Endocrinology of pregnancy Flashcards

1
Q

In the male reproductive tract, which cells can produce oestrogen?

A

Leydig cells, germ cells

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2
Q

What is oestrogen required for in male bone development?

A

Bone strength and closure of growth plates in long bones

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3
Q

What 2 things are required for maturation of spermatozoon

A

Fructose and glycoproteins

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4
Q

What is the function of sugar and glycoproteins in sperm maturation?

A
  1. Energy provision

2. Surface coating

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5
Q

What induces GP and fructose release for sperm maturation, and where are they secreted into?

A

Androgens

Epidydmal fluid

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6
Q

Describe the control of tubular fluid reabsorption

A

Controlled by oestrogen, occurs in rete testis

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7
Q

By what process do sperm become mobile?

A

Capacitation

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8
Q

Where and how do sperm achieve fertilisation capacity?

A

Female reproductive tract:
Lose GP coat
Change in surface membrane
Tail movements begin

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9
Q

What is required for sperm capacitation?

A

Oestrogen

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10
Q

What name is given to the reaction when a sperm enters the ovum?

A

Acrosome reaction

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11
Q

Recall the events of the acrosome reaction

A
  1. Sperm binds to ZP3 on ovum surface
  2. Ca++ influx into sperm
  3. Hyaluronidase and proteolytic enzyme release 4. Sperm penetrates zona pellucida
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12
Q

Upon which hormone is the acrosome reaction dependent?

A

Progesterone

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13
Q

When is the 2nd polar body expelled from the ovum?

A

Upon fertilisation

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14
Q

What is triggered by release of the 2nd polar body?

A

Cortisol reaction

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15
Q

Recall the events of the cortisol reaction

A

Cortical granules release enzymes to degrade ZP

Sperm can no longer bind

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16
Q

How are additional sperm prevented from binding to the ovum once fertilisation has taken place?

A

Cortisol reaction degrades ZP

17
Q

When does the ovum become diploid?

A

When it is fertilised

18
Q

When is the fertilised egg first known as a “morula”

A

8 cells

19
Q

Recall how the morula develops into the blastocyst

A

Has inner and outer cell masses:

Inner cell mass becomes embryo, outer cell mass destined to become chorion

20
Q

Recall the 2 main factors involved in blastocyst implantation

A

Leukaemia-inhibitory factor

IL-11

21
Q

Where is LIF produced and what is its role?

A

Produced in endometrial secretory glands

Stimulates adhesion of blastocyst to endometrial cells

22
Q

What is decidualisation?

A

Process that changes underlying uterine stroma to facilitate implantation

23
Q

Why is progesterone named as it is?

A

Pro-gesterone - promotes gestation: required for implantation

24
Q

What is the main driver of decidualisation?

A

IL11

25
Q

Recall 4 changes undergone by the endometrium in decidualisation

A

Epithelium becomes secretory
Glycogen accumulates in stroma
Capillary growth
Vascular permeability increase (–> oedema)

26
Q

When is the luto-placenteal shift?

A

Day 40

27
Q

What stimulates hormone release from the corpus luteum?

A

hCG

28
Q

What is the role of the placenta in oestrogen production?

A

Converts DHEAS to different forms of oestrogen

29
Q

What is the main form of oestrogen in pregnancy?

A

Oestriol

30
Q

Where is DHEAS produced during pregnancy

A

Liver of mother AND foetus

31
Q

Which hormone can be used to give insight into foetal wellbeing and why?

A

Oestriol

Made uniquely in response to foetal androgen production

32
Q

What stimulates the foetal adrenals to produce DHEAS?

A

Progesterone

33
Q

What is the role of oestrogen in parturition?

A

Stimulates prostaglandin production in endometrium –> Ca++ released from stores

34
Q

How is oestrogen’s effects controlled during parturition?

A

Progesterone - as it has the opposite effect

35
Q

What is the role of progesterone in parturition?

A

Inhibits PG production and subsequent Ca++ release from stores

36
Q

What is the role of oxytocin in parturition?

A

Opens Ca++ channels to increase contraction

37
Q

Recall the hormones that promote human milk synthesis and ejection

A

Synthesis: prolactin
Ejection: oxytocin