Age, lifestyle, and disease affect ciliary transport in the human fallopian tube

The synchronized beating of ciliated cells within the human fallopian tube is crucial for the transport of the oocyte and the early embryo. To date, the precise effects of age, lifestyle, and disease on ciliary beating in the human fallopian tube are still unknown. Therefore, we set out to evaluate the effects of cycle stage, age, BMI, smoking, and alcohol, as well as the impact of ovarian cysts, uterine fibroids (myomas), cervical cancer, and endometrial cancer on human tubal ciliary beat frequency (CBF). Samples were obtained from control patients undergoing risk reduction surgery as well as from patients with ovarian cysts, benign myomas, as well as from patients with cervical cancer and endometrial cancer. Tubal samples were obtained during hysterectomy with salpingo-oophorectomy and examined using quantitative digital live cell imaging under near in vivo conditions and in real-time. Our results showed that tubal CBF was independent of cycle stage and anatomical location in the oviduct. There was a significant relationship between patient age and CBF (< 45 years Spearman's rho=-0.708, p = < 0.001 and > 45 years Spearman's rho=-0.752, p = < 0.001). Smoking caused a significant increase in CBF (generalised linear model, p = 0.025), whereas regular alcohol consumption had no effect. Increased BMI was associated with significantly decreased CBF (Spearman's rho=-0.543, p = 0.024). CBF was also significantly decreased in cycling patients affected by ovarian cysts (generalised linear model for repeated measurements, p = 0.004), in patients with uterine myomas (generalised linear model, p = 0.027), as well as in patients with cervical cancer (cycling patients, generalised linear model, p = 0.002) and endometrial cancer (menopausal patients, generalised linear model, p = 0.003). Overall, our results show that tubal ciliary function is impaired by obesity and smoking, as well as by benign myomas and malignant gynaecological cancer. Altered CBF impairs proper embryo transport speed, decreasing the chance of successful pregnancy. Thus, modulating early embryo transport might be a valuable tool for optimizing the success rates of assisted reproductive technologies (ART) both in infertile healthy patients as well as in young cervical cancer patients.