Peritoneal fluid as an unrecognised vector between female reproductive tissues

Abstract

This essay discusses the potential contribution of peritoneal fluid to the regulation of reproductive processes in female mammals. After noting the relatively high concentrations of diverse hormones in peritoneal fluid, and accepting that it bathes the surface of all the internal reproductive organs, peritoneal fluid is then proposed as a means of communication between the two ovaries. It could act to influence both the hierarchy of Graafian follicles and the rate and extent of development of a newly-formed corpus luteum. Cytokines in peritoneal fluid are considered in this context, as are the differing populations of leukocytes. Circumstantial evidence is offered for entry of peritoneal fluid into the Fallopian tubes, especially close to the time of ovulation, with the suggestion that such entry could modify the nature of endosalpingeal secretion and transudation. Thereafter, the spectrum of gonadal hormones in peritoneal fluid could be influencing uterine tissues in a local manner. Finally, reference is made to regional differences in the concentration of steroid hormones in the peritoneal fluid of women, likewise to regional differences in domestic animals.

Interstitial Cajal-like cells of human Fallopian tube express estrogen and progesterone receptors

“…Moreover, each anatomic region (infundibulum with fimbria, ampulla, isthmus and intramural segment) seem to perform specific functions (Croxatto 2002;Hunter 2005). These reproductive events are regulated mainly by the plasma and/or peritoneal fluid ovarian steroid hormones, estrogen and progesterone, which influence the ciliary activity, the composition of tubal fluid and tubal peristalsis (Lyons et al 2006;Hunter et al 2007;Giretti and Simoncini 2008). Making a comparison with the digestive tract, where the slow wave electric activity is triggered by interstitial cells of Cajal (ICC) (Hirst and Edwards 2006), known as gut pacemakers (Sanders et al 2006), it is interesting to emphasize that slow waves of depolarization also occur at myosalpinx level (Talo and Hodgson 1978;Dixon et al 2009).…”

Peritoneal fluid concentrations of progesterone in women are higher close to the corpus luteum compared with elsewhere in the abdominal cavity

“…The ovaries are almost totally covered by the very thin visceral peritoneum and remain in contact with peritoneal fluid. The amount of peritoneal fluid as well as its content of several substances, including steroid hormones, may fluctuate during the ovulatory cycle (6). Notably, the concentrations of E 2 and P in peritoneal fluid collected in the pouch of Douglas have been found to be much higher than in plasma for at least 1 week after ovulation (7,8).…”

Fertility outcome of laparoscopic treatment in patients with severe endometriosis and repeated in vitro fertilization failures

“…Endometriosis causes infertility through some changes that are known (e.g., pelvic adhesions, anatomical pelvic distortion, inflammatory changes in the peritoneal fluid [PF] that affect sperm motility, and endometriomas that lead to diminished ovarian reserve) (4)(5)(6)(7)(8) and probably by some other unknown changes. The severity of endometrial symptoms cannot be correlated with the location and spread of endometrial lesions, and noninvasive diagnostic tests and serum markers for endometriosis do not exist.…”