19) The effects of ageing on the reproductive system Flashcards
Define ageing
the accumulation of physical and psychological changes that occur within a person over a period of time
What is the effect of changes in hormone levels on the female reproductive system?
many follicles don’t mature and rupture to release a secondary oocyte but instead, disappear over time until no follicles or oocytes are left
State the changes in oestrogen, FSH and LH levels in the female reproductive system due to ageing
secretion of oestrogen decreases
secretion of FSH and LH increase to peak 1-3 years after the last menstrual cycle then gradually decrease over time to 0
What do ovarian follicles capable of further development secrete?
anti-Mullerian hormone
What can the concentration of anti-Mullerian hormone in the blood indicate?
ovarian reserve
What can anti-Mullerian hormone be used as a measure of?
potential for IVF treatment to succeed
Female fertility has a _ correlation with age.
inverse
Describe changes in female fertility from puberty to 35 years
after puberty fertility increases to peak at 20-25 years and then slowly decreases to sudden drop at 35 years
Why does female fertility slowly decrease after around 25 years?
number of oocytes that can be successfully fertilised decrease
Define ovarian reserve
the ability for an ovary to produce oocytes that can be fertilised
Define menopause
the time the last menstrual cycle occurs caused by a lack of ovarian follicles
When does menopause usually occur?
50 - 54 years; after perimenopause
When is menopause completed?
when a woman has not experienced a menstrual period for one year
Name 7 commons symptoms of menopause
change in regularity of periods insomnia hot flushes high heart rate flushed skin night sweats heart racing / pounding
Name 6 additional possible symptoms of menopause
fall in libido depression headaches heart palpitations vaginal dryness (painful sexual intercourse) irritability and anxiety
Define hormone replacement therapy (HRT)
replacement of female hormones (oestrogen and progesterone) to relieve the symptoms of menopause
State and explain two types of hormone replacement therapy
unopposed oestrogen - oestrogen only
combined HRT - oestrogen with progestin (synthetic molecule with similar effects to progesterone, reduces the risk of uterine cancer from oestrogen)
State and explain two different ways hormone replacement can be administered
continuous schedule - same hormones continually through month as an oral tablet, skin patch or under-skin implant; no withdrawal bleeds
cyclical regime
- 3 weeks then withdrawal bleeds
- oestrogen continuously, progestin days 10-14 then withdrawal bleeds after day 14
Give 5 possible advantages of hormone replacement therapy
prevent hot flushes
reduce risk of developing osteoporosis
protective effect against loss of connective tissue
possible improvement in sleep and reduce in muscle ache
reduced mood swings and depressive symptoms
Give 2 potential side effects / disadvantages of hormone replacement therapy
fluid retention
breast tenderness
State 4 serious, rare health risks associated with hormone replacement therapy
venous thromboembolism (VTE)
stroke
breast cancer
endometrial (uterine) cancer
Suggest 6 reasons why HRT may not be suitable
history of breast, ovarian or endometrial cancer history of blood clots history of heart disease / stroke untreated high blood pressure liver disease irregular periods
Define and explain phytoestrogens, an alternative to hormone replacement therapy
phytoestrogens = chemicals found in plants that have a similar molecular structure to oestrogen / are converted to oestrogen-like compounds by gut bacteria
- antibacterial and antifungal properties
- taken as supplements / increase dietary intake
Name 3 different relaxation therapies as an alternative to hormone replacement therapy
yoga, aromatherapy, reflexology
Name 5 different lifestyle changes that can be made as an alternative to hormone replacement therapy
regular exercise reducing caffeine, alcohol and spicy food intake reduce stress levels give up smoking staying cool
State of a change in hormone levels in the male urinogenital system due to ageing, and a possible effect of this
decrease in testosterone production
reduced libido
How is male fertility affected by ageing? Why?
varies between individuals
- decreased rate of sperm production
- decrease in testicular tissue mass
- prostate gland, epididymis and seminal vesicles lose surface cells
- sclerosis can occur in the epididymis causing tissue to be less elastic
Define erectile dysfunction (impotence)
continued problem of a man being unable to get/maintain an erection firm enough to have intercourse
Why may erectile dysfunction not always be a direct result of physiological ageing?
may be caused by some medications or disorders e.g. hypertension, diabetes
Define benign prostate hyperplasia (BPH)
enlargement of the prostate gland due to prostate tissue being replaced with scar tissue
Give two possible consequences of benign prostate hyperplasia
problems with ejaculation
formation of large nodules that can compress the urethra, restricting the flow of urine from the bladder or slowing urination
Name 3 factors which contribute to enable successful conception
sufficient hormone levels
sufficient pH levels
healthy uterus lining
Name 4 factors which contribute to a decrease in fertility as women age
increase in FSH + LH (increasing risk of miscarriage)
decrease in oestrogen
thinner uterus lining until periods stop
reduced sexual activity (reduced sex drive)
Suggest some factors which cause male fertility to decrease with age
erections decline in duration, rigidity and frequency
penis is less sensitive, reduced blood flow, testosterone levels and sex drive
lower sperm concentration, mobility
changes in urinary function
Couples who have difficulty conceiving a child may try artificial insemination using donor sperm. Semen is collected from the donor and injected, using a small plastic tube: near the cervix (intra-cervical insemination, ICI) or into the uterus (intra-uterine insemination, IUI). Suggest why ICI is less successful than IUI.
sperm are injected further away
vagina / cervix is a hostile environment
Name the method used to store embryos for IVF
cryogenics / frozen embryo replacement
Suggest why embryos for IVF can only be stored for a limited period of time
limited by law
lack of viability
Describe how sperm are stored in sperm banks
mixed with chemicals to prevent damage
frozen
labelled
insulated metal container
Suggest what donor sperm and semen may be screened for before storing in a sperm bank
infectious diseases genetic disease sperm volume proportion of abnormalities in sperm sperm mobility
Suggest a situation where a man may be offered the option of having his sperm harvested and stored for future use
before radiotherapy / chemotherapy / surgery
if unable to have intercourse
terminal illness
in armed forces
Explain the trend that there is a decrease in the percentage of live births per treatment cycle of IVF with increasing age
implantation less likely in older women miscarriage rate increases fewer / unbalanced hormones or menopause genetic defects increase in oocyte placental function less efficient
