Tubal Segments Research Articles

Ectopic pregnancy in uncommon implantation sites

The majority of ectopic pregnancies are located within the fallopian tube. Nevertheless, pregnancies have been reported to implant in the cervix, ovary, interstitial tubal segment, and at various intra-abdominal sites. The diagnosis and treatment of these unusual implantation sites presents a challenge for clinical as well as radiological diagnosis and there is a tendency to overlook its possibility. In this study, we attempt to summarize the current data regarding diagnosis and optimal treatment of these unusual ectopic pregnancies from our experience with six unusual types of ectopic pregnancies from the Women Hospital, Doha, Qatar.

Robotic Tuboplasty

IntroductionTubal ligation is used worldwide as a method of contraception. Many of these express regret due to a change in family circumstances such as death of a child, an improved economic situation, or a change in marital status, and then request sterilization reversal. The robotic technology allows surgeons to perform sterilization reversals with all the advantages of minimally invasive procedures with far more precision than conventional laparoscopy.MethodsPort placement is same as that of pelvic robotic surgeries. Robot docked from in between the legs. The surgical procedure consists in removing abnormal tissue from both the portions of the tube and to reapproximate the healthy tubal segments with microsuturing.ResultsThe robotic technique has comparable results to conventional minilap.ConclusionMagnified vision and the improved dexterity allow for greater precision required in tubal reanastomosis. Gives the benifits of minimal invasive surgery to the patient. IntroductionTubal ligation is used worldwide as a method of contraception. Many of these express regret due to a change in family circumstances such as death of a child, an improved economic situation, or a change in marital status, and then request sterilization reversal. The robotic technology allows surgeons to perform sterilization reversals with all the advantages of minimally invasive procedures with far more precision than conventional laparoscopy. Tubal ligation is used worldwide as a method of contraception. Many of these express regret due to a change in family circumstances such as death of a child, an improved economic situation, or a change in marital status, and then request sterilization reversal. The robotic technology allows surgeons to perform sterilization reversals with all the advantages of minimally invasive procedures with far more precision than conventional laparoscopy. MethodsPort placement is same as that of pelvic robotic surgeries. Robot docked from in between the legs. The surgical procedure consists in removing abnormal tissue from both the portions of the tube and to reapproximate the healthy tubal segments with microsuturing. Port placement is same as that of pelvic robotic surgeries. Robot docked from in between the legs. The surgical procedure consists in removing abnormal tissue from both the portions of the tube and to reapproximate the healthy tubal segments with microsuturing. ResultsThe robotic technique has comparable results to conventional minilap. The robotic technique has comparable results to conventional minilap. ConclusionMagnified vision and the improved dexterity allow for greater precision required in tubal reanastomosis. Gives the benifits of minimal invasive surgery to the patient. Magnified vision and the improved dexterity allow for greater precision required in tubal reanastomosis. Gives the benifits of minimal invasive surgery to the patient.

Effect of cigarette smoking on human oviductal ciliation and ciliogenesis

To investigate the effect of cigarette smoke exposure on ciliation and ciliogenesis in human oviductal epithelium. Molecular analysis using human tubal segments. Academic medical center. Twenty women undergoing elective tubal sterilization procedure. Expression of ciliated cell-specific markers was compared in tubal segments from smokers and nonsmokers using quantitative immunohistochemistry and Western blot analysis. The expression of transcription factors in the motile ciliogenesis program was compared using quantitative polymerase chain reaction and quantitative immunohistochemistry. Oviductal ciliation and expression of transcription factors involved in ciliogenesis. No significant differences were detected in density of ciliation between groups. Neither number of years of smoking nor pack-year history correlated with density of ciliation. Expression of ciliogenic transcription factors FOXJ1, RFX2, and RFX3 was consistent between groups. Few studies have evaluated the relationship between smoking and ciliated epithelium in human oviducts. Cigarette smoking does not seem to result in quantitative differences in the density of ciliation nor expression of ciliogenesis factors. Our findings suggest that pathophysiologic mechanisms other than ciliation account for the increased risk of ectopic pregnancy in women who smoke.

