Uterine Motility Research Articles

Biomathematical pattern of EMG signal propagation in smooth muscle of the non-pregnant porcine uterus.

Uterine contractions are generated by myometrial smooth muscle cells (SMCs) that comprise most of the myometrial layer of the uterine wall. Aberrant uterine motility (i.e., hypo- or hyper-contractility or asynchronous contractions) has been implicated in the pathogenesis of infertility due to the failure of implantation, endometriosis and abnormal estrous cycles. The mechanism whereby the non-pregnant uterus initiates spontaneous contractions remains poorly understood. The aim of the present study was to employ linear synchronization measures for analyzing the pattern of EMG signal propagation (direction and speed) in smooth muscles of the non-pregnant porcine uterus in vivo using telemetry recording system. It has been revealed that the EMG signal conduction in the uterine wall of the non-pregnant sow does not occur at random but it rather exhibits specific directions and speed. All detectable EMG signals moved along the uterine horn in both cervico-tubal and tubo-cervical directions. The signal migration speed could be divided into the three main types or categories: i. slow basic migration rhythm (SBMR); ii. rapid basic migration rhythm (RBMR); and iii. rapid accessory migration rhythm (RAMR). In conclusion, the EMG signal propagation in smooth muscles of the porcine uterus in vivo can be assessed using a linear synchronization model. Physiological pattern of the uterine contractile activity determined in this study provides a basis for future investigations of normal and pathologicall myogenic function of the uterus.

Predictive factors of uterine movement during definitive radiotherapy for cervical cancer.

To determine the predictive factors affecting uterine movement during radiotherapy (RT), we quantified interfraction uterine movement using computed tomography (CT) and cone-beam CT (CBCT). A total of 38 patients who underwent definitive RT for cervical cancer were retrospectively analyzed. We compared pre-RT planning CT (n = 38) and intratreatment CBCT (n = 315), measuring cervical and corporal movement in each direction. Correlations between uterine movement and volume changes of the bladder and rectum on all CBCT scans were analyzed using Spearman rank correlation analysis. Relationships between the mean uterine movement and patient factors were analyzed using the Mann–Whitney test. The mean corpus movement was: superior margin (cranio–caudal direction), 7.6 ± 5.9 mm; anterior margin (anteroposterior direction), 8.3 ± 6.3 mm; left margin (lateral direction), 3.3 ± 2.9 mm; and right margin (lateral direction), 3.0 ± 2.3 mm. Generally, the mean values for cervical movement were smaller than those for the corpus. There was a significant, weak correlation between changes in bladder volume and the movement of the superior margin of the corpus (ρ = 0.364, P < 0.001). There was a significant difference in movement of the superior margin of the corpus between the subgroups with and without a history of previous pelvic surgery (P = 0.007). In conclusion, change in bladder volume and a history of previous surgery were significantly related to intrafractional corpus movement; however, our observations suggest that the accurate prediction of uterine movement remains challenging.

Lidocaine decreases the xylazine-evoked contractility in pregnant cows

The objective of this in vitro study was to evaluate and compare the effects of xylazine on basal uterine contractility of bovine pregnant uterine strips and that of lidocaine on xylazine-sensitized bovine pregnant uterine strips, at different stages of pregnancy. Basal contractility was evaluated in an isolated organ bath and the functionality of the strips throughout the experiment was evaluated using a dose of carbachol (10−5M). Uterine motility, expressed with amplitude, frequency of contractions as well as the area under the curve, was recorded in different stages of pregnancy and data were collected at 15-min intervals (5-min before and 5-min after xylazine administration and 5-min after lidocaine addition on the plateau contraction induced by xylazine). Uterine motility increased in all the stages of pregnancy after xylazine addition and gradually decreased after treatment with lidocaine. These data suggest that lidocaine might decrease the tonic effect induced by xylazine on bovine pregnant uteri.

Age features of uterine motility in infertile women with adenomyosis, uterine fibroids, and their combination

Age features of uterine motility in infertile women with adenomyosis, uterine fibroids, and their combination

Traction force needed to reproduce physiologically observed uterine movement: technique development, feasibility assessment, and preliminary findings.

