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 mostly mild endom etriosis were subjected to vaginal sonography of uterine peristalsis d uring the menstrual period, the early, mid- and late follicular phases , and the mid-luteal phase of the menstrual cycle, The data obtained w ere compared with those of healthy controls, Women with endometriosis displayed a marked uterine hyperperistalsis that differed significantl y from the peristalsis of the controls during the early and mid-follic ular and mid-luteal phases, During the late follicular phase of the cy cle, uterine peristalsis in women nifh endometriosis became dysperista ltic, arrhythmic and convulsive in character, while in controls perist alsis continued to show long and regular cervico-fundal contractions, Hysterosalpingoscintigraphy during the early, mid- and late follicular phases revealed that hyperperistalsis in the early and mid-follicular phases of patients with endometriosis resulted in a dramatic increase in the transport of inert particles from the vaginal depot, through t he uterus into the tubes and also into the peritoneal cavity, During t he late follicular phase of the cycle, the dysperistalsis observed in women with endometriosis resulted in a dramatic reduction of uterine t ransport capacity in comparison with the healthy controls. We consider uterine hyperperistalsis to be the mechanical cause of endometriosis rather than retrograde menstruation, Dysperistalsis in the late follic ular phase of patients with endometriosis may compromise rapid sperm t ransport, Uterine hyperperistalsis and dysperistalsis are considered t o be responsible for both reduced fertility and the development of end ometriosis.