Reproductive Endocrinology Flashcards
Explain the synthesis of sex hormones.
- Cholesterol
- Pregnenolone -> Progesterone
- Other steps
- Androstenedione -> estrone (CYP19) and testosterone (17beta-HSD)
- Testosterone -> estradiol (Aromatase/ CYP19)
- Testosterone -> Dihydrotestosterone (5alpha-reductase)
Carnegie Stages
System used by embryologists to describe the apparent maturity of embryos (Embryonic, E)
Postovulatory Age
- Frequently used by clinicians to describe the maturity of an embryo
- Refers to the length of time since the last ovulation before pregnancy (days, d)
Gonadal Ridge
- Bipotential gonad
- First thing to differentiate
Rspo1
- XX
- Wnt4/beta-catenin
- Female gene development: Mullerian duct (uterine tube)
- Reduction of Wolffian duct
Sry
- XY
- Sox9
- Testosterone and Anti Mullerian hormone (AMH)
- AMH represses female gonadal development
- Wolffian duct development (vas deferens)
What are the components of male genitalia?
- 2 testes
- 2 ductus deferens
- Accessory sex glands (prostate, seminal vesicles, etc.)
- Pelvic/penile urethra
- Penis
- Seminal vesicle is testosterone tissue
What are the components of female genitalia?
- 2 ovaries
- 2 uterine tube/oviduct
- Uterus
- Cervix
- Vagina
Explain the process of sexual differentiation of the brain.
- Androgens produced by fetal and neonatal testes are converted to estradiol in the brain by aromatase
Bovine Twins
- Female (XX): does not have reproductive anatomy (infertile)
- Freemartin
Dichlorodiphenyltrichloroethane (DDT)
- Androgen receptor antagonist (DDE) (can also bind to estrogen receptor beta) -> not activated (poor or no differentiation in tissues)
- Endocrine disruptor
Explain the HPG axis basics.
- Hypothalamus: Gonadotropin releasing hormone (GnRH)
- Anterior Pituitary Gland: Luteinizing Hormone/ Follicle Stimulating Hormone (LH/FSH)
- LH -> endocrine cells -> steroid and peptide hormones
- FSH -> gamete production
Oxytocin
- Effects: milk ejection, uterine smooth muscle contraction, maternal behavior
- Positive control: physical stimulation (teat/nipple/cervical) and psychological (visual/auditory)
- Negative control: catecholamines (stress)
Explain GnRH neuron input.
- Kisspeptin neuron -> GnRH neuron (releases GnRH)
- GnRH neurons do not express steroid R
Inhibin
- Blocks FSH production
- Androgens stimulate inhibin
- Gonadal inhibin: decreases FSH production by blocking action of activins
Activin
- Supports LH (activin A) or FSH (activin B) production
- Follistatin binds to activin and prevents it from increasing FSH
Explain the male HPG axis.
- Hypothalamus: secretes GnRH
- GnRH in hypothalamo-pituitary portal vessels
- Anterior pituitary: secretes FSH and LH
- FSH -> Sertoli cells in testes -> stimulate spermatogenesis and inhibin
- LH -> Leydig cells -> testosterone -> Reproductive tract and other organs
- Inhibin -> negative feedback to anterior pituitary (only FSH)
- Testosterone -> negative feedback to hypothalamus and anterior pituitary (only LH)
Explain the female HPG axis.
- Hypothalamus: secretes GnRH
- GnRH in hypothalamo-pituitary portal vessels
- Anterior pituitary: secretes FSH and LH
- FSH -> Granulosa cells in ovaries -> influence oocytes, secrete inhibin, and convert androgens to estrogen
- LH -> Theca cells -> androgens
- Inhibin -> negative feedback to anterior pituitary (primarily FSH)
- Estrogen -> positive feedback to anterior pituitary and hypothalamus
Where is testosterone produced in males?
Interstitial space (Leydig cells)
What types of cells are found in the seminiferous tubules?
