Ciliary ovum transport through the oviductal ampulla was investigated, in vivo, by blocking smooth muscle activity. Isoproterenol eliminated rapid muscle-induced egg movements, yet the egg and its surrounding cells reached the site of fertilization within normal time limits. The role of cilia in ovum transport thus seems more important than that of the smooth muscle.

Ovum transport in mammalian oviducts involves two main effectors: ciliary motility and muscle contractility. To study the relative contribution of cilia to ovum transport in the rat, we blocked smooth muscle activity with isoproterenol, a beta-adrenergic agonist, and measured transport rates of surrogate ova in situ. Transport rates before isoproterenol administration were 0.04 mm/s in the cephalic ampulla and 0.03 mm/s in the caudal ampulla; rates were unchanged after administration of isoproterenol. To determine if isoproterenol affected ciliary activity, we measured ciliary beat frequency with laser-scattering spectroscopy over the effective isoproterenol dosage. Isoproterenol did not cause a significant change in ciliary beat frequency. Our results show that in the rat oviductal ampulla, ciliary motion is capable of transporting ova in the absence of muscle contractility.

In Kartagener's syndrome (KS), primary defects of the ciliary axoneme cause dyskinetic ciliary motion. Because ciliary motion is an important factor in normal ovum transport, ciliary dyskinesia may cause infertility. On the other hand, the existence of some ciliary activity, albeit abnormal, may account for fertility in some women with KS. In this case study, an infertile woman diagnosed with KS had normal results in all usual infertility tests. Biopsies of tubal mucosa were obtained at laparoscopy for ovum recovery during an in-vitro fertilization cycle. Ciliary activity, measured by laser light-scattering spectroscopy, was detected in all tubal specimens; however the majority of regions sampled showed no activity. In active regions, beat frequency ranged from 5 to 10 Hz, approximately 30% of normal. Electron microscopy showed similar morphological defects in both tubal and nasal mucosa. The number of cilia per cell was approximately 20% of normal. The major ultrastructural abnormality of cilia was an absence of the central microtubules. The only demonstrable explanation for this patient's infertility was primary ciliary dyskinesia associated with KS.

The effects of repeated infections with Chlamydia trachomatis, serovars F, D, and J, were examined in pig-tailed macaques. The fallopian tubes of three experimental monkeys were inoculated at the middle of the menstrual cycle on three consecutive months. Monkey 1 received homologous F; monkey 2 received heterologous F, D, and J; and monkey 3 received homologous inoculations in the right and heterologous inoculations in the left fallopian tubes. One control monkey (4) received repeated inoculations of HeLa cell materials only and remained normal throughout the experiment. Infection was confirmed by isolating the microorganism from both the endosalpinx and endocervix. Antibody to the infecting strains was demonstrated in sera, tears, and cervical secretions by using microimmunofluorescence. Mild chronic salpingitis developed in monkeys 1 and 3, and chronic follicular salpingitis developed in monkey 2. Peritubal and periadnexal scarring and endosalpingeal adhesion formation were produced after reinfection. The right fallopian tube of monkey 3 was distally obstructed (confirmed by hysterosalpingography). Systemic complications, including perihepatitis and conjunctivitis, were also documented in these monkeys. We conclude that repeated infections produced extensive tubal scarring, chronic salpingitis, and distal tubal obstruction, findings not apparent in primary infection.

In both in vitro and in vivo experiments, polycationic macromolecules, such as poly(L-lysine), inhibited the transport of either surrogate or freshly ovulated cumulus masses across the oviduct epithelial surface without affecting the ciliary beat. Whereas transport across the fimbria in vivo was completely inhibited, transport down the ampulla was 3 to 7 times slower than normal. The effects of these polycations suggest that cilia-mediated ovum transport may involve the formation of transient adhesive bonds between the tip of the cilium and elements of the cumulus mass during each beat cycle of the cilium.Numerous studies have shown that once the ovum with its surrounding cumulus mass is discharged from the ovary, it is rapidly transported over the fimbrial surface of the oviduct and down the ampulla to the ampullar-isthmic junction (1). The ovum remains at the junction for several hours where the cumulus mass is removed; eventually, the denuded ovum travels through the isthmus to the uterus. Until recently, it has been generally accepted that the cilia of the epithelial cells that line the oviduct are responsible for movement of the cumulus over the fimbria into the ampulla and that the contractile activity of the smooth muscle cells in the wall of the ampulla is responsible for transporting the cumulus down the oviduct to the ampullar-isthmic junction (14). However, recent experiments by Halbert et al. (5,6) have shown that pharmacological inhibition of smooth muscle contractility does not impair cumulus transport in the ampulla, which suggests that smooth muscle contractility may not be the primary propulsive force in this region of the oviduct. The effects of muscle activity alone on ovum transport in the ampulla have not been determined because of the unavailability of a method specifically to inhibit cilia activity.The coordinate beating of cilia creates fluid currents over the oviduct epithelial surface, and these fluid movements have been proposed to be involved in moving the ovum (7,8). If this is the mechanism of ovum transport, then the cumulus is a passive agent that i carried in a "stream" of fluid over the epithelial surface. The only way to interfere with this process would be to alter the beating of the cilia severely enough to eliminate the surface fluid currents.Recently we reported that the portion of the rabbit oviduct ciliary membrane that covers the tip of the cilium has a high density of negative charges (9). By using polycationic ferritin as a specific electron-dense probe for anionic sites, we have shown that the probe binds to the tips of the cilia and that this binding is probably due to the presence of sialic acid-containing proteins at this site on the membrane. Evidence from other workers suggests that this might be a general property of ciliary membranes (10).The existence of negative charges on a portion of the ciliary membrane that would most likely interact with elements of the cumulus mass during ovum transport suggests that some type of electrostatic interaction betwee...