reproduction and contraception

Question 1

laparoscopy

Answer 1

a minimally invasive surgical procedure that allows a surgeon to examine and treat the organs inside the abdomen and pelvis

Question 2

two main functions of the ovaries

Answer 2

Gametogenesis: oogenesis & folliculogenesis

Steroidogenesis (production
of hormones: Estrogens and
Progesterone)

Oogenesis is the process of creating eggs, or ova, in the female body

Question 3

sertoli cell and leyding cell function

Answer 3

Sertoli cells provide the environment for germ cells to develop into sperm. They secrete molecules like androgen binding protein (ABP), inhibin B, and activin, which help with spermatogenesis.

leyding cells produce testosterone

Question 4

spermatogonia

Answer 4

Spermatogonia are stem cells in the testes that produce sperm cells, or spermatozoa, through a process called spermatogenesis

Question 5

the relevant hormones involved in the ovarian cycle

Answer 5

GnRH(hypothalamus)

LH (pituitary)

FSH (pituitary)

Oestradiol(ovarian cells)

Progesterone(luteal cells)

Question 6

how many phases of the ovarian cycle are there and what happens during these phases

Answer 6

4

Proliferative phase
After shedding of the endometrial layer during menses, regeneration of the epithelium occurs (luminal epithelium). Estrogens prime/prepares the endometrial epithelial cells (gland regrowth) and stromal cells to proliferate.

ovulation

the luteal phase : here the follicular tissue transforms into the corpus luteum, which is responsible for producing large quantities of progesterone and oestrogen. This suppresses gonadotropin release, thereby restricting further follicular growth

Secretory phase
Early Secretory: Both Progesterone and Estrogens help the cell proliferation and epithelial cell invagination. Glands will start secreting various factors like nutrients, growth factors..etc to improve endometrial receptivity and embryo adhesion. Stromal cells will differentiate into decidualised cells to prepare for embryo support post-implantation.

Late Secretory: if failure of fertilisation (or implantation), drop in estrogens and progesterone leads to spiral arteries constriction (necrosis) and start of endometrial shedding

The endometrium is the tissue that lines the inside of the uterus.

Decidualized cells are cells in the endometrium that support the developing embryo during pregnancy.

Proliferative Phase Ovulation Luteal Phase Secretory Phase (part of the luteal phase), in that order

Question 7

if the egg produced during ovulation is fertilised, what happens to the corpus luteum

what happens to the corpus luteum if no fertilisation occurs

Answer 7

it is maintained by Human chorionic gonadotropin( hCG)

corpus luteum degenerates after approx. two weeks.
Progesterone and oestrogen levels fall. Results in increase in gonadotrophinlevels and the start of the follicular phase of the next cycle.

Question 8

spermicides, what they do, and examples

Answer 8

chemical substances that’s used to prevent pregnancy by killing sperm.

Benxalkonium chloride(BZK)
Menfegol
Nonoxynol-9 (N-9)

Question 9

name some barrier contraceptives

Answer 9

male condom, female condom, diaphragms, cervical caps

Question 10

what do you know about diaphragms as a contraceptive

Answer 10

Thin, dome-shaped devices made of latex or silicone

it prevents sperm from entering the uterus and is used with spermicide to increase its effectiveness.

Spermicide jelly usually placed inside the dome before insertion

Inserted into the vagina and positioned over the cervix before intercourse, and left in place for 6 hours afterward.

Usually fitted by a physician, but can be inserted or removed by the individual

Question 11

what do you know about the cervical cap as a contraceptive

Answer 11

Made of soft rubber. can be made of silicone as well, and is placed over the cervix

prevents the sperm from entering the uterus

Spermicidal gel or cream is often used in conjunction with it

The cap needs to remain in place for 6-8 hours after intercourse to ensure that any sperm present are neutralized. It can be worn for up to 48 hours before being removed

Easy to use especially for those people with weak vaginal muscle tone

smaller than the diaphragm, but similar to it

Question 12

some hormonal contraceptive examples

Answer 12

the oral contraceptive pills

contraceptive injections

implants, inserted under the skin

patches…etc

Question 13

how do the hormonal contraceptives generally work

Answer 13

they basically consist of various combinations of oestrogen and progesterone that inhibit gonadotrophin secretion.
lead to non-physiological growth of uterine wall.

In addition, progesterone thickens cervical mucus and helps prevent sperm penetration.

Question 14

two types of intrauterine devices and how they work

Answer 14

hormonal(intrauterine system): releases synthetic progesterone, example levonorgestrel

non hormonal(aka copper coil IUD): releases copper , which is toxic to sperm and ova, thereby preventing fertilisation. it also prevents implantation

Question 15

difference between progestin and progestrone

Answer 15

Progesterone is a naturally occurring hormone, while progestin is a synthetic chemical that mimics progesterone’s effects

Question 16

similarities and differenes in both progestin and oestrogen action as contraceptives

Answer 16

ovarian and pituitary inhibition by both

differences
progestin;
thickens cervical mucus whiles oestrogen thins it

endometrial atrophy by progestin, while endometrial proliferation by oestrogen

thickening cervical mucus makes it harder for sperm to reach the uterus.

Question 17

progestin-only pills and their mode of action

Answer 17

These pills primarily work by thickening the cervical mucus, thereby preventing sperm from entering the uterus

the minipills do not always prevent ovulation, as very low progestin doses are not as consistent as intermediate-high doses

To work effectively, they must be taken at a certain time every 24 hours. Even missing one pill can greatly reduce effectiveness

note that the transdermal patches are as effective as the pills

note that the pill can prevent cancer in the ovaries, endometrium and colon and rectum

Question 18

two types of emergency contraception

Answer 18

Emergency contraceptive pill – Levonelle or ellaOne (“morning after” pill)

Non-hormonal - Intrauterine device (IUD) – aka copper coil (Cu-IUD)

Question 19

how levonelle works

Answer 19

contains levonorgestrel (synthetic version of progesterone) which delays ovulation (delays/suppresses LH peak, follicular rupture) – if taken at least 2 days before

leads LH surge

Human implantation & fertilisation unaffected

Question 20

how ellaOne works

Answer 20

contains ulipristal acetate which delays follicle development , leading to decrease in estradiol levels
it delays ovulation (follicular rupture) by modulating progesterone receptor (represses the expression of progesterone-dependent genes important for ovulation)

Inhibit uterine decidualization and luteal phase endometrial maturation

oestradiol is a form of oestrogen

. Unlike levonorgestrel, ulipristal acetate may have
some effect even after the start of LH surge – inhibited 100% of follicular rupture when taken prior to LH rise

Both levonelle and ellaOne are not effective post-ovulation
both delay ovulation for 5 days