This study aimed to describe a novel strategy to determine the traction forces needed to reproduce physiologic uterine displacement in women with and without prolapse. Participants underwent dynamic stress magnetic resonance imaging (MRI) testing as part of a study examining apical uterine support. Physiologic uterine displacement was determined by analyzing uterine location in images taken at rest and at maximal Valsalva. Force-displacement curves were calculated based on intraoperative cervical traction testing. The intraoperative force required to achieve the uterine displacement measured during MRI was then estimated from these curves. Women were categorized into three groups based on pelvic organ support: group 1 (normal apical and vaginal support), group 2 (normal apical support but vaginal prolapse present), and group 3 (apical prolapse). Data from 19 women were analyzed: five in group 1, five in group 2, and nine in group 3. Groups were similar in terms of age, body mass index (BMI), and parity. Median operating room (OR) force required for uterine displacement measured during MRI was 0.8N [interquartile range (IQR) 0.62-3.22], and apical ligament stiffness determined using MRI uterine displacement was 0.04N/mm (IQR 0.02-0.08); differences between groups were nonsignificant. Uterine locations determined at rest and during maximal traction were lower in the OR compared with MRI in all groups. Using this investigative strategy, we determined that only 0.8N of traction force in the OR was required to achieve maximal physiologic uterine displacement seen during dynamic (maximal Valsalva) MRI testing, regardless of the presence or absence of prolapse.

Uterine anatomy and function on cine magnetic resonance imaging.

The female reproductive organ undergoes dynamic morphological changes under the influence of hormonal stimuli, and particularly those mediated by estrogen and progesterone. The uterus changes both its morphological appearance and its functional movements in function of these influences. Functionally, the uterus is known to exert two kinds of inherent contractility: sustained uterine contractions and uterine peristalsis. The former is focal and consists of the sporadic bulging of the myometrium, while the latter is rhythmic and manifests itself as the subtle stripping movement in the subendometrial myometrium. The mechanisms underlying these uterine movements, their relationship and their correlation to age, pharmaceutical administration, and a variety of gynecologic and obstetrical problems remain under discussion. Cine MR imaging may offer the potential to directly observe the changes undergone by the uterus in relation to important functions such as fertility and menstrual problems.

Stress management affects outcomes in the pathophysiology of an endometriosis model.

We have previously shown detrimental effects of stress in an animal model of endometriosis. We now investigated whether the ability to control stress can affect disease parameters. Endometriosis was surgically induced in female Sprague-Dawley rats before exposing animals to a controllable (submerged platform) or uncontrollable (no platform) swim stress protocol. Corticosterone levels and fecal pellet numbers were measured as an indicator of stress. Uncontrollable stress increased the number and size of the endometriotic cysts. Rats receiving uncontrollable stress had higher anxiety than those exposed to controllable stress or no stress and higher corticosterone levels. Uncontrollable stressed rats had more colonic damage and uterine cell infiltration compared to no stress, while controllable stress rats showed less of an effect. Uncontrollable stress also increased both colonic and uterine motility. In summary, the level of stress controllability appears to modulate the behavior and pathophysiology of endometriosis and offers evidence for evaluating therapeutic interventions.

Evaluation of phytochemistry and uterotonic activity of root aqueous extract of Uvariodendron anisatum verdec. used in childbirth in Eastern/Central Kenya.

