Fig. 6: Schematic diagram showing the insufficiency of ADM in the pathogenesis of TEP.

Reduced ADM secretion by tubal epithelial cells contributes to excessive IL-6 and IL-8 production in fallopian tube macrophages, resulting in the up-regulation of implantation-related molecules (E-cadherin, active β-catenin, LIF and HoxA-10) in the tubal epithelium. Reduction of ADM caused decreased ciliary beat frequency, leading to embryo retention within the fallopian tube.