Effects of drip system uniformity on yield and quality of Chinese cabbage heads

Chinese cabbage (Brassica rapa subsp. pekinensis) production experiments with different system uniformities and field scales controlled by driplines were conducted in a solar heated greenhouse in 2009 and 2010. Three Christiansen uniformity coefficients (CU=62, 81 and 96%) and two nitrogen application rates (150 and 300kg/ha) were evaluated in 2009. In 2010, three CU values (57, 74, and 95%) and one nitrogen application rate (225kg/ha) were tested. The uniformity of systems was established by randomly assembling segments of drip tubes with five different nominal emitter discharge rates (1.05, 1.4, 1.65, 2.3 and 2.6L/h) along a dripline. For all of the system uniformities tested, the plant height, head height to diameter ratio, dry matter above ground and nitrogen uptake displayed high uniformity coefficients throughout the entire growing season. The effects of system uniformity and nitrogen application rate on the mean yield and quality indexes and their uniformities were insignificant. With the increasing of field scale controlled by one dripline, the uniformity of crop growth, yield and quality indexes demonstrated a decreasing tendency. The results of this study showed that uniformity values that are lower than those recommended by the current standards can be used in drip irrigation systems, and their usage should consider the field scale controlled by dripline.

Bilateral Interstitial Pregnancy After In Vitro Fertilization and Embryo Transfer With Bilateral Fallopian Tube Resection Detected by Transvaginal Sonography

An ectopic pregnancy (EP) is a well-known complication after in vitro fertilization-embryo transplantation (IVF-ET). 1 An interstitial pregnancy is a rare and dangerous variation of an EP. It refers to an EP that is implanted in the interstitial portion of the fallopian tube, which is defined as the tubal segment traversing the muscular wall of the uterus. 2 In addition, an interstitial pregnancy rarely occurs after IVF-ET with salpingectomy. Although the direct transfer of embryos into the uterine cavity with bilateral salpingectomy should theoretically prevent the occurrence of an EP, an EP with bilateral fallopian tube resection has been reported rarely. 3 To our knowledge, there has been no report of a bilateral interstitial pregnancy after IVF-ET with bilateral salpingectomy. Here we present a case of a bilateral interstitial pregnancy after IVF-ET detected by transvaginal sonography (TVS) in a patient with bilateral salpingectomy. This case suggests that interstitial pregnancies occurring after bilateral tubal resection are still possible.

The molecular pathogenesis of hereditary ovarian carcinoma

BRCA1 or BRCA2 (BRCA1/2)-mutated ovarian carcinomas may originate in the fallopian tube. The authors of this report investigated alterations in BRCA1/2 tubal epithelium to define the molecular pathogenesis of these carcinomas. Tubal epithelium was evaluated from 31 BRCA1/2 mutation carriers with gynecologic carcinomas (BRCA CA), 89 mutation carriers who underwent risk-reducing salpingo-oophorectomy (RRSO), and 87 controls. Ki-67 expression and p53 foci (≥10 of 12 consecutive staining cells) were scored by 2 investigators who were blinded to patient designations. Expression levels of p27 and p21 were evaluated within p53 foci. Loss of heterozygosity at the BRCA1/2 mutation site was evaluated in microdissected p53 foci and tubal neoplasms. Background tubal proliferation as measured by Ki-67 staining was increased in the BRCA1 RRSO group (P = .005) compared with the control group. Women who had BRCA1/2 mutations had more p53 foci identified per tubal segment than women in the control group (P = .02). Levels of p27 were decreased in 12 of 28 p53 foci from women with BRCA1 mutations and in 0 of 16 p53 foci from controls (P = .002). There was no loss of the wild type BRCA1/2 allele in 5 tested p53 foci. Tubal neoplasia lost the wild type allele in 6 of 6 foci (P = .002). The current results suggested a model of tubal carcinogenesis in women with BRCA1/2 mutations. Increased proliferation occurred globally in at-risk tubal epithelium. A mutation in the tumor protein p53 gene TP53 with clonal proliferation and loss of p27 occurred before neoplastic proliferation. Loss of the wild type BRCA1/2 allele occurred with neoplastic proliferation and before invasion.

