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a11. Reproductive (Physiology) > Female Reproductive Physiology > Flashcards

Female Reproductive Physiology Flashcards

1
Q

What type of epithelium covers the ovaries?

A

Simple cuboidal epithelium

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2
Q

What are the layers that make up the ovaries?

A
  • Surface- connective tissue capsule covered with layer of simple cuboidal epithelium
  • Cortex- peripheral part, connective tissue
  • Medulla- central part, connective tissue
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3
Q

What does the cortex of the ovary contain?

A

Ovarian follicles (one oocyte surrounded by single layer of cells)

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4
Q

What does the medulla of the ovary contain?

A

Connective tissue and blood vessels

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5
Q

What is the function of the ovaries?

A
  • Oocyte production
  • Steroid hormone production
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6
Q

How many mature eggs are released from the ovaries in a menstrual cycle?

A

1

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7
Q

Approximately how many eggs are ovulated over a woman’s lifespan?

A

400

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8
Q

What steroid hormones do the ovaries produce?

A
  • Estrogen
  • Progesterone
  • Testosterone
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9
Q

What is the function of estrogen?

A

Develop secondary female sexual characteristics (e.g. breast development, hair distribution)

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10
Q

What is the function of progesterone?

A

Prepare the endometrium for implantation

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11
Q

What percentage of testosterone is produced by the ovaries prior to menopause?

A

50%

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12
Q

When does mitosis of germ cells occur?

A

In embryonic gonads (prior to birth) to increase the number of gamete cells. Following this germ cells undergo meiosis

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13
Q

Describe what happens in the first step of meiosis

A
  • Germ cell DNA (2n) replicates until each chromosome is duplicated (46 chromosomes x 2 = 92 chromosomes)

These cells are called primary oocytes (4n)

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14
Q

Describe what happens in the first meiotic division?

A

Primary gametes (2n) divide into 2 secondary gametes (1n)

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15
Q

At what stage of foetal development do oogonia complete mitosis and DNA duplication stage of meiosis?

A

5th month- this results in primary oocytes (4n)

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16
Q

When does mitosis of gametes ceases in females?

A

At birth

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17
Q

Following start of puberty, what is the next stage in cell division?

A

First Meiotic Division

After puberty, Primary oocytes (4n) containing 2 sister chromatids divide into 2 cells:

  • Secondary oocyte (2n egg)
  • Polar body (2n)
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18
Q

What number of chromosomes doe the primary oocyte contain?

A

92 chromosomes

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19
Q

What number of chromosomes does the secondary oocyte contain?

A

46 chromosomes

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20
Q

What number of chromosomes does the secondary gamete have after the second meiotic division?

A
  • 23 chromosomes (1n)
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21
Q

If a secondary oocyte is selected for ovulation, what happens to it?

A

A secondary gamete (46 chromosomes, 2n) undergoes, second meiotic division before the egg is released from the ovary (mature egg) . The sister chromatids separate, but meiosis pauses

Sister chromatids will not undergo meiosis unless the egg is fertilised

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22
Q

In what process do the ovaries release a mature egg? What happens if:

a) The egg is fertilised
b) The egg is not fertilised?

A

Ovulation

a) Meiosis takes place, half of sister chromatids remain in fertilised egg (zygote) the other half are released as a 2nd polar body (1n). 2nd polar body disintegrates
b) Meiosis doesn’t happen, egg disintegrates

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23
Q

How many mature eggs does one primary oocyte give rise to?

A

1

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24
Q

Describe Stage 1

A
  1. Embryonic gonads first undergo a series of mitotic divisions to increase their numbers (Oogonia)
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25
Q

Describe stage 2

A
  1. First step of meiosis:
  • The germ cell’s DNA (2n) replicates until each chromosome is duplicated (46 chromosomes duplicated = 92 chromosomes). (primary oocyte (4n)).
  • Each duplicated chromosome forms two identical sister chromatids, linked together at the centromere. The primary gametes are then ready to undergo meiotic divisions
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26
Q

Describe stage 3

A
  1. 1st Meiotic division
  • In the ovary, meiosis does not resume until puberty.
  • If a primary oocyte develops it divides => 2 secondary oocytes (1 large egg (secondary oocyte) and a tiny first polar body) both contain 23 duplicated chromosomes. The first polar body disintegrates.
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27
Q

