). Maximaleffect was observed at 3 h and maintained until 5 h. We concludethat in an in-vitro study, in contrast to peritoneal fluid frompatients with minimal stage endometriosis, peritoneal fluidfrom patients with unexplained infertility and no visible endometriosiscan improve sperm motility when compared with culture medium.     

CatSper gene expression in postnatal development of mouse testis and in subfertile men with deficient sperm motility

BACKGROUND: The search for Ca2+ channels residing in sperm has led to the recent cloning and characterization of a novel gene, named CatSper, which codes for a unique Ca2+ channel expressed exclusively in the testis. It plays an essential role in sperm motility, penetration into the oocyte, and ultimately in male fertility. In this study, we assessed the temporal profile of CatSper gene expression during mouse testis development and performed a semi-quantitative evaluation of expression levels in a group of subfertile men which lack sperm motility. METHODS: A small piece of testicular tissue obtained by either multi-site testicular biopsy or orchidectomy was used for semi-quantitative RT-PCR of CatSper and beta2-microglobulin (beta2m, as an internal control) genes. RESULTS: Our results reveal that: (i) the expression of mouse CatSper is developmentally regulated with a direct correlation between CatSper expression and mouse sexual maturation. CatSper gene expression is first detected at 3 weeks of age and coincides with the appearance of round spermatids in the developing mouse testis. (ii) There is a significant reduction in the level of CatSper gene expression (up to 3.5-fold difference) among patients which lack sperm motility as compared with patients whose infertility cannot be ascribed to a deficiency in motility (used as a control). CONCLUSIONS: The data obtained in this study support a potential role for CatSper in sperm motility and fertility in mouse and human. CatSper is therefore implicated as a potential target to explore the molecular mechanisms of male infertility.     

Evaluation of soluble IL-6 receptor concentration in serum and epithelial lining fluid from patients with interstitial lung diseases.

We measured soluble IL-6 receptor (sIL-6R) levels in serum and bronchoalveolar lavage fluids (BALF) from patients with interstitial pneumonia of unknown etiology (IP) (n = 17), sarcoidosis (n = 8) and normal control subjects (n = 10), to investigate its role in pulmonary diseases. Soluble IL-6R was determined by an ELISA. The volume of epithelial lining fluid (ELF) in BALF was estimated using an urea method. We found that levels of sIL-6R in serum, BALF, and ELF from patients with IP or sarcoidosis were significantly higher than those from normal subjects. Furthermore, levels of sIL-6R in BALF or ELF were significantly correlated with those of albumin, indicating that sIL-6R, together with albumin, may enter ELF as a result of the increased permeability caused by pulmonary inflammation. Thus most of the sIL-6R in ELF would be from serum, and relatively small amounts of it might be produced locally. However, sIL-6R levels in ELF, but neither serum nor BALF, were significantly correlated with levels of C-reactive protein in patients with IP. These results suggest that both systemic and local production of sIL-6R are increased, and raised sIL-6R is involved in the modulation of systemic and local inflammatory responses in patients with IP and sarcoidosis.     

Sperm motility and kinetics of dynein ATPase in astheno- and normozoospermic samples after stimulation with adenosine and its analogues

We tested the effects of adenosine and 2-deoxyadenosine on theactivation of human spermatozoa. In the asthenozoospermic groupof patients adenosine produces an increase in sperm motilityfrom 33.3 ± 2.1% to 42.1 ± 3.4%, progressive motilityfrom 22.5 ± 1.3% to 28.6 ± 1.7% and forward progressionrating from 2.1 ± 0.2% to 2.8 ± 0.1%. 2-Deoxyadenosinestimulated asthenozoospermic samples to a greater degree thanadenosine. Sperm motility rose to 48.9 ± 3.4%, progressivemotility to 32.1± 3.4% and forward progression ratingto 3.0 ± 0.1% following stimulation with 2-deoxy-adenosine.The kinetic parameters and basic characteristics of dynein ATPasewere determined. The maximum activity of dynein ATPase, V_max,was significantly different (P < 0.001) for asthenozoospermicand normozoospermic samples: 6.46 ± 2.1 nmol P_i/mg/minand 16.99 ± 3.7 nmol P_i/mg/min respectively. However,the enzyme affinity for ATP was not different. Stimulation ofasthenozoospermic samples with adenosine and 2-deoxyadenosinecaused an increase of V_max (70–90% and 90–110% respectively)and no significant change in K_M was observed. In order to blockthe nucleoside transporter and to eliminate the action of adenosineinside the cell, dipyridamole was used but the effects of adenosinewere not neutralized. 5’-(N-ethylcarboxy-amido)-adenosineshowed effects similar to those of adenosine, even when appliedin 1µM concentration. These results indicate that adenosineand its analogues stimulate sperm motility and activity of dyneinATPase, most probably via A₂ receptors.     

The effect of interleukin-6 and soluble interleukin-6 receptor protein on the bone resorptive activity of human osteoclasts generated in vitro

The role of interleukin-6 (IL-6) in the regulation of bone resorption is and has not been studied using human tissue in vitro. This study exploits a recently described in vitro model, whereby osteoclasts, defined as cells that resorb bone, can be generated from human bone marrow, and investigated the effect of IL-6 and its soluble receptor on bone resorption, in the presence of 1,25-dihydroxyvitamin D₃[1,25(OH)₂ vitamin D₃]. Human bone marrow was cultured to form a confluent stroma, sedimented onto devitalized bone slices, and recharged with non-adherent bone marrow cells. 1,25(OH)₂ vitamin D₃ increased bone resorption, whereas IL-6 failed to induce a similar stimulatory effect. Both IL-6 at 100 ng/ml and soluble IL-6 receptor protein in the absence of exogenous IL-6 inhibited the stimulatory effect of 1,25(OH)₂ vitamin D₃. Bone resorption was never observed when non-adherent haemopoietic cells were cultured in the absence of stroma but in the presence of IL-6, which indicates that IL-6 cannot replace the stromal factor(s) required for the formation of cells capable of resorbing bone. These results suggest that IL-6 at high concentrations is not a critical cytokine in stimulating osteoclastic bone resorption.     

Uterine hyperperistalsis and dysperistalsis as dysfunctions of the mechanism of rapid sperm transport in patients with endometriosis and infertility

Women suffering from infertility in association with mostlymild endometriosis were subjected to vaginal sonography of uterineperistalsis during the menstrual period, the early, mid- andlate follicular phases, and the mid-luteal phase of the menstrualcycle. The data obtained were compared with those of healthycontrols. Women with endometriosis displayed a marked uterinehyperperistalsis that differed significantly from the peristalsisof the controls during the early and mid-follicular and mid-lutealphases. During the late follicular phase of the cycle, uterineperistalsis in women with endometriosis became dysperistaltic,arrhythmic and convulsive in character, while in controls peristalsiscontinued to show long and regular cervico-fundal contractions.Hysterosalpingoscintigraphy during the early, mid- and latefollicular phases revealed that hyperperistalsis in the earlyand mid-follicular phases of patients with endometriosis resultedin a dramatic increase in the transport of inert particles fromthe vaginal depot, through the uterus into the tubes and alsointo the peritoneal cavity. During the late follicular phaseof the cycle, the dysperistalsis observed in women with endometriosisresulted in a dramatic reduction of uterine transport capacityin comparison with the healthy controls. We consider uterinehyperperistalsis to be the mechanical cause of endometriosisrather than retrograde menstruation. Dysperistalsis in the latefollicular phase of patients with endometriosis may compromiserapid sperm transport Uterine hyperperistalsis and dysperistalsisare considered to be responsible for both reduced fertilityand the development of endometriosis.