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2022 REI Written Boards > Folliculogenesis/Menstrual Cycle > Flashcards

Folliculogenesis/Menstrual Cycle Flashcards

1
Q

At what stage does the oocyte arrest in the 3-5 mo fetus? What is this oocyte callled?

A 
Prophase I (4C, 2N) 
Germinal vesicle
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2
Q

When does meiosis 1 resume?

A

LH surge

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3
Q

If egg unfertilized, in what stage does it arrest?

A

Metaphase II (2C, n)

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4
Q

Characteristics of the oocyte at ovulation?

A

1N/2C, secondary oocyte, first polar body extruded

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5
Q

What stage oocyte is capable of fertilization?

A

Metaphase II of meiosis II

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6
Q

What happens when sperm fuses with oocyte membrane?

A

Cortical reaction modifies ZP to block polyspermy by cortical granule release of enzymes that digest sperm receptor glycoproteins ZP2 and ZP3 so they can no longer bind sperm

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7
Q

What is a primordial follicle?

A
  • Oocyte arrested in diplotene of mitotic prophase
  • Surrounded by single layer of flattened pre-granulosa cells (prevent atresia)
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8
Q

How do TGF-beta family proteins (4) influence primordial follicles? (which ones promote development, which ones inhibit development?)

A
  • Activins – promote primordial develop
  • Inhibins – inhibit primordial develop
  • AMH – inhibits primordial development
  • BMPs – promote primordial development
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9
Q

How do neurotrophins (4) influence primordial follicles?

A

(NGF, BDNF, NT-3, NT-4/5) bind trk proto-oncogene family to promote development

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10
Q

How does FOXL-2 influence primordial follicles?

A
  • Essential for granulosa cell differentiation
  • Causes blepharophimosis/ptosis/epicanthus-inversus syndrome
  • Affects eyelid and causes premature ovarian failure
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11
Q

How does kit-ligand influence primordial follicles?

A
  • Expressed on GCs of growing follicles
  • Mutations lead to failure of follicular growth beyond primary stage
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12
Q

General structure of primary oocyte

A

Oocyte surrounded by a cuboidal layer of granulosa cells

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13
Q

What are gap junctions in the primary oocyte?

A

Collections of intercellular membrane channels that allow adjacent cells to share small molecules (< 1 kDa). Gap junction channels are composed of connexins, a homologous family of more than 20 proteins. Located btwn granulosa cells and btwn granulosa cells and oocytes.

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14
Q

Name 2 of the most important connexins in primary oocyte and their location

A

Connexin-37 and connexin-43: form gap junctions with different permeability properties.
Connexin-37: predominant connexin in the oocyte
Connexin-43: predominates in granulosa cells

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15
Q

Layers of theca cells in secondary follicle

A
  • Theca interna (closest to basal lamina)
  • Theca externa (furthest from basal lamina)
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16
Q

Theca cells express genes for what hormone and which has the highest output?

A

Androgen production, androstenedione

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17
Q

What enzyme evidence in theca/granulosa cells supports the 2-cell, 2 gonadotropin explanation for estrogen production?

A

Presence of P450c17 (17alpha hydroxylase) only in theca and P450arom (aromatase) only in granulosa

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18
Q

Name 2 gonadotropin independent signals in primary follicle

A

GDF-9, BMP-15

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19
Q

What is GDF-9 and where is it expressed?

A

TGF-beta family protein – highly expressed in oocytes; lesser extent in GCs
• Signals via serine-threonine kinase receptors, produced by oocytes in primary and larger follicles but absent in primordial follicles
• Mutation in mice prevents follicle development beyond primary stage and absence of thecal markers, and eventual oocyte death

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20
Q

What does BMP-15 do and when does its action start?

A
  • Promotes growth and maturation of follicles
  • Starting in gonadotropin independent phase (primary follicle)
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21
Q

Characteristics of secondary/pre-antral follicle

A

Ongoing granulosa cell proliferation (2nd layer forms)

theca layer forms; vascular supply develops

Increase in oocyte size

Presence of FSH receptors (needs FSH to form antrum)

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22
Q

Hormone signaling to secondary/pre-antral follicle?