- Germ cells (spermatogonia)
- Sustentacular (Sertoli cells): produce inhibin
Leydig Cells
- Interstitial space (between seminiferous tubules)
- Respond to LH to secrete testosterone (feedback to brain to decrease GnRH and LH
- Indirectly support spermatogenesis by producing testosterone
- Rich in steroidogenic enzymes necessary for steroidogenesis (testosterone production)
Sertoli Cells
- Support germ cells
- Secrete inhibins (feedback to brain to decrease FSH)
- Respond to FSH
- In fetal life, secrete AMH
- Form tight junctions (blood testis barrier)
What are the roles of testosterone?
- Stimulate spermatogenesis
- Maintain Wolffian duct, accessory glands
- External genitalia, secondary sex characteristics
- Simulate metabolism (muscle growth)
- Affect CNS function/behavior
Cryptorchidism
- Undescended testes
- Most common birth defect of male genitalia
- Will not produce normal sperm but will produce androgens
- Increased risk of testicular cancer
- Caused by hormonal abnormalities, genetic or environmental changes
Kisspeptin
- Receptor: KISS1R/ GPR54 (Gq, PLC)
- Produced by neurons and adipose tissue (increased with obesity)
- Inactivating mutations of KISS1R/GPR54 or KP leads to reproductive failure (hypogonadotropic hypogonadism)
Gonadotropin Inhibiting Hormone (GnIH)
- GnIH-R (GPCR) found on GnRH neurons and gonadotropes
- Inhibits reproductive axis, counterbalancing GnRH1 (primary form of GnRH that stimulates gonadotropin release)
- Responsive to environmental factors (stress and photoperiod)
- Increased when reproduction is less advantageous
Explain the four stages of puberty.
- Prepubertal stage: growth and development determined by nutritional status, genetics, and environmental factors, GnRH suppression: GnRH is low (LH/FSH suppressed)
- Pubertal Onset: Hormonal activation (GnRH pulses increase in frequency and amplitude, stimulating the anterior pituitary to release FSH and LH) and follicle and seminiferous development (FSH stimulates follicle development in the ovaries, spermatogenesis in the testes)
- Sexual Maturation: secondary sexual characteristics (increased levels of sex steroids lead to visible secondary sexual characteristics, such as muscle growth and behaviors) and first ovulation or spermatogenesis (production of viable sperm in males and first ovulation in females males functional reproductive maturity)
- Reproductive capability: regular cyclicity in females (females begin regular estrous cycles) and sperm maturation in males (sperm production sufficient to support fertility over time)
Tanner Staging (Sexual Maturity Rating)
- Used by human healthcare providers to document and track the development of secondary sex characteristics of children during puberty
Stage 1: Hormone are active, but no visible signs of puberty
Stage 2: first physical signs of puberty appear (breast buds or pubic hair)
Stage 3: Growth spurt, acne, axilla hair growth
Stage 4: Development continues and first menses occurs in females
Stage 5: Reproductive organs and genitals are fully developed and facial hair appears in males
What are the signals for pubertal onset?
- Age: nutrition, genetics, body condition or critical body weight by a certain age
- Timing: season/photoperiod, social cues, pheromones
- Endocrine input/disruption: GnRH, leptin (body condition), Kisspeptin (key signaling mechanism from adipose tissue), GnIH
How is prostaglandin synthesized?
- Plasma membrane with membrane bound phospholipids
- Stimulus activates phospholipase
- Arachadonic acid
- Cyclooxygenase (COX)
- Eicosanoids (ex: prostaglandin F2 alpha in uterus)
Anti-Mullerian Hormone (AMH)
- Protein hormone
- AMH-receptor 2 (TGFbeta type)
- Produced by Sertoli cells of the testes of XY fetus during sexual differentiation
- Causes Mullerian ducts (precursors to female reproductive organs) to regress and may help with testicular descent
- Produced by granulosa cells of ovary of XX fetus after Mullerian ducts have regressed