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Endo > 11: Endocrinology of pregnancy > Flashcards

11: Endocrinology of pregnancy Flashcards

1
Q

What hormone induces tubular reabsorption in the male reproductive tract?

A

Oestrogen

Concentrates the sperm

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2
Q

What hormone induces nutrient and glycoprotein secretion into the epididymal fluid?

A

Androgens

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3
Q

How many sperm in semen?

A

15-120 million/ml

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4
Q

How much seminal fluid in semen?

A

2-5 ml

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5
Q

How many sperm reach the egg?

A

1 in a million

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6
Q

What parts of the male reproductive system make the seminal fluid?

A

Mostly from accessory sex glands:

  • Seminal vesicles
  • Prostate
  • Bulbourethral glands

Some contribution from epididymis/testis

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7
Q

Give 3 ways in which sperm cells achieve capacitation

A
  1. Loss of glycoprotein coat
  2. Change in surface membrane characteristics
  3. Develop WHIPLASH movements of tail
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8
Q

Where does capacitation take place and what is required for it?

A

Occurs in ionic & proteolytic environment in Fallopian tube
Need oestrogen + calcium

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9
Q

What is the acrosome reaction?

A

Mechanism by which sperm penetrates the Zona Pellucida of ovum

  1. Sperm binds to ZP3 glycoprotein receptor on egg
  2. This causes Ca2+ influx into sperm (stimulated by progesterone)
  3. Release of hyaluronidase & proteolytic enzymes from the acrosome which breaks down Zona pellucida
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10
Q

What happens during fertilisation?

A

Occurs in fallopian tube

Fertilisation triggers CORTICAL reaction:
Cortical granules within the egg release molecules that degrade the Zona Pellucida (including ZP2&3 receptors).
This prevents further sperm from binding to the egg

Egg turns from haploid to DIPLOID (since sperm provides father’s set of chromosomes)

This egg is now a 1-cell ZYGOTE

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11
Q

Where does the conceptus get its nutrients from?

A

Uterine secretions

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12
Q

How long does the free-living phase last? (phase before attaching to endometrium)

A

9-10 days

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13
Q

Describe the divisions of the conceptus as it moves down the fallopian tube to the uterus

A

1-cell zygote (fertilised egg)
2 cell conceptus
4 cell conceptus
8 cell conceptus

Then COMPACTION occurs and forms the MORULA
Morula develops into a BLASTOCYST

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14
Q

Describe the structure of blastocyst

A

Trophoblast cells on the outside (which will later form the chorion)

Inner cell mass (which develops into the embryo)

Blastocoelic cavity

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15
Q

What are the 2 steps of implantation?

A
  1. Attachment phase: Trophoblast cells contact the uterine surface epithelium
  2. Decidualisation phase: Changes in underlying uterine stromal tissue
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16
Q

What 2 things are required for implantation to occur?

A

Progesterone domination + oestrogen

17
Q

Describe the attachment phase

A
  1. Leukemia Inhibitory Factor (LIF) = released from endometrial secretory glands - stimulates ADHESION of blastocyst to endometrial cells
  2. IL-11 = Also from endometrial cells, released into uterine fluid
18
Q

What happens in the decidualisation phase?

A

Endometrial changes due to progesterone

  1. Glandular epithelial secretion
  2. Glycogen accumulation in stromal cell cytoplasm
  3. Growth of capillaries
  4. Increased vascular permeability
19
Q

What factors other than progesterone are involved in the decidualisation phase?

A

IL-11
Histamine
Other prostoglandins
TGF-beta (promotes angiogenesis)

20
Q

What is hCG and where is it produced?

A

Human Chorionic Gonadotrophin

Produced by the placenta
This is what we test for in urine pregnancy tests

21
Q

After conception, where is progesterone produced?

A

First 40 days in Corpus Luteum (maternal ovary)
This is stimulated by hCG (produced by trophoblasts) which bind to LH receptors

From day 40, placenta takes over (luteoplacental shift)

22
Q

What else does hCG do during pregnancy?

A

Drives the release of oestrogen

Inhibits maternal FSH/LH

23
Q

What hormones are increased during pregnancy?

A 
ACTH
Adrenal steroids
Prolactin
IGF1 (Placenta releases GH variant)
Iodothyronines
PTH related peptides
24
Q

What hormones are decreased during pregnancy?

A

Gonadotrophins (due to high oestrogen -> negative feedback)
Pituitary GH
TSH

25
Q

How is an increase in iodothyronines stimulated?

A

hCG shares alpha subunit with TSH, so high hCG will also sitmulate thyroid

26
Q

Describe the endocrine effects on labour (parturition)

A

Oxytocin binds to its receptors (upregulated during pregnancy) on endometrial muscle, causing Ca2+ influx -> uterine contractions

Oestrogen (from placenta) can also activate oxytocin receptors.
Oestrogen also activates Phospholipase A2 which also causes release of Ca2+ from microsomes within the uterus.

Cortisol, produced from the fetal adrenals, can also influence labour

Progesterone has negative effects on oxytocin receptors and Phospholipase A2

27
Q

Describe the endocrine control of lactation

A

Suckling -> hypothalamus -> pituitary

Neurohypophysis -> Oxytocin -> Milk ejection

Adenohypophysis -> Prolactin -> Milk synthesis

Endo (13 decks)

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