A

FSH: Required beyond two layers of granulosa cells
• FSH acts via FSH-R in adenylate cyclase system
• This induces aromatase and causes estrogenic microenvironment
• FSH and estrogen act synergistically to up-regulate FSH receptors
• The relative estrogen/androgen ratio determines the fate (grown vs. atresia) of the follicle

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23
Q

Characteristics of antral follicle

A

Antrum first appears as coalescence of Call-Exner bodies, cavity first filled with cellular debris, liquid accumulates from transudation of blood through avascular granulosa from theca vessels.

early - Granulosa cells surrounding the oocyte are now designated cumulus oophorus (also have corona radiate around ZP, membrana - interior to basal lamina, periantral - adjacent to the antrum)

Formation of antrum is FSH dependent

late - secrete estrogen & inhibin

24
Q

Describe the two-cell, two-gonadotropin system as pertains to the antral follicle

A
  • Granulosa cells lack c17 (similar to placenta, which lacks C17) so follicular estrogen production is dependent on aromatization by the granulosa of androgen substrate made by the theca
  • LH receptors only on theca cells (in response to LH: cholesterol -> androgens)
  • FSH receptors only on granulosa cells (in response to FSH: androgens -> estrogens, via aromatase)
  • Only FSH is required for folliculogenesis; however, the final stages of maturation are optimized by LH, increasing the amount of androgen substrate for estrogen production and promoting growth of dominant follicle while simultaneously hastening the regression of smaller follicles
25
Q

Two advantages of dominant follicle over other growing antral follicles

A

• Greater content of FSH receptors; because rate of granulosa cell proliferation surpasses that of its cohort
• Enhancement of FSH action
(these allow dominant follicle to remain responsive to FSH despite waning levels)

26
Q

What induces LH receptor development on granulosa cells for response to LH surge?

A

FSH

27
Q

When does ovulation occur?

A

34-36 hours after onset of LH surge and 24-26 hours after peak E2 levels

28
Q

Molecular events following LH surge (3)

A
  • Increase in cAMP
  • Breakdown of gap junctions in cumulus
  • Decrease in oocyte maturation inhibitor and luteinization inhibitor
29
Q

Detail response to the LH surge

A
  • Initiates continuation of meiosis in the oocyte, luteinization of the granulosa, and synthesis of progesterone and prostaglandin within the follicle
  • Stimulates plasminogen activator -> plasmin -> activates collagenase to disrupt follicular wall
  • Ovulation is the result of proteolytic digestion of the follicular apex (called the stigma)
30
Q

Response of MMP enzymes and their endogenous inhibitors TIMPS to LH surge

A

Increase

31
Q

Characteristics of the corpus luteum

A

o Granulosa cells hypertrophy, gradually filling in the cystic/hemorrhagic cavity of the early corpus luteum
o For the first time, granulosa becomes markedly luteinized - incorporating lipid-rich vacuoles in its cytoplasm
o A new yellow body is formed, now dominated by the enlarged, lipid-rich, fully vascularized granulosa

32
Q

Estrogen feedback at pituitary and hypothalamus

A

Initial inhibitory role at both the hypothalamus and anterior pituitary, decreasing both GnRH pulsatile secretion and GnRH pituitary response followed by switch to positive feedback in the late follicular phase

33
Q

Progesterone feedback

A

o When introduced after adequate estrogen priming, P4 facilitates the positive feedback response, in a direct action on the pituitary
o Both PR isoforms (A and B) are highest in the peri-ovulatory phase; PR-A is always higher than PR-B

34
Q

Follicular inhibin structure differences and production location

A

Inhibin A and B: common alpha subunit, different beta
Inhibin A: mostly produced by CL
Inhibin B: produced by granulosa cells of small developing antral follicles

35
Q

Inhibin A levels throughout life, menstrual cycle, and pregnancy? (puberty, luteal phase, postmenopause, pregnancy)