A Resistance-Integral Natural-Coordinate Method for Diffusive Transport

Numerical models of diffusive transport, commonly considered as approximate solvers of the partial differential equation, focus on evaluation of gradients at a point. Gradient-approximation inaccuracies manifest themselves as errors in conductances and capacitances that enter into matrices that are finally solved. In turn, these errors arise from a lack of consideration of flow geometry in the point’s vicinity. In order to improve accuracy, flow geometry may be incorporated into evaluation of conductances and capacitances by choosing segments of flow tubes as volume elements. Flow tubes, inherent in the initial conditions, can be generated using appropriate interpolation schemes that are built into contouring algorithms. The principal task is to structure contouring tools in such a way as to generate information to facilitate accurate evaluation of conductances and capacitances. The logical framework of this novel approach is founded on the contributions of Maxwell, who visualized a flow domain as a collection of flow tubes, Ohm, who introduced the notion of resistance of a finite body, and Fick, who introduced a differential equation for diffusive flow through a tube of non-uniform cross section. Computer-graphics capability to implement this approach has become available only over the past two decades. Casting aside the notion of a point, the new paradigm is to evaluate flow-resistance over finite distances. The method suggested is referred to as a Resistance-Integral Natural-Coordinate Method (RINC). Formulated from first principles, this method dispenses with the differential equation as an intermediary to formulate the numerical equations. It proceeds directly from the physical problem to its numerical representation.

Effect of Tamoxifen on Cytosolic Estrogen Receptor in the Different Parts of Fallopian Tube and Uterus during Ovum Transport

The effect of tamoxifen (ICI-46474) (alpha-[4-(beta-N-dimethylamino ethoxy)-phenyl]alpha'-ethyl trans stilbene on estrogen cytosolic receptor was observed in different parts of fallopian tube and uterus of rabbits during ovum transport. Tubal segments viz. ampulla (A), ampullary isthmic junction (AIJ), isthmus (I), uterine isthmic junction (UIJ) and uterus (U) were studied during the passage of ovum. Significant differences were observed in normal, drug treated and pregnant animals at 14, 24, 34, 48, 72, 144 and 168 h. In treated animals during 14 h post-coitum (p.c.) to 34 h p.c. the ampullary cytosol receptor concentration increased and suddenly decreased at 48 h p.c. whereas from 72 h p.c. to 144 h p.c. it increased gradually. Tamoxifen accelerated the rate of egg transport decreasing tubal cytosolic receptors at 48 h p.c. However, beyond 48 h p.c. receptors increased till 144 h p.c. Results suggest that tamoxifen modulated tubal cytosolic estrogen receptors during egg transport and prevents pregnancy.

Unilateral congenital ovarian and partial tubal absence: Report of four cases with review of the literature

To present four rare cases of congenital unilateral tubal and ovarian abnormalities with their laparoscopic images. Case report. Baskent University Faculty of Medicine, Department of Obstetrics and Gynecology, Konya, Turkey. Three patients with infertility showing abnormality on hysterosalpingography and a fourth patient with acute pelvic pain who were admitted to our clinic. All four patients underwent laparoscopic surgery. Case 1 showed an absence of a distal tubal segment with ipsilateral ovarian agenesis. Case 2 showed a unilateral partial distal tubal absence with normal adjacent ovary. Case 3 showed a twisted and adherent tube with ipsilateral ovarian absence. Case 4 showed a unilateral ovarian agenesis and contralateral acute adnexal torsion. We detected four cases of unilateral ovarian and partial tubal absence in these operations. We present four unusual cases of unilateral ovarian and partial tubal absence. The absence of one ovary and tube may be explained by two possible etiopathogenic causes: asymptomatic adnexial torsion or congenital malformation.

Ectopic Pregnancies in Unusual Locations

The majority of ectopic pregnancies are located within the fallopian tube. Nevertheless, pregnancies have been reported to implant in the cervix, ovary, interstitial tubal segment, and at various intra-abdominal sites. The diagnosis and treatment of these unusual implantation sites presents both diagnostic and therapeutic dilemmas. The majority of data regarding these unusual ectopic pregnancies come largely from case reports and anecdotal information. In the past, treatment of these ectopic pregnancies used various combinations of surgery and/or systemic and local chemotherapy. In this article, we attempt to summarize the current data regarding diagnosis and optimal treatment of these unusual ectopic pregnancies.

Inhibitory effects of selected antiepileptics on spontaneous motility of isolated human oviducts

Spontaneous motility of the human oviduct is an important factor in the regulation of fertility that can be influenced by a variety of substances. In this study we examined the effects of several antiepileptic drugs on spontaneous contractions of isolated human oviducts. The isolated ampullar and isthmic segments of Fallopian tubes, taken from 34 patients with extensive uterine fibroids, were exposed to carbamazepine, lamotrigine, valproic acid, phenobarbital, diazepam and lorazepam. Carbamazepine and lamotrigine produced concentration-dependent inhibition of spontaneous contractions of both ampullar and isthmic isolated preparations, while the other investigated substances did not exhibit any effect. The effective concentrations of carbamazepine and lamotrigine fall within the range of their therapeutic serum concentrations. When choosing antiepileptics for women of reproductive age, the effects of the drug on motility of the Fallopian tubes should also be considered.

