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However, little is known about how excess testosterone affects the function of the human fallopian tube\u2014the site of gamete transport, fertilization, and early embryogenesis. Therefore, this study aimed to characterize alterations caused by long\u2010term exposure to male testosterone levels. For this purpose, the Fallopian tubes of nine female\u2010to\u2010male transsexuals, who had been undergoing testosterone treatment for 1\u20133 years, were compared with the tubes of 19 cycling patients. In the ampulla, testosterone treatment resulted in extensive luminal accumulations of secretions and cell debris which caused ciliary clumping and luminal blockage. Additionally, the percentage of ciliated cells in the ampulla was significantly increased. Transsexual patients, who had had sexual intercourse before surgery, showed spermatozoa trapped in mucus. Finally, in the isthmus complete luminal collapse occurred. Our results imply that fertility in women with elevated levels of testosterone is altered by tubal luminal obstruction resulting in impaired gamete transport and survival.<\/jats:p>","DOI":"10.1002\/mrd.23291","type":"journal-article","created":{"date-parts":[[2019,11,9]],"date-time":"2019-11-09T17:33:56Z","timestamp":1573320836000},"page":"30-44","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["How do elevated levels of testosterone affect the function of the human fallopian tube and fertility?\u2014New insights"],"prefix":"10.1002","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4312-1366","authenticated-orcid":false,"given":"Kate","family":"Dulohery","sequence":"first","affiliation":[{"name":"School of Medicine, Health Sciences Centre University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Trottmann","sequence":"additional","affiliation":[{"name":"Department of Urology Klinikum Grosshadern, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Bour","sequence":"additional","affiliation":[{"name":"Department of Urology Klinikum Grosshadern, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Liedl","sequence":"additional","affiliation":[{"name":"Department of Urogenital Surgery Clinic for Surgery Munich\u2010Bogenhausen Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Alba\u2010Alejandre","sequence":"additional","affiliation":[{"name":"Department of Gynaecology Klinikum Grosshadern, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4605-9791","authenticated-orcid":false,"given":"Sven","family":"Reese","sequence":"additional","affiliation":[{"name":"Department of Veterinary Sciences, Institute of Veterinary Anatomy Histology and Embryology, LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Hughes","sequence":"additional","affiliation":[{"name":"School of Medicine, Health Sciences Centre University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3291-9460","authenticated-orcid":false,"given":"Christian G.","family":"Stief","sequence":"additional","affiliation":[{"name":"Department of Urology Klinikum Grosshadern, LMU Munich  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-0498","authenticated-orcid":false,"given":"Sabine","family":"K\u00f6lle","sequence":"additional","affiliation":[{"name":"School of Medicine, Health Sciences Centre University College Dublin Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)49155-7"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1095\/biolreprod66.2.297"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del474"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijir.2013.9"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2014-1198"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00507-8"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00323-4"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2011.06.031"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)35940-4"},{"issue":"3","key":"e_1_2_8_11_1","first-page":"219","article-title":"Microplicae\u2010like structures of the fallopian tube in postmenopausal women as shown by electron microscopy","volume":"21","author":"Correr S.","year":"2006","journal-title":"Histology and Histopathology"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1096\/fj.201600078R"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a138428"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0212"},{"key":"e_1_2_8_15_1","unstructured":"Dubowsky S. 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