Reproductive Physiology P1+2 Flashcards
describe structure of the female reproductive system
what are different structures of the ovaries
surface
cortex
medulla
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
what are the two main functions of the ovary
oocytre production
sterior hormone production
oocyte production
One mature egg per menstrual cycle, around 400 ovulated during entire reproductive lifespan
Majority of eggs perish during the cycle
Finite number, declines with increasing age
sterior hormone production
Estrogen develops female secondary sexual characters
Progesterone prepares endometrium for implantation
50% of testosterone produced by ovaries before menopause
what is the process of oogenesis
Primordial germ cell mitosis in fetal life only and primordial follicles arrested in the stage of first meiotic division until puberty (before birth)
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
primordial follicle
primary oocyte arrested in first meiotic division surrounded by one layer of squamous pre granulosa cells
primary follicle
oocyte surrounded by zona and cuboidal granulosa cells
secondary follicle
increased oocyte diameter and multiple layer of granulosa cells, resumption of first meiotic division
tertiary / graffian follicle
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.
describe chromosomal division during oogenensis
oogonium
MITOSIS
primary oocyte
MEIOSIS
secondary oocyte
OVULATION + sperm
MEIOSIS fertilisation
main hormones that control female reproduction from hypothalamus
GnRH –> anterior pituitary
FSH / LH –> ovary
Estrogen / progrsterone –> uterus
what are the phases of the ovarian cycle?
follicular phase
ovulation
luteal phase
menstruation
follicular phase
FSH causes folicle to mature and produce estrogen
ovulation
LH surge causes ovulation
luteal phase
ruptured follicle forms corpus luteum and secretes progesterone
menstruation
corpus luteum degenerates –> corpus albicans
new ovarian cycle begins
what is amenorrhea
no periods
why may ammenorrhea occur
Problem with regulating hormones
Problem with ovarian function
Problem with uterus or outflow tract
Problem with regulating hormones
Hypothalamic or Pituitary cause- hypogonadotropic hypogonadism(Low FSH, LH, high prolactin)
Functional– Excessive weight loss or gain, over exercising, stress
Chronic medical conditions- Diabetes, 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
Problem with ovarian function
Hypergonadotropic hypogonadism- high or normal FSH, LH
Genetic- Turner’s syndrome(46X), Fragile X
Ageing- steep decline in ovarian function past 35 years
POI or POF
Chronic illness- autoimmune diseases
Radiotherapy or Chemotherapy
Infection- tuberculosis, mumps oophoritis
Problem with uterus or outflow tract
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
management amenorhea
Life style changes
Optimise control of medical illness
Stop drugs or switch to alternatives
Prolactinoma- medical treatment
Intracranial SOL- surgical treatment
Vaginal anomalies( septum or hymen)- surgical treatment
Uterine adhesions- surgical division hysteroscopic
Fertility preservation before radiotherapy and chemotherapy
Fertility treatment- IVF with own or donor eggs
