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The fallopian tubes, also known as uterine tubes, oviducts or salpinges (singular salpinx), are paired tubes in the human female that stretch from the
uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The ...
to the ovaries. The fallopian tubes are part of the female reproductive system. In other mammals they are only called
oviduct The oviduct in mammals, is the passageway from an ovary. In human females this is more usually known as the Fallopian tube or uterine tube. The eggs travel along the oviduct. These eggs will either be fertilized by spermatozoa to become a zygote, ...
s. Each tube is a muscular
hollow organ In biology, an organ is a collection of tissues joined in a structural unit to serve a common function. In the hierarchy of life, an organ lies between tissue and an organ system. Tissues are formed from same type cells to act together in a ...
that is on average between 10 and 14 cm in length, with an external diameter of 1 cm. It has four described parts: the intramural part, isthmus, ampulla, and infundibulum with associated fimbriae. Each tube has two openings a proximal opening nearest and opening to the uterus, and a distal opening furthest and opening to the abdomen. The fallopian tubes are held in place by the mesosalpinx, a part of the broad ligament mesentery that wraps around the tubes. Another part of the broad ligament, the mesovarium suspends the ovaries in place. An
egg cell The egg cell, or ovum (plural ova), is the female reproductive cell, or gamete, in most anisogamous organisms (organisms that reproduce sexually with a larger, female gamete and a smaller, male one). The term is used when the female gamete is ...
is transported from an ovary to a fallopian tube where it may be fertilized in the ampulla of the tube. The fallopian tubes are lined with simple columnar epithelium with hairlike extensions called
cilia The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projecti ...
which together with peristaltic contractions from the muscular layer, move the fertilized egg (zygote) along the tube. On its journey to the uterus the zygote undergoes cell divisions that changes it to a
blastocyst The blastocyst is a structure formed in the early embryonic development of mammals. It possesses an inner cell mass (ICM) also known as the ''embryoblast'' which subsequently forms the embryo, and an outer layer of trophoblast cells called th ...
an early embryo, in readiness for implantation. Almost a third of cases of
infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal st ...
are caused by fallopian tube pathologies. These include
inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...
, and tubal obstructions. A number of tubal pathologies cause damage to the cilia of the tube which can impede movement of the sperm or egg. The name comes from the Italian
Catholic priest The priesthood is the office of the ministers of religion, who have been commissioned ("ordained") with the Holy orders of the Catholic Church. Technically, bishops are a priestly order as well; however, in layman's terms ''priest'' refers only ...
and
anatomist Anatomy () is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science that deals with the structural organization of living things. It is an old science, having it ...
Gabriele Falloppio, for whom other anatomical structures are also named.


Structure

Each fallopian tube leaves the uterus at an opening at the uterine horns known as the proximal tubal opening or ''proximal ostium''. The tubes have an average length of that includes the intramural part of the tube. The tubes extend to near the ovaries where they open into the abdomen at the distal tubal openings. In other mammals the fallopian tube is called the
oviduct The oviduct in mammals, is the passageway from an ovary. In human females this is more usually known as the Fallopian tube or uterine tube. The eggs travel along the oviduct. These eggs will either be fertilized by spermatozoa to become a zygote, ...
which may also be used in reference to the fallopian tube in the
human Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
. The fallopian tubes are held in place by the mesosalpinx a part of the broad ligament mesentery that wraps around the tubes. Another part of the broad ligament, the mesovarium suspends the ovaries in place.


Parts

Each tube is composed of four parts: from inside the proximal tubal opening the intramural or interstitial part, that links to the narrow isthmus, the isthmus connects to the larger ampulla, which connects with the infundibulum and its associated fimbriae that opens into the
peritoneal cavity The peritoneal cavity is a potential space between the parietal peritoneum (the peritoneum that surrounds the abdominal wall) and visceral peritoneum (the peritoneum that surrounds the internal organs). The parietal and visceral peritonea are lay ...
from the distal tubal opening.


Intramural part

The intramural part or interstitial part of the fallopian tube lies in the myometrium, the muscular wall of the uterus. This is the narrowest part of the tube that crosses the uterus wall to connect with the isthmus. The intramural part is 0.7 mm wide and 1 cm long.


Isthmus

The narrow isthmus links the tube to the uterus, and connects to the ampulla. The isthmus is a rounded, and firm muscular part of the tube. The isthmus is 1–5 mm wide, and 3 cm long. The isthmus contains a large number of secretory cells.


