Embryology Flashcards
- Definition of Embryology
Embryology is the branch of medicine that studies human development
- What are the parts of the development period?
Embryonic period - beginning of embryo development, first eight weeks
Fetal period - begins on the ninth week of development
- When do you start counting the weeks of development?
In embryology, from the fertilisation
For pregnancy, from day one of last menstrual cycle (about two weeks earlier)
- Parts of uterine wall
Perimetrium - most external, vascularised
Myometrium - farthest away from the uterine cavity
Endometrium - composed by basal and functional layer
- Classification of functional layer of the endometrium
Compact layer - outermost layer, dense connective tissue that surrounds the neck of uterine gland
Spongy layer - highly vascularised, connective tissue, contains branched uterine glands
- Origin and storage of primordial germs cells.
Derive from epiblast during blastula development and remain dormant until puberty.
During the embryonic period the PGCs are kept aside in the yolk sac to be preserved from mutations
6th week of embryonic development - males PGCs will arrest divisions and enter premeiotic stage
5th month of embryonic development - same happens to females
- Effects of testosterone production.
All secondary sex characteristics, induces testis growth and seminiferous tubules maturation and commencement of spermatogenesis.
- Immune privilege of the testicles.
Sertoli cells + seminiferous tubules basement
Blood testis barrier
Needed because sperm cells are highly immune reactive
- Function of the epididymis.
Allows storage and full maturation of sperm cells
Adds fluids to help the travel.
- Capacitation of the sperm cells
Functional maturation that takes place as soon as it enters the female organs due the pH change
The acrosome prepares for the release of proteolytic enzymes to enter the zona pellucida
- Reasons for infertility.
Males
- Problems with the enzyme in the acrosome (IVF can solve)
Females
- Oogenesis
Fetal period - proliferation of immature oocyte to form primary oocyte.
Puberty - primary oocyte completes first meiotic division, forms secondary oocyte and one polar body that will degenerate
Ovulation - beginning of secondary division, which is completed in case of fertilisation
- Male meiosis inhibitor.
Microenviroment factor produced by Sertoli cells to help the differentiation of male PGCs
If the PGCs fail to reach the gonads they will mature as oocytes, even with the presence of the Y chromosome
- Menstrual cycle
Menstrual phase - shedding of functional layer of the endometrium
Proliferative phase - follicular cells will produce estrogen, estrogen will stimulate thickening of the uterine wall, once it’s thick enough, ovulation occurs and the mature follicle is released
Luteal phase - leftovers of the follicle degenerate and form the corpus luteum and produce progesterone inducing the differentiation of uterine wall cells in order to allow implantation
With no fertilisation, the cycle restarts
- What is the ovarian cycle?
The process that leads to the development of a mature follicle, followed by follicle rupture and oocyte expulsion for fertilisation
- How do primordial follicles mature into primary follicles?
Through the change of feeding cells from squamous epithelium to cuboidal epithelium (becomes thicker)
It’s yet unknown the specific process and hormones
- Which hormone will be responsible for the maturation of the follicles?
FSH will help proliferation and differentiation of the primary into mature follicles
- What are the four staged of the follicle maturation
- Unilaminar primary follicle (up to 150 µm, enlarged nucleus, cuboidal cells and beginning of basal lamina)
- Multifamiliar primary follicle (proliferation and stratification around oocyte, follicular cells are now granulosa or stromal cells and zona pellucida is formed)
- Secondary (antra) follicle (increased number of follicular cells and accumulation of liquor folliculi)
- Graafian (mature) follicle (formation of the antrum and corona radiata)
- What is the function of the theca interna and esterna?
Interna - originated by the granulosa cells, it will produce androstenedione (male sex hormone) which will be converted into estrogen
Esterna - made of fibrous connective tissue
- How and when the release of the oocyte happens?
On the day 14, a sudden surge of LH production by hypophysis will complete maturation and induce the release into the Fallopian tubes
- What is the cumulus oophorus?
