Reproductive Physiology Basics (Parts 1-6) Flashcards

1
Q

Describe the structure of ovaries

surface, cortex, medulla

A
  • surface: connective tissue capsule covered with layer of simple cuboidal epithelium.
  • cortex: peripheral part, connective tissue containing ovarian follicles (one oocyte surrounded by single layer of cells).
  • medulla: central part, connective tissue with blood vessels.
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2
Q

what are the functions of ovaries?

A
  • oocyte production
  • steroid hormone production: estrogen develops secondary sexual characteristics, progesterone prepares endometrium for implantation, 50% of testosterone produced by ovaries before menopause
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3
Q

outline the process of oogenesis

A
  • primordial germ cell mitosis in fetal life only and primotdial follicles arrested in the stage of 1st meiotic division until puberty.
  • first meiotic division complete and second division starts after puberty and leads to release of one secondary oocyte in a menstrual cycle which is capable of fertilisation.
  • second meiotic division completes after fertilisation of oocyte with sperm.
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4
Q

describe primordial follicles

A

primary oocyte arrested in first meiotic division surrounded by one layer of squamous pre granulosa cells

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5
Q

describe a primary follicle

A

oocyte surrounded by zona and cuboidal granulosa cells

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6
Q

describe a secondary follicle

A

increased oocyte diameter and multiple layer of granulosa cells, resumption of first meiotic division

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7
Q

describe tertiary/graffian follicles

A

follicular fluid between the cells which coalesce to form antrum, completion of first meiotic division to form secondary oocyte and start of second meiotic division.

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8
Q

what are the four phases of the ovarian cycle?

A
  • follicular phase
  • ovulation
  • luteal phase
  • menstruation
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9
Q

what happens during the follicular phase of ovarian cycle?

A
  • FSH causes follicle to mature and produce oestrogen (inhibiting development of other follicles)
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10
Q

what happens during the ovulation phase of ovarian cycle?

A
  • an LH surge causes ovulation (follicle ruptures and releases a secondary oocyte).
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11
Q

what happens during the luteal phase of ovarian cycle?

A
  • ruptured follicle forms a corpus luteum and secretes progesterone (and some oestrogen).
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12
Q

what happens during the menstruation phase of ovarian cycle?

A
  • when the corpus luteum degenerates (forms a corpus albicans), a new ovarian cycle can begin.
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13
Q

what problems can cause amenorrhoea (no periods)?

A
  • problem with regulating hormones
  • problem with ovarian function
  • problem with uterus or outflow tract
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14
Q

which conditions/drugs can cause ameorrhoea due to a problem with regulating hormones?

A
  • functional: excessive weight loss or gain, over exercising, stress
  • chronic medical conditions: diabtetes, sarcoidosis, renal disease, TB
  • intracranial space occupying lesion: prolactinoma, tumours, cysts
  • infection or trauma: meningitis, intracranial bleed, Sheehan’s
  • drugs: glucocorticoids, anabolic steroids, opiates
  • genetic: Kallmann’s syndrome
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15
Q

List some problems with ovarian function that can cause amenorrhoea

A
  • hypergonadotropic hypogonadism: high or normal FSH,LH
  • genetic: Turner’s syndrome (46X), fragile X
  • ageing: steep decline in ovarian function past 35 years
  • primary ovarian insufficiency
  • chronic illness: autoimmune disease
  • radiotherapy or chemotherapy
  • infection: tuberculosis, mumps oophoritis
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16
Q

list some problems with the uterus or outflow tract which can cause amenorrhoea

A

Congenital:
- absent uterus, vagina- lack of Mullerian duct development (MRKH syndrome)
- transverse vaginal septum or imperforate hymen- Mullerian duct fail to canalise
- androgen insensitivity syndrome

Iatrogenic:
- uterine adhesions or synechiae (Asherman syndrome)
- radiotherapy (pelvic or cervical)

17
Q
A
18
Q
A
19
Q

list the three types of cells within the seminiferous tubules and their function

A
  • germ cells produce- produce sperm
  • sertoli/sustenacular cells- support sperm producing cell, induce inhibin
  • interstitial (Leydig) cells- produce testosterone
20
Q

what are the functions of the testes?

A
  • sperm production
  • testosterone production- male secondary secual characteristics, controls spermatogenesis
21
Q

how do pituitary hormones interact with testes hormones?

A

LH and FSH stimulate spermatogenesis and testosterone secretion by the testes.

22
Q

how do testes hormones interact with pituitary hormones?

A

Testosterone and inhibin inhibit the secretion of GnRH by the hypothalamus and LH and FSH by the pituitary (negative feedback)

23
Q

describe spermatogenesis

A
  • Sperm production from the primordial germ cells.
  • Average cycle of spermatogenesis is 64 days in which the germ cells pass through different developmental stages

Two distinct phases during the development:
- Spermatocytogenesis- Clonal expansion and maturation through mitotic and meiotic process
- Spermiogenesis- Differentiation into mature sperm cells
Process starts at puberty and continues lifelong

24
Q

describe the chromosomal division during spermatogenesis

A

One mitotic division- Spermatogonium to primary spermatocyte-duplication, diploid chromosomes number(46)

First meiotic division- primary spermatocyte to secondary spermatocyte, two cells with haploid chromosome number(23)

Second meiotic division- secondary spermatocyte to spermatid, two cells with haploid chromosome number(23)

Spermiogenesis- maturation of spermatids into functional sperm cells

25
Q

list some pretesticular medical factors affecting spermatogenesis

problem with hormonal control

A
  • Functional- excessive weight loss, gain
  • Intracranial tumours, cysts, bleed
  • Prolactinoma
  • Medications- opiates, external testosterone, steroids(body building)
  • Genetic- Kallmann’s syndrome
26
Q

list some testicular medical factors affecting spermatogenesis

problem at the site of production

A
  • surgery: orchidectomy, orchidopexy
  • STI
  • mumps orchitis
  • testicular trauma or torsion
  • radiotherapy or chemotherapy
  • genetic: Klinefelters (46 XXY), Y- chromosome microdeletion
27
Q

list some steps to reduce the impact of factors affecting fertility

A
  • improve lifestyle: normal BMI, stop smoking, alcohol limitation, healthy diet, exercise, adjustments to occupational exposure
  • optimise underlying medical condition
  • stop medications or switch to alternative pregnancy compatible medications
  • reduce STI risk and treat promptly if diagnosed
  • fertility preservation - sperm freezing prior to surgery or cancer treatment