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Reproduction and the growing child > Initiation of pregnancy > Flashcards

Initiation of pregnancy Flashcards

1
Q

Name the parts of the uterine tube;

A

Isthmus
Ampulla
Infundibulum

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2
Q

Common site of fertilisation:

A

Ampullary-isthmic junction

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3
Q

Female fertility is

A

Episodic

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4
Q

Male fertility is

A

Continual

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5
Q

2 phases of the ovarian cycle:

A

Follicular

Luteal

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6
Q

Phases of the uterine cycle:

A

Menstration
Proliferation
Secretary

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7
Q

Match the ovarian cycle and uterine cycle phases

A

Follicular phase: menstration and proliferative

Luteal phase: secretory phase

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8
Q

Follicular phase ends at…

A

Ovulation (day 14)

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9
Q

Mentration begins at…

A

Start of cycle (14 days after ovulation)

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10
Q

Most fertile at what point in menstrual cycle?

A

5 days before and 1 day after ovulation

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11
Q

What is released from the hypothalamus?

A

GnRH

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12
Q

What is released from the anterior pituitary gland?

A

FSH LH

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13
Q

Follicular phase:

A

LH acts on theca cells to produce androgens
FSH acts on granulosa cells to produce aromatase, inhibin and ostrogen

Oestrogen has a -ve feedback on LH and inhibin has a -ve feedback on FSH

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14
Q

What causes the LH surge?

A

High levels of oestrogen, changes from -ve to +ve feedback

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15
Q

Events of the luteal phase:

A

Follicle becomes corpus luteum which produces progesterone and some oestrogen. This has a -ve feedback on LH

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16
Q

If no pregnancy occurs …

A

Corpus luteum becomes corpus albicans. Stops producing progesterone so endometrial lining is shed.

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17
Q

If pregnancy occurs …

A

hCG is produced which is structurally similar to LH. Maintains endometrium and CL

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18
Q

What produces progesterone at the start of pregnancy and what takes over?

A

Corpus luteum

Placenta

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19
Q

Average time sperm can survive:

A

5 days

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20
Q

Average survival of occyte

A

24 hrs

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21
Q

Sperm must undergo what to be able to fertilise the egg?

A

Capacitation

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22
Q

Capacitation involves:

A
  • Acquiring characteristic ‘whiplash’ movement

- Acrosome reaction (shedding glycoprotein coat by rubbing on oviduct epithelia)

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23
Q

What is capacitation dependent on?

A

Calcium

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24
Q

2 enzymes in acrosome:

A

Hyaluronidase

Acrosin

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25
Q

Acrozene =

A

Digests zona pellucida

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26
Q

Hyaluronidase =

A

Digests hyaluronic acid made my cumulus cells

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27
Q

Acrosome reaction occurs in response to …

A

Oocyte being near

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28
Q

What does sperm bind to to fuse with oocyte?

A

ZP 2/3 (zona pellucida glycoproteins 2 and 3)

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29
Q

How does sperm activate the egg?

A
  • Release phospholipase gamma C
  • Ca2+ influx
  • Breaks down MPF
  • Resumes meiosis II
30
Q

MPF =

A

cyclin B + cdk 1

31
Q

Before activation, egg is arrested at

A

Meiosis II

32
Q

How does an egg prevent polyspermia:

A

Cortical granules release contents, conformational change of Zp 2/3

33
Q

2nd polar body is shed to form:

A

Female pronucleus

34
Q

Multiple sperm bind =

A

Polyspermia

35
Q

Meiotic error within egg, 2 female pronuclei =

36
Q

Artificial triggering of Ca2+ transcience causes resumption of meosis II without sperm =

A

Parthenogenetic

37
Q

What hormone dominated the luteal phase?

A

Progesterone

38
Q

What inhibits FSH?

A

Inhibin from granulosa cells

39
Q

Enzyme which converts androgens to oestrogens

40
Q

What occurs at cell 4 stage?

A

Zygotic genome activation

41
Q

Zygotic genome activation =

A

Genetic reprogramming. Genome is wiped of all methylation marks and re-methylated

42
Q

What implants into uterus?

A

Blastocyst

43
Q

What day does blastocyst form/implant?

44
Q

Describe the strucutre of a blastocyst before it hatches

A

Zona pellucida
Trophoepiblasts
Inner cell mass
Blastocoel cavity

45
Q

What is the ICM become?

A

Trilaminary disc/foetus

46
Q

What does a blastocyst produce?

47
Q

hCG =

A

Human chorionic gonadotropin

48
Q

hCG has a similar chemical structure to…

49
Q

Why do hCG levels drop mid pregnancy?

A

Placenta is established and begins steroid synthesis

50
Q

How do the fetus and placenta work together to produce oestrogens?

A 
Foetus = C19 androgens from adrenal
Placenta = Aromatises these to oestrogens
51
Q

2 types of twins =

A

Monozygotic

Dizygotic

52
Q

Dizygotic twins most likely due to =

A

Hyperovulation due to increased FSH

53
Q

Types of monozygotic twins =

A

Dichorionic-diamnionic
Monochorionic-diamnionic
Monochorionic-monoamnionic

54
Q

Dichornionic-diamnionic =

A

Splits before blastocyst stage. Own placenta and amniotic sac

55
Q

Monochorionic-diamnionic

A

Occurs when blastocyst hatches. Share placenta but different amniotic sacs

56
Q

Monochorionic-monoamnionic =

A

Occurs at blastocyst stage. Same placenta and amniotic sac

57
Q

What is the risk with monochorionic-monoamnionic twins?

A

Twin-Twin transfusion syndrome

58
Q

Where are eggs aspirated from for IVF?

A

The follicle

59
Q

In IVF how are the egg and sperm fertilised?

A

Co-incubated for 24 hrs

60
Q

ICSI =

A

Intracytoplasmic sperm injection

61
Q

When is ICSI used?

A

Low sperm count/male infertility

62
Q

PESA =

A

Percutaneous epididymal sperm aspiration

63
Q

MESA =

A

Microepididymal sperm aspiration

64
Q

TESE =

A

Testicular sperm extraction (biopsy)

65
Q

TESA =

A

Testicular sperm aspiration

66
Q

Most common causes of infertility =

A 
Male
Unexplained
Ovulatory disorder
Tubual disease
Endometriosis
67
Q

Meds used for down-regulation =

A

GnRH agonists = Lupron, zoladex

GnRH antagonists = Antagon, cetrotide

68
Q

Zoladex =

A

GnRH antagonist

69
Q

Cerotide =

A

GnRH agonist

70
Q

Superovulation =

71
Q

Why down regulation?

A

Stop LH surge and spontaneous rupture of follicle

72
Q

Some IVF criteria:

A 
<42, >23
19-29 BMI
Non-smoker for 6 mnths
No existing children
Stable 2 year relationship
Regular unprotected intercourse for 2 years

Reproduction and the growing child (15 decks)

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