172 phase is characterized by contractions directed towards the fundus at a high frequency. Uterine peristalsis is relatively quiescent during the luteal and earlyto-mid follicular phases (238). If uterine contractile patterns differ significantly from the norm, dysperistalsis occurs, leading to uncoordinated and ineffective uterine contractions. Relative consensus exists as to how uterine behaviour changes throughout the menstrual cycle; however, little is known about uterine activity in abnormal uteri, and if altered contractions are the intermediate for lower fertility outcomes and/or other symptomatology. It is well known that uterine abnormalities are associated with subfertility (239–242). We hypothesise that these uterine abnormalities such as uterine fibroids, adenomyosis and congenital uterine anomalies may disrupt uterine peristalsis thereby contributing to the associated symptoms of these disorders. In this systematic review we investigated the available literature to assess if uterine peristalsis is adversely affected in women with such uterine abnormalities. The primary objective of this review is to assess the influence of uterine abnormalities on uterine peristalsis, including leiomyomas, adenomyosis and congenital uterine anomalies.
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