They are the cells that attach the oocyte to the follicle wall
- What are the possible ends for the corpus luteum?
If fertilisation occurs, it increases in size and will keep producing progesterone and will begin producing hCG (human chorionic gonadotropin) that will help it’s survival
If it doesn’t, it will degenerates to corpus albicans and progesterone levels will drop causing menstruation
- What does IVF stand for?
In vitro fertilization
- What is IVF used for?
Induce pregnancy when fertilization isn’t possible: for example if there’s scarring in uterile tubes.
- How can the egg be retrieved to perform IVF?
FSH + clomiphene citrate (drug that prevents hypothalamic cells from detecting estrogen in blood)
- How would you check if the FSH is working using a blood test in IVF?
Estrogen level. If the FSH will actually help the follicle to grow, the estrogen level in the blood is supposed to go up.
3005.Once we have enough follicles ready, what do we need in order to reach complete maturation in IVF?
High Dose of LH
- At what stage is the oocyte implanted in IVF?
As late blastocyst
- What happens when blastocyst reaches uterus?
Gets rid of the zona pellucida and adheres to the uterine lining.
- What is the decidual reaction?
In endometrial stroma, adjacent cells respond to the presence of the blastocyst and of progesterone by differentiating into metabolically active cells, called decidual cells
- What do the endometrial glands right before implantation?
They enlarge, allowing vascularization of uterine wall, helping with the implantation
- What are the elements needed for implantation?
The secretion of both endometrial glands and decidual cells. They contain growth factors and metabolites that will contribute to the growth of the embryo
- What produces human chorionic gonadotropin (hCG) and what does it do?
If an embryo implants, cells of the trophoblast produce hCG, which supports the corpus luteum and thus maintains the supply of progesterone (maternal recognition of pregnancy
- What’s an ectopic pregnancy?
It’s when the blastocyst implants at the wrong location. Can be fatal to mother, because embryo keeps growing.
Has to be surgically stopped.
- How can ovulation be controlled?
Through the pill, contains estrogen + progestin
Blocks release of FSH and LH
- What drugs can be used to stop a pregnancy?
- RU-486, mifepristone, which is an antagonist of progesterone. Can be used up until 8 weeks after the last menstrual cycle.
- Plan B (the morning-after or day-after pill) is an abortifacient. Contains progestin levonorgestrel.
Must be taken soon after intercourse. It also works by inhibiting/delaying ovulation
- What do the cells of the blastocyst differentiate in?
- Embryoblasts (the inner cell mass), will lead to the formation of the body of the baby
- Trophoblasts (surrounding cells) feed growing embryo
- When does implantation start?
6 days after fertilization
- What happens during initiation of implantation?
Trophoblast starts to proliferate and then differentiates into 2 cell types called:
- Syncytiotrophoblast: outer layer that is composed of a multinucleated protoplasmic mass (formed by the fusion of cells)
- Cytotrophoblast: inner layer of the trophoblast
- What happens at the end of first week?
Syncytiotrophoblast develops finger-like projections which increase the area between itself and the uterine wall where the blastocyst will get implanted.
- How does implantation happen?
The implantation happens with syncytiotrophoblast invading the maternal endometrium
- What’s the embryonic pole?
It’s an area where the syncytiotrophoblast, the cytotrophoblast and the inner cell mass are connected
- Where does implantation happen?
In the endometrium and usually in the superior part of the uterus (fundus)
- First stage of implantation (1/4)
The actively erosive syncytiotrophoblast invades the endometrial connective tissue that supports the uterine capillaries and glands.
The blastocyst slowly embeds itself into the endometrium.
- Second stage of implantation (2/4)
Syncytiotrophoblast cells produce proteolytic enzymes that degrade all the collagen in CT . Trigger apoptosis in endometrial cells, which facilitates the implantation.
Decidual cells provide a rich source of nutrients, also control the depth of penetration of the syncytiotrophoblast.