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eLCRS - 엔도 > Endo 11: endocrinology of pregnancy > Flashcards

Endo 11: endocrinology of pregnancy Flashcards

1
Q

Most tubular fluid = reabsorbed in the ________ + _______ under the control of oestrogen

A

Most tubular fluid = reabsorbed in the RETE RESTIS + EARLY EPIDIDYMIS under the control of oestrogen

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2
Q

Where is oestrogen mainly produced by?

A

sertoli cells.

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3
Q

nutrients = secreted into epididymal fluid to:

A
  • provide energy for impending possible journey
  • to coat surface of spermatozoon

–> nutrients = secreted under influence of androgens

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4
Q

What does semen contain?

A
  • spermatozoa
  • seminal fluid
  • leucocytes
  • potentialy virus e.g HIV
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5
Q

Where does seminal fluid mainly come from?

A

mainly from accessory sex glands

  • seminal vesicles
  • prostate
  • bulbourethral glands

small contribution from epididymis

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6
Q

What 3 stages are involved in the capacitation of sperm?

A
  1. loss of glycoprotein coat
  2. change in surface memb characteristics
  3. development of whiplash movements of tail
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7
Q

Where does capacitation of sperm take place in?

A

takes place in ionic + proteolytic environment of the fallopian tube

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8
Q

Capacitation is dependent on 2 things.

what are the 2 things?

A
  • oestrogen dependent

- Ca2+ dependent

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9
Q

What causes calcium dependent acrosome reaction?

A
  • sperm approaches ovum
  • spermatozoon binds to ZP3 glycoprotein on zona pellucida (outer layer of ovum)
  • once bound –>progesterone stimulates Ca2+ influx into the spermatozoon
  • causes Ca2+ dependent acrosome reaction
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10
Q

What happens after Ca2+ dependent acrosome reaction?

A
  • enables exposed spermatozoon recognition site to bind to 2nd glycoprotein ZP2
  • once bound –> acrosome released enzymes
  • allows penetration of zona pellucid
  • so head of spermatozoon can enter the ovum .
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11
Q

Fertilisation results in expulsion of ______________

A

Fertilisation results in expulsion of 2nd polar body

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12
Q

what happens in zonal reaction after fertilization?

A
  • ca2+ dependent process:
  • cortical granules release molecules that degrade the zona pellucida
  • which prevents binding of other sperms
  • when diploidy = established, zygote starts dividing to form initial 2-cell conceptus
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13
Q

Describe the development of the Conceptus

A
  • conceptus continues to divide as it moves down fallopian tube –> to uterus (3-4 days)
  • it receives nutrients from uterine secretions
  • and this free living phase can last for 9-10 days
  • the conceptus undergoes compaction to form a 8-16 morula
  • then it becomes a blastocyst
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14
Q

inner cell mass of blastocyst becomes:

A

inner cell mass of blastocyst becomes: the embryo

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15
Q

Trophectoderm of blastocyst becomes:

A

Trophectoderm of blastocyst becomes: the chorion –> which later becomes placenta

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16
Q

What are the 2 phases of implantation?

A
  1. attachment phase

2. decidualisation phase

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17
Q

What happens in the attachment phase?

A
  • outer trophoblast cells come into contact with the uterine surface epithelium
18
Q

What happens in the decidualisation phase?

A

“endometrial changes due to progesterone”

  • glandular epithelial secretion
  • glycogen accumulation in stroll cell cytoplasm
  • growth of capillaries
  • increased vascular permeability
19
Q

implantation requires _________ domination in presence of _________

A

implantation requires progesterone domination in presence of oestrogen

20
Q

What are the 2 molecules important for attachment/ implantation of ovum?

A

Leukemia Inhibitory Factor (LIF):

  • -> from endometrial secretory glands
  • -> stimulates adhesion of blastocyst to endometrial cells

Interleukin-11 (IL-11) :

  • -> released from endometrial cells
  • -> released into uterine fluid
21
Q

What factors are involved in decidualisation?

