Reproductive Physiology P1+2

Question 1

describe structure of the female reproductive system

Question 2

what are different structures of the ovaries

Answer 2

surface
cortex
medulla

Question 3

surface

Answer 3

connective tissue capsule covered with layer of simple cuboidal epithelium

Question 4

cortex

Answer 4

peripheral part, connective tissue containing ovarian follicles (one oocyte surrounded by single layer of cells)

Question 5

medulla

Answer 5

central part, connective tissue with blood vessels

Question 6

what are the two main functions of the ovary

Answer 6

oocytre production
sterior hormone production

Question 7

oocyte production

Answer 7

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

Question 8

sterior hormone production

Answer 8

Estrogen develops female secondary sexual characters

Progesterone prepares endometrium for implantation

50% of testosterone produced by ovaries before menopause

Question 9

what is the process of oogenesis

Answer 9

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

Question 10

primordial follicle

Answer 10

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

Question 11

primary follicle

Answer 11

oocyte surrounded by zona and cuboidal granulosa cells

Question 12

secondary follicle

Answer 12

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

Question 13

tertiary / graffian follicle

Answer 13

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.

Question 14

describe chromosomal division during oogenensis

Answer 14

oogonium
MITOSIS
primary oocyte
MEIOSIS
secondary oocyte
OVULATION + sperm
MEIOSIS fertilisation

Question 15

main hormones that control female reproduction from hypothalamus

Answer 15

GnRH –> anterior pituitary
FSH / LH –> ovary
Estrogen / progrsterone –> uterus

Question 16

what are the phases of the ovarian cycle?

Answer 16

follicular phase
ovulation
luteal phase
menstruation

Question 17

follicular phase

Answer 17

FSH causes folicle to mature and produce estrogen

Question 18

ovulation

Answer 18

LH surge causes ovulation

Question 19

luteal phase

Answer 19

ruptured follicle forms corpus luteum and secretes progesterone

Question 20

menstruation

Answer 20

corpus luteum degenerates –> corpus albicans

new ovarian cycle begins

Question 21

what is amenorrhea

Answer 21

no periods

Question 22

why may ammenorrhea occur

Answer 22

Problem with regulating hormones
Problem with ovarian function
Problem with uterus or outflow tract

Question 23

Problem with regulating hormones

Answer 23

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

Question 24

Problem with ovarian function

Answer 24

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

Question 25

Problem with uterus or outflow tract

Answer 25

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

Question 26

management amenorhea

Answer 26

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