The Menstrual Cycle Flashcards

1
Q

What are the aims of the menstrual cycle?

A
  • selection of a single oocyte
  • regular spontaneous ovulation
  • correct number of chromosomes in eggs
  • cyclical changes in the vagina, cervix and fallopian tube
  • preparation of the uterus
  • support of the fertilised dividing egg
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2
Q

What is the follicular phase of the menstrual cycle?

A

It is the first half of the menstrual cycle, up to ovulation (Day 14).

It encompassed the growth of follicles up to ovulation, and is dominated by oestradiol production from the dominant follicle.

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3
Q

What is the luteal phase of the menstrual cycle?

A

It is the second half of the menstrual cycle, from ovulation to the end of the cycle.

It is the formation of the corpus luteum from the empty follicle, and dominated by progesterone production from the corpus lueteum

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4
Q

Describe how feedback in the follicular phase is variable?

A

1) We get the release of negative feedback
2) Negative feedback is then reinstated
3) Then, we switch from negative feedback to positive feedback

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5
Q

Why is the inter-cycle rise and fall in FSH important?

A

It allows for the selection of a single follicle

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6
Q

Describe follicle selection

A

The raises FSH presents a window of opportunity

The FSH threshold hypothesis:

  • one follicle from the group of antral follicles in the ovary is just at the right stage at the right time
  • this becomes the dominant follicle which goes on to ovulate
  • it can happen in either ovary

Oestradiol levels rise, reinstating negative feedback at the pituitary, causing FSH levels to drop, preventing further follicle growth

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7
Q

How does the dominant follicle survive the fall in FSH?

A

As FSH falls, LH increases.

The dominant follicle acquires LH receptors on granulosa cells. The dominant follicle also increases sensitivity to FSH by increasing FSH receptors and increases the number of granulosa cells

Other follicles do not, so they lose their stimulant and die

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8
Q

What happens when the dominant follicle is selected?

A

It grows rapidly, doubling in diameter in seven days, from 7mm to 14mm.

It needs masses of growth factors, nutrients and steroids. There is also rapid neoangiogenesis (formation of new blood vessels).

Oestrogen is released from the follicle into the circulation.

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9
Q

Describe the LH surge during the menstrual cycle?

A

Throughout the follicular phase, oestrogen feedback is negative. At the end of the follicular phase, oestrogen levels are raised for long enough that feedback switches from negative to positive.

This causes a massive release of LH from the pituitary. There is an exponential rise of LH in the serum. This triggers the ovulation cascade.

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10
Q

What is the ovulation cascade?

A

Ovulation occurs via a cascade of events:

  • blood flow to the follicle increases dramatically (the increase in vasculature permeability increase intra-follicular pressure)
  • an appearance of an apex or stigma in the ovary wall
  • the local release of proteases
  • the enzymatic breakdown of the ovary wall
  • 12-18 hours after the peak of LH, a hole appears in the follicle wall and ovulation occurs
  • the occyte with cumulus cells is extruded from the ovary under pressure
  • follicular fluid may pour into the Pouch of Douglas
  • the egg is ‘collected’ by the fimbrae of the fallopian tube
  • the egg progresses down the tube by peristalsis and the action of the cilia
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11
Q

How is the oocyte prepared for division?

A

For its formation as a primary oocyte in the foetal ovary up until ovulation, the oocyte has been arrested in the first meiotic division.
This permits the oocyte to retain all of the DNA and remain as large as possible during its long wait.

In response to the LH surge, the nucleus of the oocyte in the dominant follicle completes the first meiotic division, but it does not divide

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12
Q

How does the oocyte move from primary to secondary?

A

Half of the chromosomes are put into a small ‘package’ in the egg called the ‘first polar body’. The egg is now a secondary oocyte. The first polar body plays no further part in the process and does not divide again.

The oocyte begins the second meiotic division, but arrests again.

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13
Q

How long does the oocyte spend in the fallopian tube?

A

2-3 days, and if it meets with a sperm, fertilisation will occur

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14
Q

Describe corpus luteum formation

A

After ovulation, the follicle collapses. The corpus luteum is then formed, often called ‘the yellow body’.

Progesterone production greatly increases, along with oestrogen.

The corpus luteum contains large numbers of LH receptors. The corpus luteum is supported by LH and hCG (from the implanting embryo, if a pregnancy occurs).

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15
Q

Describe the secretions of the corpus luteum and what they do

A

PROGESTERONE:

  • supports oocyte on its journey
  • prepares the endometrium
  • controls the cells in the fallopian tubes
  • alters secretions in the cervix

OESTRADIOL:
- for the endometrium

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16
Q

Describe the demise of the corpus luteum

A

If fertilisation doesn’t occur, the corpus luteum has a finite lifespan of 14 days.

The removal of the corpus luteum is essential to initiate the new cycle.

Cell death occurs, there is vasculature breakdown and the corpus luteum shrinks. This process is not yet well understood.