Over 56 % of pregnant women in Kenya deliver at home with the assistance of mainly traditional birth attendants who use herbal remedies to complete the processes of child bearing in both urban and rural communities. The medicines and indigenous knowledge used by traditional birth attendants deserve to be properly validated through scientific scrutiny under conditions mimicking the indigenous methods of use. This work seek to evaluate the phytochemistry and ethnopharmacology of Uvariodendron anisatum Verdeck (Annonaceae) which is used in the management of a variety of conditions including root decoction to ease labor or if the after birth is late or retained. This study is to investigate the phytochemical group of compounds and effects of of Uvariodendron anisatum aqueous root extract on the uterus of Wistar rats. Phytochemical screening was carried out using the accepted standard procedures and the extract was prepared by maceration. In-vitro pharmacological assay was done using doses of 50 mg, 200 mg, 400 mg and 800 mg. Phytochemical screening revealed the presence of alkaloids, glycosides, tannins, phenols, anthraquinones, steroids, carotenoids, coumarins, tannins, flavonoids, saponins and volatile oils. The extract also demonstrated weak uterine motility which corresponded to the dosage and displayed similar motility as oxytocin at high dose (800 mg). KEYWORD: Annonaceaea, Oxytocic activity, Maceration, Phytochemical screening

First Preliminary Data on Measurement of Uterine Dynamics in Non-Pregnant Uteri Using Transvaginal Recorded Ultrasound and Strain Imaging

Normal and abnormal uterine peristalsis in a non-pregnant uterus has proven to play a role in natural fecundity. However, quantification of uterine movement is yet not performed. In this feasibility study we measure myometrial uterine movement by strain analysis of activity, velocity and amplitude. Since now strain analysis has been only been used to evaluate myocardial contractility. We correlated strain measurements in uteri that were previously described to have active and non-active uteri.

Towards improving uterine electrical activity modeling and electrohysterography: ultrasonic quantification of uterine movements during labor

The electrohysterogram is a potential new tool for diagnosing preterm labor. Parameters from the electrohysterogram may be influenced by uterine movement. An observational study was performed quantifying uterine movement during labor as a step towards improving electrohysterogram analysis for predicting preterm labor. The uterine wall was continuously tracked by ultrasound imaging during first stage of labor while an accelerometer recorded external abdominal accelerations in six women. A cyclic cranial-caudal movement of the uterine wall, caused by maternal respiration, was observed. This is reported and quantified for the first time. Average frequency, amplitude, and peak speed were 0.27±0.07Hz, 0.68±0.84cm, and 1.04±1.20cm/s, respectively. The accelerometer signal correlated with uterine movement and therefore can possibly provide a reference for removing movement-induced artifacts. There is a need to model and measure the effect of uterine movement on the electrohysterogram parameters and make measurements more robust to movement artifacts.

Effects of the precalving administration of omega-3 fatty acids alone or in combination with acetylsalicylic acid in periparturient dairy cows1

This study investigated the effects of the administration of long chain omega-3 fatty acids (ω-3 FA) and acetylsalicylic acid (ASA) on inflammation, performance, and fertility in periparturient dairy cows. Five weeks before calving, 26 multiparous dairy cows were randomly assigned to 1 of 3 treatments: ω-3 FA (n = 9; OME), ω-3 FA and ASA (n = 9; OMAS), or palm oil (n = 8; CTR). During the last 3 wk of pregnancy, OME and OMAS groups received daily 12.0 g of fish-derived ω-3 FA, whereas CTR cows received only SFA. In addition, OMAS cows received daily 6.0 mg ASA/kg BW starting at 7 d before calving. Only a few cows had health problems after calving, but those in OMAS were most affected (n = 3 vs. 1 in CTR). Inflammatory status around calving did not improve in OME cows, as confirmed by the patterns of concentration of acute-phase proteins (APP), which were similar to CTR. Compared with CTR and OME, the increase of the positive APP and the decrease of the negative APP (e.g., albumin; P < 0.01) observed in OMAS cows suggested a severe inflammatory status after calving. Compared with OMAS, postcalving energy metabolism was better in OME cows as shown by a lower degree of lipomobilization (smaller BCS drop, greater glucose) and milder ketogenesis (less β-hydroxybutyrate; P < 0.01). Cows in CTR had optimal fertility indices, whereas OMAS was the worst group. The severe inflammation and the more negative energy balance likely contributed to the poor fertility parameters in those cows. It is known that ASA exerts an inhibitory effect on cyclooxygenases, causing a possible decrease in the synthesis of PGF2α. A decreased concentration of PGF2α is connected with alterations in the physiologic processes related to labor and to uterine motility. Cows in OMAS had a longer pregnancy (P < 0.10 vs.OME) and a greater frequency of retained placenta, which may be attributed to decreased synthesis of PGF2α. The administration of ω-3 FA alone did not delay calving or the expulsion of fetal membranes. In conclusion, long-chain ω-3 FA improved the physiological status of cows, partly through better energy balance. The administration of ASA before calving (even at a low dose) in combination with ω-3 FA did not exert any synergistic positive effect on inflammation and performance.

