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Endocrinology and Reproduction > Female Reproductive Endocrinology I > Flashcards

Female Reproductive Endocrinology I Flashcards

1
Q

Traditionally defined as gonadal activation: the abilities of:

1) the testes to produce steroid hormones and viable sperm, and
2) the ovaries to produce steroid hormones and ovulate one viable oocyte (egg) during each menstrual cycle.

A

Puberty

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2
Q

Male and female gonadal function is dependent on the gonadotropins

A

LH and FSH

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3
Q

The secretion of LH and FSH is regulated by

A

GnRH

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4
Q

Exerts the fundamental hormonal control of reproductive function by regulating gonadotropin secretion

A

Hypothalamic release of GnRH

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5
Q

The mature hypothalamus (specifically, neurons within the preoptic nucleus) regulates the secretion of FSH and LH via the controlled release og

A

GnRH

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6
Q

The mature hypothalamus secretes GnRH in a pulsatile manner at defined intervals, this causes the pituitary gonadotropes to produce and secrete

A

FSH and LH in a pulsatile manner

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7
Q

The so-called hypothalamic GnRH pulse-generator is itself regulated in the sexually mature brain by several neurotransmitters including

A

Endorphins, NP-Y, and adrenergics

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8
Q

Prolonged extremes in steroid hormone production, and/or pharmacologically elevated and/or clamped serum androgen, estrogen, or progesterone concentrations, will disrupt the GnRH pulse generator; thus perturbing

A

LH and FSH secretion

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9
Q

The aforementioned is the physiologic rationale for estrogen-progesterone based

A

Contraception

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10
Q

Have very high circulating levels of estrogens; due to carry-over from in utero aromatization of fetal and maternal androgens

A

Neonates

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11
Q

Shortly after birth, steroid levels plummet in the baby and remain relatively low throughout

A

Early childhood

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12
Q

Somewhere around 7-9 years-old, the adrenal cortex begins to functionally mature into an active steroidogenic tissue. This process of adrenal maturation is referred to as

A

Adrenarche

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13
Q

Adrenarche results in an increase in adrenal

A

Androgen secretion

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14
Q

Occurs well before the onset of puberty, and is NOT a prerequisite for puberty to occur

A

Adrenarche

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15
Q

What are the two theories for the onset of puberty?

A
  1. ) Hypothalamic maturation theory

2. ) Gonadostat theory

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16
Q

An unknown signal induces the maturation of GnRH secreting neurons within the medial preoptic nucleus; hence, turning-on the GnRH pulse-generator in the

A

Hypothalamic maturation theory

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17
Q

The hypothalamic maturation theory presumes that the gonads are in a latent, but more or less mature and functional state waiting for

A

Gonadotropin stimulation

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18
Q

Some agonadal children manifest the pulsatile release of GnRH and gonadotropins during young adolescence. This supports the

A

Hypothalamic maturation theory

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19
Q

In the gonadostat theory, over time, low tonic levels of gonadal steroids exert negative feedback within the

A

Hypothalamic-pituitary axis

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20
Q

During puberty, a developmental switch within the gonadal-hypothalamic pituitary axis decreases the sensitivity to negative feedback by gonadal steroids in the

A

Gonadostat theory

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21
Q

The result of this change in sensitivity in the gonadostat theory is the pulsatile release of GnRH that stimulates

A

Gonadotropin release

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22
Q

There is some direct correlation with increased body weight and the earlier onset of

A

Puberty

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23
Q

One protein hormone that may mediate this nutritional link is

-produced by adipocytes

A

Leptin

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24
Q

Leptin receptors are located within the

A

Hypothalamus and certain gonadal cells

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25
Q

Elevated leptin concentrations have been correlated with the early onset of

A

Menarche

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26
Q

The hypothesis being that with greater fat stores, more leptin is secreted, and that leptin then acts as a metabolic green light to

A

Neuroendocrine and gonadal tissues to start puberty

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27
Q

Defined by the ovulation of one mature, viable oocyte during each 28-day menstrual cycle

A

Female fertility

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28
Q

The menstrual cycle is functionally and clinically divided into which three phases?