Ampulla

The ampulla is the major part of the fallopian tube. The ampulla is the widest part of the tube with a maximal luminal diameter of 1 cm, and a length of 5 cm. It curves over the ovary, and is the primary site of fertilization. The ampulla contains a large number of ciliated epithelial cells. It is thin walled with a much folded luminal surface, and opens into the infundibulum.


Infundibulum

The infundibulum opens into the abdomen at the distal tubal opening and rests above the ovary. Most cells here are ciliated epithelial cells. The opening is surrounded by fimbriae, which help in the collection of the oocyte after ovulation. The fimbriae (singular fimbria) is a fringe of densely ciliated tissue projections of approximately 1 mm in width around the distal tubal opening, oriented towards the ovary. They are attached to the ends of the infundibulum, extending from its inner circumference, and muscular wall. The cilia beat towards the fallopian tube. Of all the fimbriae, one fimbria known as the ovarian fimbria is long enough to reach and make contact with the near part of the ovary during ovulation. The fimbriae have a higher density of blood vessels than the other parts of the tube, and the ovarian fimbria is seen to have an even higher density. An ovary is not directly connected to its adjacent fallopian tube. When ovulation is about to occur, the sex hormones activate the fimbriae, causing them to swell with blood, extend, and hit the ovary in a gentle, sweeping motion. An oocyte is released from the ovary into the peritoneal cavity and the cilia of the fimbriae sweep it into the fallopian tube.


Microanatomy

When viewed under the microscope, the fallopian tube has three layers. From outer to inner, these are the
serosa The serous membrane (or serosa) is a smooth tissue membrane of mesothelium lining the contents and inner walls of body cavities, which secrete serous fluid to allow lubricated sliding movements between opposing surfaces. The serous membrane ...
, muscularis mucosae, and the mucosa. The outermost covering layer of serous membrane is known as the serosa. The serosa is derived from the visceral
peritoneum The peritoneum is the serous membrane forming the lining of the abdominal cavity or coelom in amniotes and some invertebrates, such as annelids. It covers most of the intra-abdominal (or coelomic) organs, and is composed of a layer of mesot ...
. The muscularis mucosae consists of an outer ring of
smooth muscle Smooth muscle is an involuntary non- striated muscle, so-called because it has no sarcomeres and therefore no striations (''bands'' or ''stripes''). It is divided into two subgroups, single-unit and multiunit smooth muscle. Within single-unit ...
arranged longitudinally, and a thick inner circular ring of smooth muscle. This layer is responsible for the rhythmic peristaltic contractions of the fallopian tubes, that with the cilia move the egg cell towards the uterus. The innermost mucosa is made up of a layer of luminal epithelium, and an underlying thin layer of
loose connective tissue Loose connective tissue, sometimes called areolar tissue, is a cellular connective tissue with thin and relatively sparse collagen fibers. Its ground substance occupies more volume than the fibers do. It has a viscous to gel-like consisten ...
the lamina propria. There are three different cell types in the epithelium. Around 25% of the cells are ciliated columnar cells; around 60% are secretory cells, and the rest are peg cells thought to be a secretory cell variant. The ciliated cells are most numerous in the infundibulum, and the ampulla.
Estrogen Estrogen or oestrogen is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three major endogenous estrogens that have estrogenic hormonal a ...
increases the formation of cilia on these cells. Peg cells are shorter, have surface microvilli, and are located between the other epithelial cells. The presence of immune cells in the mucosa has also been reported with the main type being CD8+ T-cells. Other cells found are
B lymphocyte B cells, also known as B lymphocytes, are a type of white blood cell of the lymphocyte subtype. They function in the humoral immunity component of the adaptive immune system. B cells produce antibody molecules which may be either secreted ...
s, macrophages, NK cells, and
dendritic cell Dendritic cells (DCs) are antigen-presenting cells (also known as ''accessory cells'') of the mammalian immune system. Their main function is to process antigen material and present it on the cell surface to the T cells of the immune system. ...
s. The histological features of tube vary along its length. The mucosa of the ampulla contains an extensive array of complex folds, whereas the relatively narrow isthmus has a thick muscular coat and simple mucosal folds.