Describe stage 4

A
  1. 2nd Meiotic division
  • If the secondary oocyte is selected for ovulation, the second meiotic division takes place just before the egg is released from the ovary
  • Sister chromatids separate but now meiosis pauses again. The final step of meiosis, in which sister chromatids go to separate cells, does not take place unless the egg is fertilized.
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28
Q

Describe stage 5

A
  1. The ovary releases the mature egg (ovulation)
    * If the egg is not fertilized, meiosis never goes to completion, and the egg disintegrates
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29
Q

Describe stage 6

A
  1. Fertilisation
    * If fertilization by a sperm occurs, the final step of meiosis takes place. Half the sister chromatids remain in the fertilized egg (zygote), while the other half are released in a second polar body (1n). The second polar body, like the first, degenerates.
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30
Q

Fill in the diagram

A
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31
Q

Describe the follicular developmental stages

A
32
Q

What is a primordial follicle?

A

Primary oocyte arrested in first meiotic division surrounded by one layer of squamous pre granulosa cells.

33
Q

What is a primary follicle?

A

Oocyte surrounded by zona and cuboidal granulosa cells

34
Q

What is a secondary follicle?

A

Increased oocyte diameter and multiple layer of granulosa cells, resumption of first meiotic division

35
Q

What is a tertiary/Graffian follicle?

A

Follicular fluid between the cells which coalesce to form antrum, completion of first meiotic division to form secondary oocyte and start of second meiotic division.

36
Q

What happens during preantral phase of follicular development?

A
37
Q

What happens during the antral stage of follicular development?

A
38
Q

What is the female reproductive axis known as?

A

Hypothalamic-pituitary-ovarian axis

39
Q

What hormone does the hypothalamus secrete, that has an effect on the female reproductive axis? What does this hormone act on?

A

GnRH (Gonadotropin releasing hormone)

Acts on anterior pituitray

40
Q

When the anterior pituitary is stimulated by a hormone released from the hypothalamus, what other 2 hormones does it release?

A
  • FSH (Follicle stimulating Hormone)
  • LH (Luteinizing hormone)
41
Q

What organ do the hormones released by the anterior pituitary act on?

A

Ovaries

42
Q

What type of hormones does the ovary produce?

A

Steroid hormones

43
Q

What hormones does the ovary produce when stimulated?

A
  • Estrogen
  • Progesterone
44
Q

What organ do the hormones released by the ovaries act on?

A

Uterus: an act to coordinate the menstrual cycle

45
Q

What happens to the Hypothalamic-pituitary- ovarian axis when the levels of estrogen and progesterone increase?

A
46
Q

What happens to the Hypothalamic-pituitary- ovarian axis on day 12th day of the 28 day cycle?

A

Estrogen creates positive feedback to increase the GnRH and LH surge from the pituitary, helps mid cycle ovulation

47
Q

What happens at the beginning of the ovarian cycle?

A
  • FSH levels increase, and LH is secreted (allowing for development from secondary follicle to antral follicular stage)
48
Q

What occurs mid-way through an ovarian cycle?

A
  • Increase in estrogen release → Increase in LH secretion → Ovulation
49
Q

What hormone is released from the ovary in the first half of the ovarian cycle?

A

Estrogen: causes follicular development. The peak in estrogen is intended to cause ovulation to result in pregnancy every cycle. If pregnancy doesn’t occur the follicle turns into corpus luteum

50
Q

What hormone is secreted in the second half of the ovarian cycle?

A
  • Progesterone (levels rise)
51
Q

What happens to the follicle after ovulation pregnancy doesn’t occur?

A

It turns into corpus leuteum

52
Q

What are the phases of the ovarian cycle?

A
  1. Follicular phase
  2. Ovulation
  3. Luteal phase
  4. Menstruation
53
Q

What occurs during the follicular phase of the ovarian cycle?

A
  • FSH → follicles mature and produce estrogen (inhibiting development of other follicles)
54
Q

What occurs during the ovulation phase of the ovarian cycle?

A
  • LH surge → ovulation (follicle ruptures and releases 2ndry oocyte)
55
Q

What occurs during the luteal phase of the ovarian cycle?

A
  • A ruptured follicle forms a corpus leuteum and secretes progesterone (+ some estrogen)
56
Q

What occurs during the menstruation phase of the ovarian cycle?

A
  • Corpus leuteum degenerates (becomes corpus albicans), a new ovarian cycle begins
57
Q

How is the endometrial wall of the uterus affected by changing hormone levels throughout the menstrual cycle?

