High progesterone levels and ciliary dysfunction - A possible cause of ectopic pregnancy

Objectives: To investigate the effects of different levels of hormones on the ciliary activity of human oviducts and, consequently, to assess their possible role in tubal implantation of the fertilized egg. Design: Fallopian tube epithelial samples were incubated in media with the addition of Estradiol (E-2), progesterone (P), human menopausal gonadotropin (hMG), LH, or pure FSH (Metrodin) in different concentrations. The ciliary beat frequency (CBF) was measured after 24 h of incubation. Then the media were exchanged to media without the addition of hormones and the CBF was measured again 24 h later by suing the photoelectric technique. Setting: University teaching hospital, IVF unit. Results: Twenty-four hr after the addition of P to the culture medium in concentrations of 0.5 or 1 ng/ml a significant decline of the CBF down to 63% of the control level was observed (P < 0.001) and with P in concentration of 2 ng/ml or greater, 50-70% of the cilia were paralyzed. These effects of P were found to be reversible. Incubation with E2 induced a slight increase of 4% in the mean CBF (P = 0.002). Twenty-four hr incubation with Metrodin, Pergonal, or LH did nor affect ciliary motility. Conclusions: Higher levels of progesterone cause ciliary dysfunction and subsequently may be a possible cause of ectopic pregnancy.