Development

Embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sperm ...
s develop a genital ridge that forms at their tail end and eventually forms the basis for the
urinary system The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, ...
and reproductive tracts. Either side and to the front of this tract, around the sixth week develops a duct called the
paramesonephric duct Paramesonephric ducts (or Müllerian ducts) are paired ducts of the embryo that run down the lateral sides of the genital ridge and terminate at the sinus tubercle in the primitive urogenital sinus. In the female, they will develop to form the f ...
, also called the Müllerian duct. A second duct, the mesonephric duct, develops adjacent to this. Both ducts become longer over the next two weeks, and the paramesonephric ducts around the eighth week cross to meet in the midline and fuse. One duct then regresses, with this depending on whether the embryo is genetically
female Female (symbol: ♀) is the sex of an organism that produces the large non-motile ova (egg cells), the type of gamete (sex cell) that fuses with the male gamete during sexual reproduction. A female has larger gametes than a male. Females a ...
or
male Male (Mars symbol, symbol: ♂) is the sex of an organism that produces the gamete (sex cell) known as sperm, which fuses with the larger female gamete, or ovum, in the process of fertilization. A male organism cannot sexual reproduction, repro ...
. In females, the paramesonephric duct remains, and eventually forms the female reproductive tract. The portions of the paramesonephric duct which are more cranial—that is, further from the tail-end, end up forming the fallopian tubes. In males, because of the presence of the Y sex
chromosome A chromosome is a long DNA molecule with part or all of the genetic material of an organism. In most chromosomes the very long thin DNA fibers are coated with packaging proteins; in eukaryotic cells the most important of these proteins ar ...
, anti-Müllerian hormone is produced. This leads to the degeneration of the paramesonephric duct. As the uterus develops, the part of the fallopian tubes closer to the uterus, the ampulla, becomes larger. Extensions from the fallopian tubes, the fimbriae, develop over time. Cell markers have been identified in the fimbriae which suggests that their embryonic origin is different from that of the other tube segments. Apart from the presence of sex chromosomes, specific genes associated with the development of the fallopian tubes include the Wnt and Hox groups of genes, Lim1, Pax2, and Emx2.
Embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sperm ...
s have two pairs of ducts that will let
gamete A gamete (; , ultimately ) is a haploid cell that fuses with another haploid cell during fertilization in organisms that reproduce sexually. Gametes are an organism's reproductive cells, also referred to as sex cells. In species that produce ...
s out of the body when they are adults; one pair (the Müllerian ducts) develops in females into the fallopian tubes, uterus, and
vagina In mammals, the vagina is the elastic, muscular part of the female genital tract. In humans, it extends from the vestibule to the cervix. The outer vaginal opening is normally partly covered by a thin layer of mucosal tissue called the hy ...
, while the other pair (the
Wolffian duct The mesonephric duct (also known as the Wolffian duct, archinephric duct, Leydig's duct or nephric duct) is a paired organ that forms during the embryonic development of humans and other mammals and gives rise to male reproductive organs. Struc ...
s) develops in males into the
epididymis The epididymis (; plural: epididymides or ) is a tube that connects a testicle to a vas deferens in the male reproductive system. It is a single, narrow, tightly-coiled tube in adult humans, in length. It serves as an interconnection between t ...
and vas deferens. The homologous organ in the male is the appendix testis.


Function


Fertilization

The fallopian tube allows the passage of an egg from the ovary to the uterus. When an
oocyte An oocyte (, ), oöcyte, or ovocyte is a female gametocyte or germ cell involved in reproduction. In other words, it is an immature ovum, or egg cell. An oocyte is produced in a female fetus in the ovary during female gametogenesis. The femal ...
is developing in an ovary, it is surrounded by a spherical collection of cells known as an
ovarian follicle An ovarian follicle is a roughly spheroid cellular aggregation set found in the ovaries. It secretes hormones that influence stages of the menstrual cycle. At the time of puberty, women have approximately 200,000 to 300,000 follicles, each with t ...
. Just before ovulation, the primary oocyte completes meiosis I to form the first polar body and a secondary oocyte which is arrested in
metaphase Metaphase ( and ) is a stage of mitosis in the eukaryotic cell cycle in which chromosomes are at their second-most condensed and coiled stage (they are at their most condensed in anaphase). These chromosomes, carrying genetic information, align ...
of meiosis II. At the time of
ovulation Ovulation is the release of eggs from the ovaries. In women, this event occurs when the ovarian follicles rupture and release the secondary oocyte ovarian cells. After ovulation, during the luteal phase, the egg will be available to be fertilize ...
in the
menstrual cycle The menstrual cycle is a series of natural changes in hormone production and the structures of the uterus and ovaries of the female reproductive system that make pregnancy possible. The ovarian cycle controls the production and release of eg ...
, the secondary oocyte is released from the ovary. The follicle and the ovary's wall rupture, allowing the secondary oocyte to escape. The secondary oocyte is caught by the fimbriated end of the fallopian tube and travels to the ampulla. Here, the egg is able to become fertilized with sperm. The ampulla is typically where the sperm are met and fertilization occurs; meiosis II is promptly completed. After fertilization, the ovum is now called a
zygote A zygote (, ) is a eukaryotic cell formed by a fertilization event between two gametes. The zygote's genome is a combination of the DNA in each gamete, and contains all of the genetic information of a new individual organism. In multicell ...
and travels toward the uterus with the aid of the hairlike
cilia The cilium, plural cilia (), is a membrane-bound organelle found on most types of eukaryotic cell, and certain microorganisms known as ciliates. Cilia are absent in bacteria and archaea. The cilium has the shape of a slender threadlike projecti ...
and the activity of the muscle of the fallopian tube. The early embryo requires critical development in the fallopian tube. After about five days, the new
embryo An embryo is an initial stage of development of a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sperm ...
enters the
uterine cavity The uterine cavity is the inside of the uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal devel ...
and, on about the sixth day, begins to
implant Implant can refer to: Medicine *Implant (medicine), or specifically: ** Brain implant ** Breast implant **Buttock implant **Cochlear implant **Contraceptive implant **Dental implant ** Fetal tissue implant **Implantable cardioverter-defibrillator ...
on the wall of the uterus. The release of an oocyte does not alternate between the two ovaries and seems to be random. After removal of an ovary, the remaining one produces an egg every month.