A
  • 1st day of menstruation: due to bleeding endometrium is thin
  • Follicular phase: estrogen increases → endometrium begins to thicken
  • Mid-cycle: endometrium reaches a certain thickness, ovulation occurs and progesterone secretion increases → changes in blood vessels within endometrial wall
58
Q

What effect does estrogen have on the endometrial wall?

A

Increases thickness

59
Q

What effect does progesterone have on the endometrial wall?

A
  • Changes in vasculature
  • Adds to thickness of endometrium
60
Q

What name is given to the effects that ovarian hormones have on the endometrium during the menstrual cycle?

A

Decicualization: changes to the endometrium in preparation for pregnancy

61
Q

What hormonal change triggers the bleeding in a menstrual cycle?

A

Drop in levels of estrogen and progesterone (start of new ovarian cycle)

62
Q

Summarise the hypothalamic-pituitary-ovarian axis and how it affects the subsequent release of sex hormones from the ovaries and the effects of the hormones on

  • Follicle growth
  • Levels of sex hormones throughout the ovarian cycle
  • The endometrial wall changes throughout the cycle

Draw this out

A
63
Q

Define amenorrhoea

A

The absence of menstruation, often defined as missing one or more menstrual periods

64
Q

What are some causes of amenorrhoea?

A
  • Problems with hormone regulation
  • Problems with ovarian function
  • Problem with uterus/outflow tract
65
Q

What are some functional factors that could cause amenorrhoea?

A
  • Excessive weight loss/gain
  • Over exercising
  • Stress
66
Q

What are some chronic medical conditions that could cause amenorrhoea?

A
  • Diabetes
  • Sarcoidosis
  • Renal disease
  • TB
67
Q

What types of lesions within the brain may affect the function of the hypothalamus and cause amenorrhoea?

A

Intracranial space occupying lesions

  • Prolactinoma
  • Tumours
  • Cysts
68
Q

What infections or trauma could cause amenorrhoea?

A
  • Meningitis
  • Intracranial bleed
  • Sheehan’s
69
Q

What drugs could cause amenorrhoea?

A
  • Glucocorticoids
  • Anabolic steroids
  • Opiates
70
Q

What genetic conditions may cause amenorrhoea?

A

Kallmann’s syndrome: Isolated GnRH deficiency

71
Q

What is the name given to amenorrhoea caused by problems with hormone regulation?

A

Hypogonadotropic hypogonadism (Low FSH, LH, high prolactin)

72
Q

Problems with ovarian function

What are some genetic causes of hypogonadotropic hypogonadism (high or normal FSH and LH)?

A
  • Turners Syndrome (46X)
  • Fragile X
73
Q

Problems with ovarian function

What are some causes of hypogonadotropic hypogonadism (high or normal FSH and LH)?

A
  • Genetic: Turners (46X), Fragile X
  • Aging: steep decline in ovarian function >35 yrs
  • Chronic illness: autoimmune disease
  • RTx, Chemo
  • Infection: TB, Mumps, oophoritis
74
Q

What are some congenital causes of amenorrhoea due to problems with the uterus or outflow tract?

A
  • MRKH syndrome (absent uterus/vagina due to lack of Mullerian duct development)
  • Transverse vaginal septum/ Imperforate hymen-Mullerian duct fails to canalise
  • Androgen insensitivity syndrome
75
Q

What are some iatrogenic causes of amenorrhoea due to problems with the uterus or outflow tract?

A
  • Asherman syndrome: uterine adhesions/synechiae
  • RTx: pelvic/cervical
76
Q

What type of investigations should be done to investigate amenorrhoea?

A
  • Check levels of gonadotrophic hormones: FSH, LH, prolactin (high prolactin suppresses ovarian function)
  • Thyroid
  • US/ MRI uterus: check for congenital anomalies
77
Q

What are the various forms of management that could be prescribed to a patient to manage amenorrhoea?

A
  • Lifestyle changes
  • Optimize control of medical illnesses
  • Cease drugs/switch to alternatives
  • Prolactinoma (med treatment)
  • Intracranial SOL (SUrgical treatment)
  • Vaginal abnormalities of septum/hymen (surgical treatment)
  • Uterine adhesions (surgical hysteroscopic division)
  • Fertility prevention prior to RTx/CTx
  • Fertility treatment: IVF with own/donor eggs

a11. Reproductive (Physiology) (4 decks)

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