Experimental Evidence for the Influence of Cumulus-Oocyte-Complexes on Sperm Release from the Porcine Oviductal Sperm Reservoir

In the pig, a temporal relationship is suggested between sperm release from the sperm reservoir (SR) and ovulation, but the mechanism(s) is still under discussion. In two experiments, the influence of transferred ova on the release of SR-spermatozoa at ovulation and the effect of supplementation with non-sulfated glycosaminoglycan hyaluronan (HA) on embryo development and the number of accessory spermatozoa, respectively, were examined. PMSG/hCG primed ovectomized gilts that had previously received endoscopic low-dose insemination into the cranial uterine horn were used as an experimental model. After salpingectomy, tubal segments (ampulla, cranial, and caudal isthmus) were flushed and sperm numbers or respective accessory spermatozoa were counted. In Experiment 1, the distribution of the sperm population was altered in the presence of cumulus-oocyte-complexes (COCs). A higher proportion of spermatozoa was found after transfer of COCs into one oviduct in the ampulla and cranial isthmus segments compared with the controls (17.5 vs. 4.9%, p<0.05). In Experiment 2, the quality of the transferred ova and treatment influenced the presence of accessory spermatozoa. Transfer of COCs together with HA increased (p<0.05) the number of accessory spermatozoa compared with the other treatment groups and was similar to those in the "undisturbed" controls. No modifications were obtained regarding mean blastomere numbers (2.6 +/- 0.2 to 3.1 +/- 0.2). In summary, this study was demonstrated that cumulus-oocyte-complexes may be involved in triggering sperm release from the pig oviductal SR and that HA might be related to sperm release.

Interleukin-1 system messenger ribonucleic acid and protein expression in human fallopian tube may be associated with ectopic pregnancy

To investigate the interleukin-1 (IL-1) system mRNA and protein expression in human fallopian tubes with ectopic pregnancies. A controlled study. Clinical and academic research setting in a university medical center. Women undergoing salpingectomy for fallopian tube with ectopic pregnancy and women undergoing tubal ligation. Paired segments of human fallopian tubes containing an ectopic pregnancy and parafallopian tube segments adjacent to the ectopic pregnancy were collected from five women undergoing laparoscopic salpingectomy. Segments of fallopian tubes from four women undergoing tubal ligation were used as control tissues. Quantitative competitive polymerase chain reaction (QC-PCR) and immunohistochemistry were performed. The differences of IL-1 system mRNA and the ratio of IL-1beta to IL-1 receptor antagonist (IL-1ra) in both fallopian tubes with ectopic pregnancies and normal controls were analyzed. A complete IL-1 system mRNA and protein expression was identified in both fallopian tubes with ectopic pregnancies and normal controls. As QC-PCR demonstrated, IL-1beta mRNA expression was decreased, and IL-1ra and IL-1 receptor type 1 were increased in fallopian tubes with ectopic pregnancies in comparison with normal control tubes. In para-ectopic tubes, IL-1 receptor type 1 mRNA was statistically significantly increased in comparison with normal controls. There was a lower ratio of IL-1beta to IL-1ra at mRNA in fallopian tubes with ectopic pregnancies. These results suggest that an inappropriate ratio of IL-1beta to IL-1ra and a higher expression of its receptor in fallopian tubes may possibly be implicated to the implantation of an ectopic pregnancy in the oviduct.

The Truth and Consequences of Enzymatic Detergents

Enzymatic detergents are widely used to clean gastrointestinal endoscopes before high-level disinfection. Although proper use of enzymatic detergents may appear straightforward, common misuses include failure to dilute the enzymatic detergent, overdilution of enzymatic detergent, use of expired enzymatic detergent, inadequate exposure time, and failure to rinse the enzymatic detergent from the instrument being cleaned. Each type of misuse has its own rationale. In these studies, the authors show by high-performance liquid chromatography that the type of enzymatic detergent and the dilution and rinsing of enzymatic detergents affect the amount of residual high-level disinfectant (ortho-phthalaldehyde) left on test segments of flexible endoscope insertion tubes. The authors also qualitatively demonstrate that proteinaceous material, which is stained a dark color by ortho-phthalaldehyde (OPA), remains on colonoscopes that have been cleaned with improperly diluted or rinsed enzymatic detergents. These findings emphasize the importance of diluting and using enzymatic detergents exactly as directed by their manufacturers to reduce bioburden and residual amounts of high-level disinfectant on flexible endoscopes.

