Determination of velocity of tubar transport with dynamic hysterosalpingoscintigraphy

Abstract

Transport of 99mTc labelled albumin macroaggregates (MAA) can be used as a substitute for assessing transport of spermatozoa within the female genital tract. As yet, the velocity of tubar MAA transport has not been systematically studied in a large group. Dynamic hysterosalpingoscintigraphy (HSS) was performed after intrauterine instillation of 10-20 MBq 99mTc-MAA in 88 pre-ovulatory women suffering from infertility. They had to have anatomical patency of both tubes and at least one enlarged follicle. The direction and the latency of transport were evaluated. Forty-four per cent of patients exhibited MAA transport only to the dominant follicle, 31% to both ovaries and 16% to the contralateral ovary. In 9% no transport was visible. Fifty per cent of all patients studied exhibited MAA transport to the dominant follicle within 30 s, 75% within 20 min. Transport velocity in women having bilateral or ipsilateral transport did not differ significantly. There was no significant correlation between the size of the follicle and transport velocity. We conclude that in the majority of cases MAA transport occurs within 30 s after instillation. The variation in transport time between 30 s and 20 min suggests that dynamic scintigraphy is, in principle, better suited to a refined analysis of tubar function than static HSS.

Physiology of Upward Transport in the Human Female Genital Tract

“…Various radiolabeled compounds have been used the past 30 years for radionuclide imaging of the female genital tract, including aggregates of human albumin, radioactive inert gases, and labeled spermatozoa. 6,[15][16][17][18][19][20][21][22] In this study, human serum albumin macroaggregates with Tc-99m attached to the protein by noncovalent binding were used as surrogates for spermatozoa. We feel that we can adequately confirm that the radioactivity was protein-bound because: (1) we observed the disappearance of the radioactivity from the uterus after flushing with saline and (2) the radioactivity collected from the cul de sac at laparoscopy could be precipitated completely by acid and still could be centrifuged down at low speed 4-7 h after application excluding uptake by the lymphatic system.…”

“…With regard to sperm transport, our interpretation of the results of HSS is based on the assumptions that the properties of the labeled material used for examination are similar to those of human spermatozoa and that there is no separation of label from the carrier in vivo . Various radiolabeled compounds have been used the past 30 years for radionuclide imaging of the female genital tract, including aggregates of human albumin, radioactive inert gases, and labeled spermatozoa 6 , 15–22 . In this study, human serum albumin macroaggregates with Tc‐99m attached to the protein by noncovalent binding were used as surrogates for spermatozoa.…”

Uterine Peristaltic Activity and the Development of Endometriosis

“…Using dynamic HSSG, changes in uterotubal flow velocity occur at the same frequency as the peristaltic contractions 22. It therefore is reasonable to assume that the uterine peristaltic activity with cervicofundal contraction waves provides the forces that are required for the transport of spermatozoa from the external os of the cervix into the tubes within minutes.…”

“…Using dynamic HSSG, changes in uterotubal flow velocity occur at the same frequency as the peristaltic contractions. 22 It therefore is reasonable to assume that the uterine peristaltic activity with cervicofundal contraction waves provides the forces that are required for the transport of spermatozoa from the external os of the cervix into the tubes within minutes. According to the data obtained by applying hysterosalpingoscintigraphy with labeled albumin macrospheres of sperm size, the following concept of the dynamics of rapid sperm ascension within the female genital tract could be developed.…”

Chemical and Physical Characterisation of Macroaggregated Human Serum Albumin: Strength and Specificity of Bonds with 99mTc and 68Ga

“…In the last two decades, a change in patterns of Tc-MAA has been observed with a shift from lung scan for pulmonary embolism because of extensive use of CT angiography, towards other uses such as ROLL (Radio Occult Lesion Localisation), surrogate particle of yttrium microspheres for the assessment of arterial supply and dosimetry, and for a wide series of less common applications [3][4][5][6][7][8].…”