Clinical significance

Almost a third of cases of
infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal st ...
are caused by fallopian tube pathologies. These include inflammation, and tubal obstructions. A number of tubal pathologies cause damage to the cilia of the tube which can impede movement of the sperm or egg. A number of sexually transmitted infections can lead to infertility.


Inflammation

Salpingitis is inflammation of the fallopian tubes and may be found alone, or with other
pelvic inflammatory disease Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. Often, there may be no ...
s (PIDs). A thickening of the fallopian tube at its narrow isthmus portion, due to inflammation, is known as salpingitis isthmica nodosa. Like another PID
endometriosis Endometriosis is a disease of the female reproductive system in which cells similar to those in the endometrium, the layer of tissue that normally covers the inside of the uterus, grow outside the uterus. Most often this is on the ovaries, ...
, it may lead to fallopian tube obstruction. Fallopian tube obstruction may be a cause of
infertility Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species (mostly haplodiploid insects). It is the normal st ...
or
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these sympt ...
.


Blockage or narrowing

If a blocked fallopian tube has affected fertility, its repair where possible may increase the chances of becoming pregnant. Tubal obstruction can be proximal, distal or mid-segmental.Tubal obstruction is a major cause of infertility but full testing of tubal functions is not possible. However, the testing of patency – whether or not the tubes are open can be carried out using hysterosalpingography, laparoscopy and dye, or hystero contrast sonography (HyCoSy). During surgery, the condition of the tubes may be inspected and a dye such as
methylene blue Methylthioninium chloride, commonly called methylene blue, is a salt used as a dye and as a medication. Methylene blue is a thiazine dye. As a medication, it is mainly used to treat methemoglobinemia by converting the ferric iron in hemoglob ...
can be injected into the uterus and shown to pass through the tubes when the
cervix The cervix or cervix uteri (Latin, 'neck of the uterus') is the lower part of the uterus (womb) in the human female reproductive system. The cervix is usually 2 to 3 cm long (~1 inch) and roughly cylindrical in shape, which changes durin ...
is occluded. As tubal disease is often related to ''Chlamydia'' infection, testing for ''Chlamydia'' antibodies has become a cost-effective screening device for tubal pathology.


Ectopic pregnancy

Occasionally the embryo
implants Implant can refer to: Medicine *Implant (medicine), or specifically: **Brain implant **Breast implant **Buttock implant **Cochlear implant **Contraceptive implant **Dental implant **Fetal tissue implant **Implantable cardioverter-defibrillator ** ...
outside of the uterus, creating an
ectopic pregnancy Ectopic pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus. Signs and symptoms classically include abdominal pain and vaginal bleeding, but fewer than 50 percent of affected women have both of these sympt ...
. Most ectopic pregnancies occur in the fallopian tube, and are commonly known as ''tubal pregnancies''.


Surgery

The surgical removal of a fallopian tube is called a salpingectomy. To remove both tubes is a bilateral salpingectomy. An operation that combines the removal of a fallopian tube with the removal of at least one ovary is a salpingo-oophorectomy. An operation to remove a fallopian tube obstruction is called a tuboplasty. A surgical procedure to permanently prevent conception is tubal ligation.


