Endoscopic visualization of the process of fimbrial ovum retrieval in the human.

The process of ovum retrieval by the fimbriae in the human still remains elusive. Animal studies have suggested that ova can be 'sucked' into the oviduct by negative pressure caused by muscular contractions of the tube, while laparoscopic observations in women have indicated a close relationship between fimbriae and the ovulating ovary. Here, a case is described in which the process of ovum retrieval was observed directly using a new endoscopic technique, called transvaginal hydrolaparoscopy. The access is through the posterior fornix of the vagina and saline is used for distension. The tubo-ovarian structures during the process of ovum retrieval were visualized under fluid. The fimbriae on the ovulatory side appeared congested and tumescent and showed pulsatile movements synchronous with the heartbeat. The cumulus mass was adherent to the fimbriae and released from the site of rupture by the sweeping movements of the fimbriae until it disappeared between the rigid fimbrial folds. To the best of our knowledge this is the first direct observation of the process of ovum retrieval in the human. Vascular congestion causing erection and pulsatile movements of the fimbriae play a role in the retrieval of the ovum. The retrieval process from the site of rupture is slow and transport is achieved by ciliary activity only. The fimbrial changes are apparently controlled by the ovulatory ovary.