A
  1. ) Follicular (proliferative) phase ( days 1-14)
  2. ) Ovulation (day 14)
  3. ) Luteal (secretory) phase (days 15-28)
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29
Q

Regulated by GnRH, pituitary gonadotropins, as well as growth factor-mediated autocrine and paracrine interactions within the ovary

A

Ovulation

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30
Q

Together, the aforementioned establish the feedback loops within the

A

Ovarian-hypothalamic-pituitary axis

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31
Q

The feedback loops in the ovarian-hypothalamic-pituitary axis control

A

Female cyclicity and fertility

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32
Q

The ovary has several distinct anatomical components. The key functional structures are spheroid tissues known as

A

Folliicles

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33
Q

House growing oocytes

A

Follicles

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34
Q

Each follicle contains one

A

Oocyte

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35
Q

Hormone factories that make estrogens, progestins, and androgens, as well as a host of protein hormones, growth hormones, and cytokines

A

Follicles

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36
Q

Follicular steroidogenesis fosters the growth and maturation of the

-maintains neuroendocrine feedback loops

A

Oocyte

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37
Q

In addition to one oocyte, each follicle contains which two cell populations

A
  1. ) Theca cells

2. ) Granulosa cells (GC)

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38
Q

Surround the basal lamina and are the outer-most layer of follicle cells

A

Theca Cells

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39
Q

The theca cell layers, i.e. theca externa and theca interna are

A

Vascularized

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40
Q

The basal lamina (rich in structural proteins: collagens, laminins, etc.) separates the theca cells from the

A

GCs

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41
Q

More-or-less an inner-most structure, and is surrounded by GC

A

Oocyte

42
Q

The oocyte contains the maternal genetic component. This 4n is arrested in

A

Meiosis I

43
Q

Comprise the regions between the follicles

A

Ovarian interstitial cells

44
Q

The largest and most mature follicles

A

Selected, preovulatory, or Graafian Follicles

45
Q

The largest and most mature follicles (referred to as selected, preovulatory, or Graafian follicles) contain a large antrum that is filled with

A

Follicular fluid

46
Q

The hypothalamic GnRH pulse-generator is affected by changes in circulating

A

Steroid hormone concentrations

47
Q

Slow GnRH pulse frequency is associated with stimulating

A

FSH secretion

48
Q

Rapid, high amplitude GnRH pulse frequency is associated with stimulating

A

LH secretion

49
Q

Targets the theca cells and GCs

A

LH

50
Q

Stimulates theca cell and GC steroidogenesis

A

LH

51
Q

Furthermore, LH causes the changes in GC function and cytoarchitecture that enable

A

Ovulation

52
Q

Also, LH stimulates the terminal differentiation of GC and theca cells; a process identified as

A

Luteinization

53
Q

Luteinization of the selected follicle begins immediately prior to

A

Ovulation

54
Q

Following ovulation, LH stimulates the luteinized GC and theca cells within the

A

Corpus Luteum

55
Q

Following ovulation, LH stimulates the luteinized GC and theca cells within the corpus luteum to produce and secrete appreciable amounts of

A

Progesterone and estrogens

56
Q

Enables GC to convert aromatizable androgens into estrogens

A

FSH

57
Q

Do not contain FSH receptors

A

Theca cells

58
Q

FSH stimulates steroidogenesis in

A

GCs

59
Q

FSH also regulates GC mitosis during

A

Follicular growth (folliculogenesis)

60
Q

Importantly, the mitogenic actions of FSH are mediated by growth factors, cytokines, and steroid hormones that are often secreted by ovarian cells in response to

A

FSH and/or LH

61
Q

A key signal transduction mechanism that mediates the responsiveness of follicle cells to FSH and LH

A

cAMP/PKA-dependent signal transduction cascade

62
Q

Failure of the neuroendocrine system to secrete sufficient levels of FSH and/or LH necessary to stimulate ovarian function is known as

A

Hypogonadotropic Hypogonadism

63
Q

Note that serum gonadotropin levels may appear deceivingly normal, but do not undergo the cyclical rises necessary to support

A

Follicular development, steroidogenesis, and/or ovulation

64
Q

Women with hypogonadotrophic hypogonadism have low\ serum estradiol, due to reduced

A

FSH and/or LH levels

65
Q

A cohort of ovarian follicles is recruited to begin the growth and maturation process during the

