Functional Morphology of the Human Uterine Tubes in the 21st Century: Anatomical Novelties and Their Possible Clinical Applications

Abstract

The uterine tube (UT) pathologies account for 25-35 % of female factor infertility. Although these peculiar organs were first studied several hundred years ago, they have become overlooked and neglected mainly due to the successes of reproductive medicine. Nevertheless, reproductive medicine still faces many challenges regarding the fertility outcomes of in vitro fertilization (IVF). Many obstacles and problems can be resolved by a more detailed understanding of the UT morphology and function during normal reproduction. Over the course of the 21st century, many new insights have been obtained: the presence of a population of telocytes in the tubal wall responsible for normal motility and hormone sensory function, the demonstration of lymphatic lacunae of the mucosal folds necessary for oocyte capture and tubal fluid recirculation, or a thorough profiling of the immune makeup of the UT epithelial lining with the discovery of regulatory T cells presumably important for maternal tolerance towards the semi-allogenic embryo. New discoveries also include the notion that the UT epithelium is male sex hormone-sensitive, and that the UT is not sterile, but harbors a complex microbiome. The UT epithelial cells were also shown to be the cells-of-origin of high-grade serous ovarian carcinomas. Finally, yet importantly, several modern morphological directions have been emerging recently, including cell culture, the development of tubal organoids, in silico modelling, tissue engineering and regenerative medicine. All these novel insights and new approaches can contribute to better clinical practice and successful pregnancy outcomes.

Region-Specific Decellularization of Porcine Uterine Tube Extracellular Matrix: A New Approach for Reproductive Tissue-Engineering Applications

“…Pre-pubertal porcine uterine tubes were chosen in this study since pig slaughter occurs with high frequency in commercial slaughterhouses, and reproductive tissues are discarded or underutilized, which reinforces the relevance of recycling these biological materials for biotechnological purposes [64,65]. Another interesting factor to be considered is the homogeneity of the samples used to generate the biomaterials, due to the animals reproductive cycle consistency [66,67]. Indeed, hormonal stimulation is able to induce structural and functional alteration on reproductive tissues, which reflects on ECM organization and composition, and thus, in the production of biomaterial [68][69][70].…”

Region-Specific Decellularization of Porcine Uterine Tube Extracellular Matrix: A New Approach for Reproductive Tissue-Engineering Applications

“…Pre-pubertal porcine uterine tubes were chosen in this study since pig slaughter occurs with high frequency in commercial slaughterhouses and reproductive tissues are discarded or underutilized, which reinforce the relevance of recycling these biological materials for biotechnological purposes [62,63]. Another interesting factor to be considered is the homogeneity of the samples used to generate the biomaterials, due to the animal's reproductive cycle consistency [64,65]. Indeed, hormonal stimulation is able to induce structural and functional alteration of reproductive tissues, which reflects on ECM organization and composition, and thus, on the production of biomaterial [66][67][68].…”

Morphology of the immune cells in the wall of the human uterine tube and their possible impact on reproduction—uterine tube as a possible immune privileged organ

“…However, the uterine tube has many other unique functions, such as sperm selection (an essential mechanism for preventing polyspermatic fertilization) or formation of a unique tubal fluid. Tubal fluid is important not only during fertilization but activates sperm before fertilization and nourishes the embryo during transport to the uterine cavity ( Csöbönyeiová et al, 2022b ; Varga et al, 2022 ; Hamranová et al, 2023 ).…”