Fimbrio-Ovarian Relationship in Unexplained Infertility

A Review: Biomechanical Aspects of the Fallopian Tube Relevant to its Function in Fertility

The fallopian tube (FT) plays a crucial role in the reproductive process by providing an ideal biomechanical and biochemical environment for fertilization and early embryo development. Despite its importance, the biomechanical functions of the FT that originate from its morphological aspects, and ultrastructural aspects, as well as the mechanical properties of FT, have not been studied nor used sufficiently, which limits the understanding of fertilization, mechanotrasduction, and mechanobiology during embryo development, as well as the replication of the FT in laboratory settings for infertility treatments. This paper reviews and revives valuable information on human FT reported in medical literature in the past five decades relevant to the biomechanical aspects of FT. In this review, we summarized the current state of knowledge concerning the morphological, ultrastructural aspects, and mechanical properties of the human FT. We also investigate the potential arising from a thorough consideration of the biomechanical functions and exploring often neglected mechanical aspects. Our investigation encompasses both macroscopic measurements (such as length, diameter, and thickness) and microscopic measurements (including the height of epithelial cells, the percentage of ciliated cells, cilia structure, and ciliary beat frequency). Our primary focus has been on healthy women of reproductive age. We have examined various measurement techniques, encompassing conventional metrology, 2D histological data as well as new spatial measurement techniques such as micro-CT.

Radiographic morphology of fallopian tubes in women of child-bearing potential: a descriptive study

AIM

The aim of this study was to determine the radiographic morphological characteristics of fallopian tubes in women of child-bearing age.

MATERIAL AND METHODS

From 2007 to 2008 we retrospectively collected records from women aged 19-45 years undergoing fertility evaluation who had normal salpingograms. Women were excluded if they had abnormal imaging on salpingogram, ultrasound, or hysteroscopy, and if they had any history of pelvic disease or pathology, were febrile, or were taking oral contraceptives at the time of the salpingogram.

RESULTS

We analyzed the salpingograms from 100 women. The interstitial portion of the tube is funnel-shaped. The mean diameter of the proximal tubal opening was 1.07 ± 0.43 mm. The mean length of the interstitial portion was 5.27 ± 4.28 mm, and the mean internal diameters of the middle and distal segments of the interstitial portion were 0.50 ± 0.22 mm and 0.32 ± 0.12 mm, respectively. The narrowest part of the fallopian tube was the distal segment of the interstitial portion, which is significantly different from the internal diameter of the isthmus (0.46 ± 0.28 mm) (P < 0.01).

CONCLUSIONS

This study provides detailed data of the normal fallopian tube that may be of value in the development of new contraceptive agents, as well as infertility treatments.

Endometrial scratching to improve pregnancy rate in couples with unexplained subfertility: a randomized controlled trial

AIM

The aim of this study was to examine the effect of endometrial scratching in women with unexplained infertility.

MATERIAL AND METHODS

A randomized controlled trial was conducted in Mansoura University Teaching Hospital and a private practice setting. A total of 105 couples with unexplained infertility were randomly allocated into two groups: group A comprised 54 women who underwent endometrial scratching in the luteal phase of a spontaneous menstrual cycle; and group B included 51 women who underwent a placebo procedure. The main outcome measured was cumulative clinical pregnancy rate after 6 months and miscarriage rate.

RESULTS

Clinical pregnancy rate was significantly higher in the women experiencing endometrial biopsy than in the control group (25.9% and 9.8%, respectively, P = 0.04). There was no significant difference in miscarriage rate between pregnant women in the endometrial injury group and pregnant women in the control group (12.5% and 16.5%, respectively, P = 0.79).

CONCLUSIONS

Endometrial scratching may improve clinical pregnancy rates in couples with unexplained infertility. Adequately powered studies are mandated to confirm or refute the findings.