title: Retrograde seeding of endometrial epithelial cells by uterine-tubal flushing.
abstract: OBJECTIVE
  To estimate the amount of endometrial epithelial cells in peritoneal fluid (PF) after uterine-tubal flushing (40 mL) throughout the menstrual cycle.
  
  
  METHODS
  We cultured the cell pellet of flush medium present in the peritoneal cavity.
  
  
  METHODS
  University Hospital Nijmegen, The Netherlands.
  
  
  METHODS
  Ninety-two women with various infertility-related factors.
  
  
  METHODS
  (1) ovulatory cycle, (2) patent tubes, and (3) no adhesions.
  
  
  METHODS
  None
  
  
  METHODS
  The number of developing epithelial cell colonies were counted after 7 days. We started to record the amount of flush medium recovered during the study.
  
  
  RESULTS
  The amount of flush medium recovered was positively correlated with the presence of endometriosis (P = 0.017). Endometrial epithelial cells were identified in 85 flush media (92%). The number of epithelial cell colonies varied from 0 to 100 or more and was higher when flushing was performed during the early follicular phase (P less than 0.01). High estradiol-17 beta and progesterone levels in culture medium did not change the number of developing cell colonies. Methylene blue significantly reduced the number of cell colonies (P = 0.002).
  
  
  CONCLUSIONS
  Uterine-tubal flushing results in varying numbers of endometrial epithelial cells in PF. Methylene blue adversely affects the growth potential of these cells.
authors.affiliation: Department of Obstetrics and Gynecology, St. Radboud University Hospital, School of Medicine, University of Nijmegen, The Netherlands.
authors.forename: R F
authors.initials: RF
authors.lastname: Kruitwagen
authors.forename: L G
authors.initials: LG
authors.lastname: Poels
authors.forename: W N
authors.initials: WN
authors.lastname: Willemsen
authors.forename: P H
authors.initials: PH
authors.lastname: Jap
authors.forename: C M
authors.initials: CM
authors.lastname: Thomas
authors.forename: R
authors.initials: R
authors.lastname: Rolland
mesh_terms: D002455:Cell Division / Q000187:drug effects; D004717:Endometrium / Q000166:cytology*; D004847:Epithelial Cells; D004958:Estradiol / Q000494:pharmacology; D005187:Fallopian Tubes; D005260:Female; D006801:Humans; D008751:Methylene Blue / Q000494:pharmacology; D011374:Progesterone / Q000494:pharmacology; D012044:Regression Analysis; D007507:Therapeutic Irrigation
chemical_list: D011374:Progesterone; D004958:Estradiol; D008751:Methylene Blue