A
  • IL-11

+histamine, TGFB

22
Q

In the first 40 days of pregnancy:
- progesterone + oestrogen = produced in ______ _______

from day 40:

A

In the first 40 days of pregnancy:

  • progesterone + oestrogen = produced in CORPUS LUTEUM (triggered by hCG)
  • -> essential for development of fetoplacental unit
  • -> inhibits LH + FSH

from day 40:
- placenta takes over

23
Q

Describe the production of oestradiol in the placenta

A
  • mother provides pregneolone as precursor
  • -> which leads to progesterone
  • progesterone leads to steroid production by foetus
  • maternal + foetal adrenals produce precursor DHEAS
  • which is taken up by placenta
  • to produce oestradiol
24
Q

Why are levels of oestradiol / oestrogen not a useful indicator of the baby’s health?

A
  • because estradiol /oestrogen also comes from the mother as well
25
Q

how is oestriol produced by the foetus?

A
  • in foetal liver:
  • DHEAS = conjugated to form 16a - hydroxy DHEAS
  • -> then it goes to the placenta which deconjugates it
  • and uses it to form oestriol
26
Q

endocrine control of parturition?

A

oxytocin allows cervical dilatation

+ uterine contraction

27
Q

What are the 2 hormones involved in lactation?

A
  • prolactin

- oxytocin

28
Q

How do prolactin + oxytocin differ in lactation?

A
  • prolactin: promotes milk synthesis

- oxytocin: promotes milk ejection

29
Q

note: in an ejaculate there are approx 15-120 million sperms

A

-

30
Q

Which maternal hormones may increase physiologically with pregnancy?

A
  • ACTH
  • Adrenal Steroids
  • Prolactin
  • IGF1
  • Iodothyronines
  • PTH related peptides
31
Q

Which maternal hormones may decrease physiologically with pregnancy?

A
  • Gonadotrophin
  • pituitary GH
  • TSH
32
Q

hCG shares alpha subunit with TSH whats the importance of this in terms of pregnancy and thyroid treatment?

A

so if pregnant + is on thyroxine –> asked to increase dose (by 30%)

33
Q

When does hCG peak?

what is its role?

A

8 weeks

  • Mimics LH by binding to LH receptors on corpus luteum
  • And stimulates production of oestrogen + progesterone
34
Q

how does hormone production change at 5 weeks of conception?

A
  • Role of hormone production = handed over form corpus luteum to placenta
35
Q

What is human placental lactogen?

A

human placenta lactogen = growth hormone with prolactin like effects

  • important for growth and development of foetus.
36
Q

Which androgen precursor is formed by the maternal and foetal adrenals?

A

DHEAS

37
Q

Oestriol = main oestrogen of pregnancy.

How is it produced?

A
  • DHEAS from foetal adrenal = conjugated in foetal liver to form 16-alpha hydroxyl DHEAS
  • The 16 alpha hydroxyl DHEAS = deconjugated in placenta + used to produce oestriol
38
Q

when foetus reaches a particular size, there is a switch in steroid synthesis from progesterone to oestrogen synthesis.

Why is this important ?

A
  • it causes oestrogen dominance
  • Which increases prostaglandin production and release of calcium from intracellular stores
  • Which then promotes contraction of muscles
39
Q

how does oestrogen increases the chance of contraction?

when giving birth

A
  • Oestrogen binds to oestrogen receptors –> triggers prostaglandin synthesis in endometrial cells
  • Which then stimulates the release of Ca2+ from intracellular stores
  • Which increases chance of contraction
40
Q

how does oxytocin increases the chance of contraction?

when giving birth

A
  • Oxytocin binds to receptor on endometrial cells
  • which opens Ca2+ channels
  • and allows Ca2+ ions to move in

eLCRS - 엔도 (20 decks)

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