Integration of Female Reproduction Flashcards
What is primary amenorrhea?
Absence of menses in female by age 17
What is secondary amenorrhea?
Cessation of menses longer than 6 months
What are the most common causes of secondary amenorrhea?
Pregnancy
Menopause
Hyperprolactinemia with excessive PRL
What is oligomenorrhea?
Infrequent periods with length >35 days between menses
What is dysmenorrhea?
Painful menses related to uterine contractions
What is hirsutism?
Inappropriate hair growth in androgen sensitive areas
What is virilization?
Androgen stimulation with deep voice/balding/male features
What is a possible cause of oligomenorrhea?
Intense exercise
When does PMS occur?
Late luteal phase
What are the causes of polycystic ovarian syndrome?
The main cause of PCOS is insulin resistance and obesity, both which are also effects of the condition. PCOS also leads to infertility.
How does insulin resistance lead to PCOS?
High insulin stimulates androgen production (causing infertility), increased conversion to estrogens (weight gain).
What causes the cysts in PCOS?
Follicle development is impaired and ovulation isn’t completed so follicles degenerate into cysts.
What are the treatments for PCOS?
Weight Loss
Smoking Cessation
Metformin (for insulin resistance)
What must occur to have fertilization?
Sperm must penetrate the zona pellucida of the egg.
What are the steps that lead to fertilization?
Sperm Capacitation
Acrosomal Reaction
Zona Reaction
What occurs with sperm capacitation and what is the purpose of it?
Changes occur in properties of the sperm as they traverse the female tract and these changes allow for the penetration of the egg.
What occurs with acrosomal reaction and what is the purpose of it?
Release of the proteolytic enzymes and the sperm binds ZP3 which leads to increased [Ca2+] in the cell that will lead to the fusion of the sperm and egg and the exocytosis of the sperm contents.
What occurs with zona reaction and what is the purpose of it?
Prevents polyspermy with sperm penetration leading to the exocytosis of oocyte internal cortical vesicles that will harden the glycoproteins of the zona pellucida and prevent successive sperm penetration.
What are the essential steps of fertilization?
- Exocytosis of sperm contents
2. Exocytosis of oocyte vesicles
When does the second meiotic division of the oocyte occur?
Same increase in [Ca2+] that triggers the cortical reaction also triggers completion of the second meiotic division and the second polar body is released leaving oocyte with haploid, unduplicated chromasomes.
This occurs during fertilization.
What is the function of E2 in sperm transport?
E2 primes the female tract to aid sperm transport to the oviduct
What is the function of cGMP in sperm transport?
cGMP increases velocity and direction of sperm
What is the function of decreased [H+] in sperm transport?
Decreased [H+] of vagina facilitates sperm motility
What change in the cervical mucus occurs and why?
Decreased viscosity of cervical mucus increases sperm access to uterine cavity
Describe oocyte transport.
After its release it is taken into the oviduct by the fimbriae and then the ampulla will churn to promote random egg/sperm interactions.
How does blastocyst transport occur?
E2 will cause isthmus contraction in the oviduct and delay the transport of the blastocyst and an increase in progesterone will relax the myometrium to allow passage.
What are the steps of implantation?
Adhesion
Penetration
Invasion
What occurs in adhesion?
Zona pellucida dissolves (egg hatches) under the control of progesterone
What causes the bonding of endometrial and blastocyst cells to themselves?
IL-1 from the blastocyst triggers increase in integrins which bond these cells to like cells
What is the function of osteopontin?
Binds integrins of endometrium and blastocysts together as a bridge
What occurs in penetration?
Progesterone promotes fibroblast-type stromal cells enlarging and forming the decidua, which serves as the source of nutrients for the embryo until vascular connections are established and as a barrier.
What occurs in invasion?
Balance between the defensive decidua and offensive trophoblast cell migration.
Trophoblast MMPs and IGF-2 VS Anti-MMP and IGF-binding proteins
What is the function of syncytiotrophoblasts?
Responsible for most endocrine functions (hCG/hPL)
What is the function of cytotrophoblasts?
Secrete CRH/TRH/Somatostatin
What are the functions of the placenta?
- Transports nutrients (glucose/O2)
- Transports waste (urea/CO2)
- Endocrine function secreting hormones
What are the functions of hCG?
Similar to LH.
It rescues the corpus luteum and is made by the syncytiotrophoblasts under cytotrophoblast GnRH control.
It is also what leads to maternal recognition of the pregnancy.
What are the functions of hPL?
Similar to GH.
AKA human chorionic somatomammotropin
It is produced by syncytiotrophoblasts and acts in response to hypoglycemia. HPL stimulates lipolysis and has anti-insulin actions on maternal carbohydrate metabolism which leads to an increase in plasma glucose and free fatty acids to maintain continuous flow of nutrients to the fetus.