Hyaluronan and its binding proteins in the epithelium and intraluminal fluid of the bovine oviduct

Hyaluronan (HA) is involved in several important steps of sperm storage and of fertilization. This study investigates the presence and concentration of HA in oviductal fluid (ODF), together with the localization of HA and the presence of hyaluronan-binding proteins (HABPs) in the oviductal epithelium of normally cycling dairy heifers and cows. The concentration and amount of HA in ODF, collected over the course of several oestrous cycles via catheters placed in the isthmic and ampullar tubal segments, were measured using an ELISA. The concentration and amount of HA in ODF did not vary significantly between these anatomical regions, nor between the stages of the oestrous cycle (p > 0.05), although the amount of HA seemed to peak during oestrous. The most HA per day (2.9 +/- 0.64 microg, least square mean +/- SEM) was produced on the day of ovulation, whereas the lowest amount (1.25 +/- 0.68 microg) was produced 4 days before ovulation. To investigate the localization of HA, tissue samples were retrieved at well-defined stages of the oestrous cycle and from corresponding regions of the oviduct. Sections and protein extracts from the tissue samples were studied histochemically using biotinylated HABP and immunoblotted with fluorescein isothiocyanate (FITC)-HA, respectively. Presence of HA labelling in the oviductal epithelium was restricted to the sperm reservoir, a localization that seemed to be cycle-independent. The immunoblotting of samples from the lining epithelium revealed seven bands of HABPs. We confirm that the bovine oviduct produces HA and its binding proteins, and that HA is mainly localized to the epithelium of the sperm reservoir.

Versatile Visualization of Individual Single-Walled Carbon Nanotubes with Near-Infrared Fluorescence Microscopy

Fluorescence microscopy in the near-infrared between 950 and 1600 nm has been developed as a novel method to image and study single-walled carbon nanotubes (SWNTs) in a variety of environments. Intrinsic photoluminescence of disaggregated pristine SWNTs was excited by a diode laser and detected with a two-dimensional InGaAs photodiode array. Individual nanotubes were visualized with a spatial resolution of ca. 1 microm and characterized with polarization measurements and emission spectroscopy. Spatially resolved emission spectra allowed (n,m) identification of single nanotubes and revealed small environmentally induced spectral shifts between segments of long tubes. Nanotube motions in aqueous surfactant were visualized with a time resolution of 50 ms and used to estimate the diffusion coefficient.

Effects of three different sterilization methods on utero-ovarian Doppler blood flow and serum levels of ovarian hormones

Objective:The aim of the study was to assess pre-operative and post-operative serum levels of ovarian hormones and changes in utero-ovarian arterial blood flow by Doppler ultrasonography in women in whom one of three different sterilization methods was applied. Study design:The Pomeroy method of tubal ligation, fimbriectomy, or laparoscopic bipolar coagulation were applied in 42 patients. Serum levels of sex hormones were checked, and utero-ovarian arterial Doppler measurements were performed pre-operatively and post-operatively. The presence or absence of dysmenorrhea was noted before and after the operations. Results:We detected a significant increase in the average uterine arterial resistivity index (RI) and both ovarian arterial pulsatility index (PI) values in the Pomeroy method group (p<0.05). There was a significant increase in dysmenorrhea complaints in the total number of patients (p<0.05), particularly in the fimbriectomy group. Conclusion:The significant increase in uterine arterial Doppler measurements with the Pomeroy method may be due to the removal of a larger tubal segment. Even though the increase is not statistically significant, fimbriectomy should not be applied in young women, because it may increase dysmenorrhea and the procedure is not reversible.