Colorectal and uterine movement and tension of the inferior hypogastric plexus in cadavers.

BackgroundHypotheses on somatovisceral dysfunction often assume interference by stretch or compression of the nerve supply to visceral structures. The purpose of this study is to examine the potential of pelvic visceral movement to create tension of the loose connective tissue that contains the fine branches of the inferior hypogastric nerve plexus.MethodsTwenty eight embalmed human cadavers were examined. Pelvic visceral structures were displaced by very gentle 5 N unidirectional tension and the associated movement of the endopelvic fascia containing the inferior hypogastric plexus that this caused was measured.ResultsMost movement of the fascia containing the inferior hypogastric plexus was obtained by pulling the rectosigmoid junction or broad ligament of the uterus. The plexus did not cross any vertebral joints and the fascia containing it did not move on pulling the hypogastric nerve.ConclusionsUterine and rectosigmoid displacement produce most movement of the fascia containing the hypogastric nerve plexus, potentially resulting in nerve tension. In the living this might occur as a consequence of menstruation, pregnancy or constipation. This may be relevant to somatovisceral reflex theories of the effects of manual therapy on visceral conditions.

Immunohistochemical analysis of bone morphological protein signaling pathway in human myometrium

We assessed by immunohistochemistry the expression of the phosphorylated (activated) form of Smad1 and 5 (P-SMAD1/5), of Noggin and of two smooth muscle cell markers (α-SMA and SM22) in a series of human myometrium samples and in a smooth muscle cell line derived from human myometrium (HUt-SMC, PromoCell, USA). Myometrium samples were removed from two cadavers (a fetus at 26weeks of gestation and a neonate) and from ten non-menopausal women who underwent hysterectomy for adenomyosis and leiomyoma. P-SMAD1/5 expression was never detected in myometrium (both normal and pathological specimens), but only as a nuclear positive staining in glandular and luminal epithelial cells in sections in which also the endometrial mucosa was present. Noggin was strongly expressed especially in myometrium and adenomyosis samples from non-menopausal patients in comparison to the neonatal and fetal myometrium specimens in which muscle cells were less positive. In more than 95% of HUt-SMCs, α-SMA and Desmin were co-expressed, indicating a pure smooth muscle phenotype. When progesterone was added to the culture medium, no P-SMAD1/5 expression was detected, whereas the expression Noggin and SM22, a marker of differentiated smooth muscle cells, increased by 3 fold (p=0.002) and 4.3 fold (p=0.001), respectively (p=0.002).Our results suggest that, in non-menopausal normal human myometrium, the BMP pathway might be inhibited and that this inhibition might be enhanced by progesterone, which increases the differentiation of smooth muscle cells (SM22 levels). These findings could help in the identification of new mechanisms that regulate uterine motility.

A Modified Hai–Murphy Model of Uterine Smooth Muscle Contraction

We extend and analyze the Wang and Politi modified Hai-Murphy model of smooth muscle cell contractions to capture uterine muscle cell response to variations in intracellular calcium concentrations. This model is used to estimate values of unknown parameters in uterine smooth muscle cell cross-bridging. Uterine motility is responsible for carrying out important processes throughout all phases of the nonpregnant female reproductive cycle, including sperm transport, menstruation, and embryo implantation. The modified Hai-Murphy partial differential equation model accounts for the displacement of myosin cross-bridge heads relative to their binding sites. This model was originally developed for the study of airway contractions; we now extended it for use in modeling nonisometric uterine contractions. Our extended model incorporates cross-bridge position and contractile velocity into the original model, resulting in more accurate modeling of the initial stages of contraction and modeling nonisometric contractions. Numerical simulations show that the contraction rate in our extended model is faster than the original Hai-Murphy model. These simulations provide quantitative estimates for the increased level of responsiveness of our extended model to intracellular calcium concentrations. The extended model and new parameter estimates for the cross-bridging can be coupled with uterine flow models to advance our understanding of embryonic motility and intrauterine flow.

