ENDOSCOPIC VISUALIZATION OF THE PROCESS OF FIMBRIAL OVUM RETRIEVAL INTHE HUMAN

The process of ovum retrieval by the fimbriae in the human still remai ns elusive. Animal studies have suggested that ova can be 'sucked' int o the oviduct by negative pressure caused by muscular contractions of the tube, while laparoscopic observations in women have indicated a cl ose relationship between fimbriae and the ovulating ovary. Here, a cas e is described in which the process of ovum retrieval was observed dir ectly using a new endoscopic technique, called transvaginal hydrolapar oscopy, The access is through the posterior fornix of the vagina and s aline is used for distension. The tube-ovarian structures during the p rocess of ovum retrieval were visualized under fluid. The fimbriae on the ovulatory side appeared congested and tumescent and showed pulsati le movements synchronous with the heartbeat. The cumulus mass was adhe rent to the fimbriae and released from the site of rupture by the swee ping movements of the fimbriae until it disappeared between the rigid fimbrial folds. To the best of our knowledge this is the first direct observation of the process of ovum retrieval in the human. Vascular co ngestion causing erection and pulsatile movements of the fimbriae play a role in the retrieval of the ovum, The retrieval process from the s ite of rupture is slow and transport is achieved by ciliary activity o nly. The fimbrial changes are apparently controlled by the ovulatory o vary.