Alterations in Reproductive Function Flashcards
the main hormonal feedback pathway responsible for the reproductive system
HPO axis
the first menstrual cycle achieved
menarche
the opening from the uterus through the cervix into the vagina
os
the top of the uterus, during pregnancy this can be used as one measurement point for monitoring growth of the fetus
fundus
failure to achieve pregnancy after one year of unprotected sex, noting that if the female partner is over 35 years then the interval is shortened to 6 months
infertility
where a small catheter is passed into the uterus via the vagina and cervix so that the semen may be instilled directly into the uterus.
IUI (intra-uterine insemination)
the process by which the ova and semen are collected from the individuals and mixed together to permit fertilization to occur and after 3-5 days later 1-2 growing embryos are returned to the uterus, any remaining fertilized ova can be frozen for future attempts
IVF (in vitro fertilization)
the period of time from conception to the birth of the infant
prenatal or antenatal
the period of time from the delivery of the infant until complete resolution of the body to the pre-pregnant state, (usually 6-8 weeks)
post-natal
the number of deliveries that a women has had over 20 weeks gestation
parity
total number of pregnancies
Gravida
total # of deliveries over 37 weeks gestation
term
total # of deliveries between 20-37 weeks
Preterm
spontaneous or therapeutic
abortions
of living children
Living (L)
the point at which should a fetus deliver there is a reasonable expectation of survival, usually defined as 500gm or more than 20 weeks gestation.
viability
when the fetal head size has grown larger than can be passed vaginally
macrosomia
the amount of amniotic fluid is more than 2 standard deviations above the norm for gestational age.
polyhydramnios
when does sexual differentiation occur for an embryo?
7th week gestation
what is the testes determining factor?
SRY protein on male (Y) chromosome
stimulates the growth of follicles of the ovaries to produce estrogen, progesterone, and inhibin.
FSH
responsible for stimulating the ovulation
LH
development and maintenance of the female reproductive structures, secondary female characteristics such as adipose tissue deposition, voice pitch, broad pelvis and pattern of hair growth.
estrogen
can work synergistically with human growth hormone, it can increase protein synthesis including bones.
estrogen
is secreted mainly by the cells of the corpus luteum in the last 2 weeks of the menstrual cycle.
progesterone
It works with estrogen to prepare and maintain the endometrium and to prepare the mammary glands for lactation.
progesterone
is produced by the corpus luteum and it has a role to play with the relaxation of the uterine smooth muscle.
relaxin
is secreted by the granulosa cells of the follicles and together with the levels of estrogen and progesterone, these hormones provide feedback for the HPO axis, either stimulating or inhibiting further release of FSH and LH.
inhibin
normal range of menstrual cycle
24-36 days
when the uterus sheds all but the deepest layers of the endometrium - about 50-150mL of blood, tissue, fluid, mucus, and epithelial cells.
menstrual phase
day 1-5
menstruation is due to decreased amount of ___
progesterone and estrogen
This phase is the proliferative phase of the uterus as estrogen promotes the endometrial growth.
Maturation of the dominant follicle occurs due to FSH.
pre-ovulatory phase
day 6-14
The secondary oocyte is released into the pelvic cavity, surrounded by the zone pelucida and corona radiata.
Ovulation
Day 14
the progesterone and estrogen secreted by the corpus luteum causes further growth and coiling of the endometrial glands and thickening of the endometrium, all in preparation for a fertilized ovum.
Post-ovulatory phase
Day 15-28
fertilized ovum
zygote
Up to 2 weeks this collection of rapidly proliferating cells is called the ___
blastocyst
2-8 weeks gestation
embryo
8 weeks to birth
fetus
marker used to detect pregnancy in urine & blood
hCG - human chorionic gonadotope hormone
is specifically produced during pregnancy and the role is to maintain the corpus luteum, which produces the increasing amounts of progesterone needed to support and thicken the uterine lining
hCG
is a stage of rapid development of the ectodermal, endodermal and mesodermal layers for all the structures and systems in the human embryo and fetus.
embryogenesis
The _____ divides rapidly and creates small finger-like projections to the uterine myometrium to begin to form the chorionic villi.
trophoblast
The ____ fills in these projections with branches of umbilical vessels so that they become vascularized.
mesoderm
At ___ weeks, the chorionic villi and intervillous spaces or maternal sinuses has blood flowing and can facilitate nutrient and gas exchange.
10-14 weeks
is a membranous sac that surrounds the developing fetus and provides protection as the fetus grows.
The amnion
carries oxygenated blood to the fetus
umbilical vein
remove deoxygenated blood
umbilical arterties
carry deoxygenated blood to the lungs
pulmonary arteries
return the oxygenated blood to the heart
pulmonary veins
in which the major umbilical vessels separate in the fetal membranes before reaching the placental disk.
Velamentous
vessels are seen running unprotected through the membranes
vasa previa
Results from a lack of formation of a normal decidual plate. The chorionic villi extend into myometrium, and the placenta cannot separate normally following delivery and severe hemorrhage results.
Placenta accreta
is a condition whereby the placenta forms so that it is either completely or partially covering the uterine os.
placental previa
- maintain endometrium of uterus during pregnancy
- help prepare mammary glands for lactation
- prepare mother’s body for birth of baby
Progesterone
Estrogens
- increases flexibility of pubic symphysis
- helps dilate uterine cervix during labour
Relaxin
- helps prepare mammary glands for lactation
- enhances growth by increasing protein synthesis
- decreases glucose use and increases fatty acid use for ATP production
Human chorionic somatomammotropin (hCS)
- Establishes the timing of birth
- increases secretion of cortisol
corticotropin-releasing hormone
the uterine isthmus becomes soft and compressible
Hegar’s sign
a glycoprotein that binds testosterone and estradiol in the circulation to make them inactive, thus there will be more biologically active steroids available.
serum sex hormone-binding globulin (SHBG)
done to evaluate the patency of the fallopian tubes
HSG
hysterosalpingography
least invasive and involves instilling the semen directly into the uterus
IUI
intrauterine insemination
is a process whereby the ova and sperm are combined outside the body, permitted to develop for 3-5 days and then the resultant zygotes are transferred into the woman’s uterus.
in vitro fertilization