Cancer

Fallopian tube cancer, which typically arises from the
epithelial Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellu ...
lining of the fallopian tube, has historically been considered to be a very rare malignancy. Evidence suggests it probably represents a significant portion of what has previously been classified as
ovarian cancer Ovarian cancer is a cancerous tumor of an ovary. It may originate from the ovary itself or more commonly from communicating nearby structures such as fallopian tubes or the inner lining of the abdomen. The ovary is made up of three different ...
, as much as 80 per cent. These are classed as
serous carcinoma A serous tumour is a neoplasm that typically has papillary to solid formations of tumor cells with crowded nuclei, and which typically arises on the modified Mullerian-derived serous membranes that surround the ovaries in females. Such ovaria ...
s, and are usually located in the fimbriated distal tube.


Other

In rare cases a fallopian tube may
prolapse In medicine, prolapse is a condition in which organs fall down or slip out of place. It is used for organs protruding through the vagina, rectum, or for the misalignment of the valves of the heart. A spinal disc herniation is also sometimes ...
into the vaginal canal following a
hysterectomy Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries ( oophorectomy), Fallopian tubes ( salpingectomy), and other surrounding structures. Usually performed by a gynecologist, a hysterectomy may ...
. The swollen fimbriae can have the appearance of an
adenocarcinoma Adenocarcinoma (; plural adenocarcinomas or adenocarcinomata ) (AC) is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular origin, glandular characteristics, o ...
.


History

The fallopian tube was first described as a structure linked to fertilization by the
Greek Greek may refer to: Greece Anything of, from, or related to Greece, a country in Southern Europe: *Greeks, an ethnic group. *Greek language, a branch of the Indo-European language family. **Proto-Greek language, the assumed last common ancestor ...
physician
Soranus of Ephesus Soranus of Ephesus ( grc-gre, Σωρανός ὁ Ἑφέσιος; 1st/2nd century AD) was a Greek physician. He was born in Ephesus but practiced in Alexandria and subsequently in Rome, and was one of the chief representatives of the Methodic ...
(
1st century The 1st century was the century spanning AD 1 ( I) through AD 100 ( C) according to the Julian calendar. It is often written as the or to distinguish it from the 1st century BC (or BCE) which preceded it. The 1st century is considered part of ...
AD). The fallopian tubes were named by
Vesalius Andreas Vesalius (Latinized from Andries van Wezel) () was a 16th-century anatomist, physician, and author of one of the most influential books on human anatomy, '' De Humani Corporis Fabrica Libri Septem'' (''On the fabric of the human body'' ...
after his assistant the 16th-century Italian anatomist Gabriele Falloppio, the first person to provide a detailed description of the tubes. He thought they resembled
trumpet The trumpet is a brass instrument commonly used in classical and jazz ensembles. The trumpet group ranges from the piccolo trumpet—with the highest register in the brass family—to the bass trumpet, pitched one octave below the standar ...
s, ' in Italian, which was misunderstood and became the English "tube". Though the name ''Fallopian tube'' is
eponymous An eponym is a person, a place, or a thing after whom or which someone or something is, or is believed to be, named. The adjectives which are derived from the word eponym include ''eponymous'' and ''eponymic''. Usage of the word The term ''epon ...
, it is often spelt with a lower case ''f'' from the assumption that the adjective ''fallopian'' has been absorbed into modern English as the ' name for the structure.
Merriam-Webster Merriam-Webster, Inc. is an American company that publishes reference books and is especially known for its dictionaries. It is the oldest dictionary publisher in the United States. In 1831, George and Charles Merriam founded the company as ...
dictionary for example lists ''fallopian tube'', often spelt ''Fallopian tube''.


Additional images

File:Illu ovary.jpg, Image showing numbered parts of the fallopian tubes and surrounding structures File:Scheme female reproductive system-number-full-cropped.svg, Female reproductive system numbered parts File:Gray1161.png, Image showing the right fallopian tube (here labeled the uterine tube) seen from behind. The uterus, ovaries and right broad ligament are labeled. File:Normal Fallopian Tube, Human.jpg, Cross-section of fallopian tube,
stained A stain is a discoloration that can be clearly distinguished from the surface, material, or medium it is found upon. They are caused by the chemical or physical interaction of two dissimilar materials. Accidental staining may make materials app ...
and viewed under microscope


References


External links


Histology image: 18501loa
– Histology Learning System at Boston University

{{DEFAULTSORT:Fallopian Tube Pelvis Human female reproductive system