Detection of the Hyaluronan Receptor CD44 in the Bovine Oviductal Epithelium

Hyaluronan is involved in fundamental reproductive events such as sperm storage in the female reproductive tract, fertilization, and early embryo development, these functions are presumably mediated by its major cell surface receptor, CD44. The present study was conducted to investigate the presence and localization of CD44 in the bovine oviductal epithelium, using immunohistochemical and Western blot methods on tissue sections and epithelial cell extracts collected from the uterotubal junction (UTJ), isthmus, and ampulla of animals in the oestrus or luteal phase of the oestrous cycle. While positive immunolabelling for CD44 was found on the ad-luminal surface and supra-nuclear region of epithelial cells in all tubal segments investigated, in the UTJ, there were epithelial cells in which the entire cytoplasm positively stained. We found no differences in terms of CD44-positive staining between the different stages of the oestrous cycle. Presence of CD44 was detected by Western blotting in the tubal epithelium as a single band at 200 kDa. Although it appeared in all tubal segments, the expression of CD44 protein was more accentuated in the sperm reservoir (UTJ) than in the other segments. This is the first time CD44 has been detected in the epithelium of the tubal sperm reservoir in cattle, suggesting a pathway for the action of hyaluronan in this segment.

Immunolocalization of integrins and fibronectin in tubal pregnancy

Integrins are a large family of cell adhesion molecules that serve as receptors involved in cell-to-cell and cell-to-matrix interactions during implantation. We studied immunohistochemical staining of integrins ( α3, αV, β1, and α2 β1) and fibronectin in ectopic tubal pregnancy. Thirty fallopian tube samples with ectopic pregnancies and five normal tubal segments were obtained during ligation operations; the latter specimens served as controls in the study. Formalin-fixed paraffin-embedded tissue sections were stained with hematoxylin–eosin or primary antibodies against α3, β1, αV, and α2 β1 integrins and fibronectin, using the avidin–biotin–peroxidase method. A semi-quantitative grading system was used to compare staining intensities. In the control samples, immunostaining of all integrins was found in a single layer of tall columnar epithelial cells, the lamina propria (Lp) and the muscular layer. Fibronectin staining was detected in the Lp and the muscular layer. Staining intensities of α3 and β1 integrins and fibronectin were increased in the normal part of fallopian tubes with ectopic pregnancies. Staining of β1 integrin was more intense than staining of α3 and fibronectin, whereas there was no difference in αV and α2 β1 integrin expression between normal tubal tissue in the ectopic pregnancy group and control tubal tissue. In the tubal pregnancy group at the site of implantation, staining intensity of α3 and β1 integrins and fibronectin was strong in decidual cells, supporting tissue and placental villi, whereas αV and α2 β1 staining was mild. We concluded that integrins, especially β1 and α3, and fibronectin may play a role in progression of tubal implantation. Although the role of integrins has not yet been clearly defined, these molecules may function as markers of normal and abnormal states of receptivity. We like to suggest that integrins and fibronectin, which are needed in utero implantation, are expressed in tubal tissues during ectopic pregnancy and are involved in ectopic implantation.

Immunolocalization of integrins and fibronectin in tubal pregnancy

Integrins are a large family of cell adhesion molecules that serve as receptors involved in cell-to-cell and cell-to-matrix interactions during implantation. We studied immunohistochemical staining of integrins (α3, αV, β1, and α2β1) and fibronectin in ectopic tubal pregnancy. Thirty fallopian tube samples with ectopic pregnancies and five normal tubal segments were obtained during ligation operations; the latter specimens served as controls in the study. Formalin-fixed paraffin-embedded tissue sections were stained with hematoxylin–eosin or primary antibodies against α3, β1, αV, and α2β1 integrins and fibronectin, using the avidin–biotin–peroxidase method. A semi-quantitative grading system was used to compare staining intensities. In the control samples, immunostaining of all integrins was found in a single layer of tall columnar epithelial cells, the lamina propria (Lp) and the muscular layer. Fibronectin staining was detected in the Lp and the muscular layer. Staining intensities of α3 and β1 integrins and fibronectin were increased in the normal part of fallopian tubes with ectopic pregnancies. Staining of β1 integrin was more intense than staining of α3 and fibronectin, whereas there was no difference in αV and α2β1 integrin expression between normal tubal tissue in the ectopic pregnancy group and control tubal tissue. In the tubal pregnancy group at the site of implantation, staining intensity of α3 and β1 integrins and fibronectin was strong in decidual cells, supporting tissue and placental villi, whereas αV and α2β1 staining was mild. We concluded that integrins, especially β1 and α3, and fibronectin may play a role in progression of tubal implantation. Although the role of integrins has not yet been clearly defined, these molecules may function as markers of normal and abnormal states of receptivity. We like to suggest that integrins and fibronectin, which are needed in utero implantation, are expressed in tubal tissues during ectopic pregnancy and are involved in ectopic implantation.