Acupuncture for infertility: Is it an effective therapy?

Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer (IVF-ET), and male infertility. This review summarizes the recent studies which investigated the role of acupuncture in infertility. In conclusion, most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear. Even though a positive effect of acupuncture in infertility has been found, well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore, it is urgent and necessary to clarify the mechanism of acupuncture for infertility.

Transient β2-Adrenoceptor Activation Confers Pregnancy Loss by Disrupting Embryo Spacing at Implantation

Pregnancy loss is a serious social and medical issue, with one important cause associated with aberrant embryo implantation during early pregnancy. However, whether and how the process of embryo implantation is affected by environmental factors such as stress-induced sympathetic activation remained elusive. Here we report an unexpected, transient effect of β2-adrenoreceptor (β2-AR) activation (day 4 postcoitus) in disrupting embryo spacing at implantation, leading to substantially increased midterm pregnancy loss. The abnormal embryo spacing could be prevented by pretreatment of β2-AR antagonist or genetic ablation of β-AR. Similar β2-AR activation at day 5 postcoitus, when implantation sites have been established, did not affect embryo spacing or pregnancy outcome, indicating that the adverse effect of β2-AR activation is limited to the preimplantation period before embryo attachment. In vitro and in vivo studies demonstrated that the transient β2-AR activation abolished normal preimplantation uterine contractility without adversely affecting blastocyst quality. The contractility inhibition is mediated by activation of the cAMP-PKA pathway and accompanied by specific down-regulation of lpa3, a gene previously found to be critical for uterine contraction and embryo spacing. These results indicated that normal uterine contraction-mediated correct intrauterine embryo distribution is crucial for successful ongoing pregnancy. Abnormal β2-AR activation at early pregnancy provided a molecular clue in explaining how maternal stress at early stages could adversely affect the pregnancy outcome.

Changes of Connexin43 Expression in Non‐pregnant Porcine Myometrium Correlate with Progesterone Concentration During Oestrous Cycle

Connexin43 (Cx43) is a major protein of myometrial gap junctions. The number of Cx43 gap junctions increase dramatically with the onset of labour in association with development of synchronized uterine contractions. The formation of myometrial gap junctions follows an increase in the oestrogen to progesterone ratio indicating an important role of steroid hormones in regulating Cx43 expression at term. However, no relationship has been established between the expression of Cx43 in the non-pregnant myometrium and concentration of steroid hormones during the oestrous cycle. Here, we used immunofluorescence and Western blotting to analyse the expression of Cx43 gap junctions in the myometrium of pre-pubertal pigs (n = 7) and mature pigs at pre-ovulatory (n = 7), luteal (n = 5) and late luteal (n = 3) stages of the oestrous cycle. The number of Cx43 gap junctions calculated per 1 mm(2) of the myometrial section was low in pre-pubertal pigs and significantly higher (p < 0.022) in pre-ovulatory animals. In relation to pre-ovulatory animals the number of myometrial gap junctions was significantly lower (p < 0.019) at the luteal phase and correlated with significantly higher (p < 0.005) concentration of endogenous progesterone. Phosphorylated isoforms of Cx43 protein were expressed in the myometrium of pre-pubertal pigs and mature animals at pre-ovulatory and late luteal phases, while they were down regulated at the luteal stage. These results indicate that changes of Cx43 expression in the porcine myometrium during the oestrous cycle may be regulated by progesterone concentration and may contribute to the modulation of uterine motility.

