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Published on: May 23, 2014
Retrograde seeding of endometrial epithelial cells by uterine-tubal flushing
R F Kruitwagen1, L G Poels, W N Willemsen
1Department of Obstetrics and Gynecology, St. Radboud University Hospital, School of Medicine, University of Nijmegen, The Netherlands.
Objective:
To estimate the amount of endometrial epithelial cells in peritoneal fluid (PF) after uterine-tubal flushing (40 mL) throughout the menstrual cycle.
Design:
We cultured the cell pellet of flush medium present in the peritoneal cavity.
Setting:
University Hospital Nijmegen, The Netherlands.
Patients:
Ninety-two women with various infertility-related factors.
Inclusion Criteria:
(1) ovulatory cycle, (2) patent tubes, and (3) no adhesions.
Interventions:
None
Main Outcome Measure(S):
The number of developing epithelial cell colonies were counted after 7 days. We started to record the amount of flush medium recovered during the study.
Results:
The amount of flush medium recovered was positively correlated with the presence of endometriosis (P = 0.017). Endometrial epithelial cells were identified in 85 flush media (92%). The number of epithelial cell colonies varied from 0 to 100 or more and was higher when flushing was performed during the early follicular phase (P less than 0.01). High estradiol-17 beta and progesterone levels in culture medium did not change the number of developing cell colonies. Methylene blue significantly reduced the number of cell colonies (P = 0.002).
Conclusions:
Uterine-tubal flushing results in varying numbers of endometrial epithelial cells in PF. Methylene blue adversely affects the growth potential of these cells.