A

Follicular phase of each menstrual cycle

66
Q

The entire process of follicular growth occurs over a period of approximately

A

3-4 menstrual cycles

67
Q

A new cohort of follicles is recruited to begin growing during each

A

Menstrual cycle

68
Q

The anatomical sequence of follicular growth is:

A

Primordial, primary, secondary, tertiary, and preovulatory (dominant or Graffian)

69
Q

Prior to being recruited into a growing cohort, follicles remain in an arrested, immature state of development. These are the

A

Primordial follicles

70
Q

Immature follicles each contain an oocyte that is surrounded by one layer of

A

Non-steroidogenic GC (pre-GC)

71
Q

Prior to the onset of puberty, Oocytes within these follicles are arrested in

A

Meiotic Prophase I (4n)

72
Q

Recruitment is defined by the entry of primordial follicles into the growth phase; in other words, the differentiation of primordial follicles into

A

Primary and then secondary follicles

73
Q

As follicular differentiation begins, the first cells to grow and functionally differentiate are the

A

GC and oocyte

74
Q

This initial growth phase occurs independent from

A

FSH

75
Q

The recruitment of a cohort of follicles is counter-modulated by

A

Antimullerian Hormone (AMH)

76
Q

Required to sustain the growing follicle in the advanced secondary stages and beyond

A

FSH and (later) LH

77
Q

Probably represent a transitional phase from FSH-independence to FSH-dependence

A

Young secondary follicles

78
Q

Not present until the later secondary stage of follicular development

A

Theca Cells

79
Q

The appearance of morphologically distinct theca cells occurs concaminant with follicular vascularization and appears to require

A

LH

80
Q

As mentioned, very early follicular growth occurs independent from gonadotropin support; however, it appears that maturation of the previously recruited preantral follicles requires a

A

Jolt of LH and FSH

81
Q

This jolt occurs via the

A

Preovulatory gonadotropin surge

82
Q

A profound and transient increase in serum FSH and LH just prior to ovulation

A

Preovulatory gonadotropin surge

83
Q

Functions as a counter-modulator by reducing the sensitivity of GC within small follicles to FSH

A

Antimüllerian hormone

84
Q

In response to FSH and LH, the cohorts of young follicles undergo further growth and differentiation. Growth stops during the mid-to-late

A

Luteal phases

-resumes again during the next follicular phase

85
Q

This stop-and-go pattern of follicular growth and maturation of a given follicular cohort continues until the dominant follicle is

A

Ovulated

86
Q

The non-selected sister follicles undergo

A

Atresia

87
Q

As a recruited cohort of follicles begins to grow, serum FSH and LH levels are

A

Waning (from the previous cycle)

88
Q

Without FSH stimulation, there is very low production of

A

estradiol-17B (E2)

89
Q

Exert a negative feedback effect on the hypothalamic/pituitary axis; resulting in a further suppression of FSH and LH secretion

A

Low Serum E2 levels

90
Q

Basically, during the early follicular phase of the cycle, FSH and LH levels are decreasing, and this downward slope in the level of FSH and LH secretion is sustained by

A

Low serum E2 levels

91
Q

Sometime around the tertiary/antral stage of development, one follicle within the recruited cohort is selected to

-will eventually ovulate

A

Differentiate

92
Q

Within the selected follicle, GC express more FSH receptors, and also begin to produce the peptide

A

Inhibin B

93
Q

Increase during the mid-follicular phase and fall at mid-cycle

A

Inhibin B levels

94
Q

Blocks the secretion of FSH by the pituitary

-hence FSH levels are further suppressed via the selected follicle

A

Inhibin B

95
Q

One theory is that the selected follicle contains enough FSH receptors so that it can continue to utilize the modicum of available

A

Serum FSH

96
Q

Meanwhile, the remaining (non-selected) sister follicles within the growing cohort cannot bind FSH, and are thus

A

FSH-starved

97
Q

In response to being FSH starved, all of the non selected follicles within the growing cohort begin to die by the process of apoptosis which leads to

A

Follicular atresia

98
Q

The selected follicle can respond to the very low concentrations of available FSH because its GC contain a lot of

A

FSH receptors

99
Q

In response to FSH, these GC secrete

A

Inhibin B

100
Q

As the selected follicle grows, its antrum becomes engorged with

A

Follicular fluid

Endocrinology and Reproduction (15 decks)

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