Physiological uptake of 18F-fluorodeoxyglucose in uterine endometrium and myometrium: Correlation with uterine motility evaluated by cine magnetic resonance imaging

Accumulation of (18)F-fluorodeoxyglucose ((18)F-FDG) in the uterine endometrium and uterine motility are dependent on menstrual cycle. However, the relationship between them remains unknown. To investigate the relationship between radiometabolic activity of (18)F-FDG in the uterus and uterine motility observed by cine magnetic resonance imaging (MRI). The study population consisted of 65 healthy, fertile women, selected from 229 women who underwent positron emission tomography (PET), computed tomography (CT), and MRI for cancer screening at our facility. They were divided into three groups according to their menstrual cycle phases: menstrual, follicular-periovulatory, and luteal. Regions of interest (ROIs) were placed over the endometrium and myometrium to calculate the standardized uptake value (SUV). Uterine peristalsis and contraction shown by cine MR imaging were evaluated visually, and the correlation between FDG uptake and uterine movements was assessed. After excluding nine patients due to inadequate images, 56 patients (19 follicular-periovulatory, 27 luteal, and 10 menstrual) were analyzed. FDG uptake of the endometrium, frequency of peristalsis, and the presence of sustained contraction varied according to the menstruation cycle, with a tendency toward greater uptake in the menstrual phase, but there was little relationship between the frequency of uterine peristalsis and FDG accumulation in the uterus. Significantly higher FDG accumulation in the endometrium was observed in patients with sustained contractions (3.32+/-1.47) than in those without contractions (2.45+/-0.66). Our preliminary data suggest that FDG accumulation in the endometrium tends to be higher in patients with uterine contraction, although there was no significant correlation between uterine peristalsis and FDG uptake in the uterine myometrium or endometrium.

Effect of Oxytocin Treatment on Artificial Insemination with Frozen-Thawed Semen in Murciano-Granadina Goats

The site where the semen is deposited appears to be one of the most important factors affecting pregnancy of inseminated goats. In Murciano-Granadina (MG) goats, post-cervical insemination is achieved in a limited number of females. An effective way to increase fertility rate could be by increasing post-cervical inseminations. Effect of exogenous oxytocin application to facilitate the cervical penetration and its effect on kidding rate and prolificacy in MG goats were investigated. Oestrus was synchronized using progesterone-impregnated sponges for 11 days. Females were randomly divided into three groups (n = 190) and received either an i.v. injection of 100 or 200 IU of oxytocin or saline solution 15 min before being inseminated. Data on semen deposition depth were recorded for each animal using a catheter scaled in centimetres (up to 4 cm). Depth of semen deposition was affected by the oxytocin treatment (p < 0.05). Oxytocin enhanced cervical passage only with the dose of 200 IU compared with the control group, increasing the deposition depth (2.9 cm vs 1.9 cm). No significant effect of oxytocin treatment on kidding rate and prolificacy was detected. Depth of semen deposition affected kidding rate (p < 0.01). In conclusion, oxytocin treatment improved the depth of semen deposition in AI of MG goats, but kidding rate and prolificacy was not affected. More studies must be conducted to assess the minimal effective dose required for sufficient cervical dilation, and to determine the effects of such doses of oxytocin on uterine motility, sperm transport and fertility in goats.

Transvaginal sonographic evaluation of subendometrial–myometrial contractility in women using a copper-releasing intrauterine device

BackgroundThe aim of this study was to determine the effects of a copper-releasing intrauterine device (IUD) on myometrial contractility midway through the menstrual cycle. Study DesignUterine peristalsis was studied midway through the cycle with transvaginal sonography in two groups of women, a control group and women in whom a copper-releasing IUD had been inserted. ResultsThe results showed that 12 months after insertion, no uterine motility could be detected with sonography in any of the women with an IUD, but motility did occur in all the controls. ConclusionsSubendometrial–myometrial contractility midway through the menstrual cycle had been abolished in patients with a copper-releasing IUD. The loss of motility may inhibit sperm transport from the cervix to the oviduct and account for at least part of the contraceptive effect of these devices.