A
  • Undetectable before puberty
  • Declines in late luteal phase (resulting in FSH rise)
  • Very low levels in postmenopausal state due to absent follicular secretions
  • Pregnancy: Secreted by placenta. Peaks at 8-10 weeks, declines until 20 weeks, then increases to term
36
Q

Inhibin B levels from puberty to menopause

A
  • Rises to peak in early puberty; constant level thereafter.
  • In early menopause, follicular phase Inhibin B declines while Inhibin A and E2 are still within normal range
37
Q

Inhibin action on FSH

A
  • Suppresses FSH by blocking synthesis/secretion, preventing GNRH R upregulation, reducing the number of GNRH receptors, promoting intracellular degradation of gonadotropins
  • Inhibin A rises in luteal phase (under control of LH) to inhibit FSH in luteal phase
  • Inhibin B rises in follicular phase – central inhibition (via GnRH)
38
Q

Activin structure

A

Combination of beta subunits from inhibin A and B

39
Q

Activin action on FSH

A
  • Stimulates GnRH receptors
  • Acts centrally to augment FSH secretion
40
Q

Follistatin action on FSH

A

Binds activin and therefore inhibits FSH

41
Q

FSH primary regulators

A

Activin (+), follistatin (- via binding activin), and inhibin (-)

42
Q

LH regulation

A

GnRH pulses (primarily frequency)

43
Q

LH regulation in PCOS

A

Increased GnRH pulse frequency –> increased LH

44
Q

Gonadotropin regulation in hypothalamic amenorrhea

A
  • Decreased GnRH pulse frequency (via CRH, opioids)
  • increase FSH/LH ratio
45
Q

Sialic acid residue action

A

 Decrease pH, decrease excretion
 Increased during follicular phase because low estrogen environment favors the production of so-called big gonadotropins, gonadotropins with an increased carbohydrate component and, as a result, decreased biologic activity. The greater bioactivity of FSH at midcycle is associated with less sialyated, shorter-lived isoforms

46
Q

MOA of estrogen in abnormal uterine bleeding (3)

A

a. Rapid regrowth of endometrium over denuded epithelial surface
b. Stabilizes lysosomal membranes
c. Stimulates proliferation of endometrial ground substance

47
Q

How progesterone influences GnRH pulse

A

GnRH pulse frequency determined by duration of exposure to progesterone

Long P4 exposure → decreased GnRH pulse frequency → favors FSH production

GnRH pulse amplitude determined by level of progesterone

High P4 level → increased GnRH pulse amplitude → favors FSH production

48
Q

GnRH Pulse characteristics - for which hormone?

A

LH - inc freq (q60 min), low amplitude

FSH - dec freq (q200 min), high amplitude

49
Q

LH surge time lengths

A

Occurs 34-36 hours before follicle rupture

LH surge lasts 48-50 hours

Usually occurs at 3AM

  • Rapidly ascending limb of 14 hours
  • Plateau of 14 hours
  • Descending phase of 20 hours
50
Q

Most important prostaglandins involved in ovulation? (2)

A

PGE2 is most crucial

PGF2α is also involved

51
Q

Role of IGF-1 in relation to folliculogenesis

A
  1. Major mediator of growth hormone stimulated somatic growth
  2. IGF-I and IGF-II is produced in thecal cells, granulosa cell, and luteinized granulosa cells
  3. IGF-II is the most abundant IGF in follicles
  4. Amplifies the action of FSH/LH
  5. Coordinates the functions of theca and granulosa cells
  • Increases the number of FSH/LH receptors
  • Stimulates aromatase activity and progesterone synthesis
  • Stimulates secretion of inhibin
  • Stimulates granulosa cell proliferation
52
Q

How does IGF-1 circulate?

A

98% bound to IGFBP-1 thru 6

Predominant binding protein is IGFBP-3

53
Q

Length of time in preantral phase? antral phase?

A

preantral - 290 days

antral - 60 days

54
Q

What stage follicle does ZP form?

A

Primary

55
Q

What stage follicle are FSH receptors starting to appear?

A

Primary

2022 REI Written Boards (21 decks)

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