Unit 1 Flashcards
XX
Female
XY
Male
Puberty
Series of changes over the years where reproductive organs become fully functional.
Primary Sex Characteristics
Maturation of organs related to reproduction; ova in ovaries and sperm in testes.
Secondary Sex Characteristics
Differentiate male from female; breast development + fat redistribution in females, increased muscle mass + hair growth in males.
Purpose of Hypothalamus in Puberty
Secretes GnRH
Purpose of Gonadotropin-Releasing Hormone in Puberty
Stimulates Anterior Pituitary gland to secrete Follicle Stimulating Hormone + Luteinizing Hormone.
Menarche
Start of menstruation
When does Menarche start
2-2.5 years after breast development
First outward sign of SSC development in Males starts and ends when?
usually around 9.5 years w/ final male maturation complete at approx. 17 years old.
Follicular Phase
Maturation of follicles + oocytes
Luteal Phase
Starts with ovulation, refers to the activity of corpus luteum.
FSH in women
primary hormone responsible for follicle maturation in the ovaries.
LH in women
responsible for final maturation and release of the egg from the follicle.
After follicle ruptures, becomes corpus luteum, which produces progesterone.
Estrogen
responsible for female patterns of fat distribution, dominant hormone during first half of menstrual cycle.
Progesterone
helps maintain uterine lining during second half of menstrual cycle.
hCG
if the ovum is fertilized it secretes Human Chorionic Gonadotropin (hCG) causing the persistence of the corpus luteum to maintain an early pregnancy until the placenta can take over.
Menstrual Cycle
Period of time between the start of one menses to the start of the next
Duration is approximately 28 days but can range from 20-45 days
Menstrual Phase
occurs when ovum is not fertilized and lining of endometrium sheds
Proliferative
endometrial glands enlarge and endometrium thickens
Secretory
endometrium maintained by progesterone, increased blood and secretions to endometrium, reduced contractility of uterine smooth muscles to create environment for implantation. This continues if fertilization occurs
Ischemic
corpus luteum begins to disintegrate, necrosis and breakdown of endometrial lining
Gametogenesis
Development of ova in the woman and sperm in the male
Gametes
reproductive cells
Oogenesis
Females are born with 1-2 million oocytes in their ovaries, which diminishes to 200,000-400,000 by puberty.
Spermatogenesis
does not begin until puberty in males, formation occurs in the testes
Fertilization
Typically occurs in the ampulla
Zona pellucida + Corona radiata
prevent fertilization by more than 1 sperm
Preembryonic Period
The first 2 weeks after conception
Zygote
fertilized ovum
Morula
3 days after fertilization, it is a tight ball of 12-31 cells
Blastocyst
a sac of cells with an inner cell mass
Implantation
Occurs between days 6 and 10 after fertilization. The zygote secretes hCG to signal the woman’s body that a pregnancy has begun. hCG production causes the corpus luteum to persist and continue to secrete estrogen and progesterone until the placenta takes over
Site of implantation
where the placenta develops
Best area for implantation and placental development
Upper uterus
Spotting
known as “implantation bleeding” and can be confused with menstruation by the woman.
Embryonic Period
Weeks 3-8 after conception
First functional system to develop in the embryo
Cardiovascular system
Vernix caseosa
a cheese-like secretion from the fetal sebaceous glands, covers skin to protect it from constant exposure to amniotic fluid. (Weeks 17-20)
Lanugo
fine downy hair that covers the fetal body helps the vernix to adhere to the skin. (Weeks 17-20)
Full term
after 37.0 weeks
The two most important features in the 36-40 week time period are
- addition of subcutaneous fat and brown fatfor heat maintenance and glucose storage
- maturation of lungs with surfactant production
Full term pregnancies may last up to
41-41.6 weeks
Majority of fetuses are born between
39.0-41.6 weeks
Calculation of estimated gestational age (EGA) or estimated date of confinement (EDC) is
from the first day of the last menstrual period (LMP)
Placenta
- The placenta is the disc shaped organ that is involved in the metabolic, transfer and endocrine functions
- Grows where the blastocyst implants in the uterus
- Maternal side is rough where it is attached to the uterus
Maternal and fetal blood
do NOT mix in the placenta although they flow very close to each other
Exchange of substances between mother and fetus occur
in the intervillous spaces, as approximately 150ml of the mother’s blood is outside the mother’s circulatory system and is in the intervillous space.
The fetal side of the placenta
is smooth and develops from the outer cell layer of the blastocyst (trophoblast)
Umbilical cord
inserted on the fetal side and contains 2 arteries and 1 vein. They transport blood between fetus and mother.
Umbilical vein
Carries oxygenated blood from mother to fetus
Umbilical arteries
Carry deoxygenated blood and waste from the fetus to the placenta to be excreted by the mother
Placenta primary functions
Circulation, Protection, and Hormone production
amnion
inner fetal membrane
chorion
outer fetal membrane
Amniotic fluid
made from fetal urine and fluid transported from maternal blood across the amnion and protects the growing fetus by cushioning from maternal impacts and maintaining a stable temperature.
Wharton’s jelly
prevent obstructionin umbilical arteries and vein
Ductus Venosus
liver
Foramen Ovale
flap valve in between the right and left atrium of the fetal heart
Ductus Arteriosus
connects the pulmonary artery and the descending aorta during fetal life. Dilation of the DA is maintained by prostaglandins from the placenta and low oxygen content of the blood
Changes in blood Circulation at birth
- As the infant’s lungs expand, blood flow to the lungs increases, pressure to the right side of the heart falls and the foramen ovale closes.
- The ductus arteriosus constricts as the arterial oxygen level rises.
- The ductus venosus constricts when flow from the umbilical cord stops.
delayed umbilical cord clamping
so that the oxygenated blood remains in the system while the lungs take over as the organ of respiration. If we clamp the cord before 1 minute the infant can have more difficult time with transitioning to extrauterine life.
Contraception
- Goal is to prevent unwanted or mistimed pregnancies
- Best method is the one that works for the patient
Infertility
lack of pregnancy after 12 months of well-timed intercourse when the woman is <35 years of age or after 6 months for women 35 years and older
Well-timed intercourse
regularly starting at 5 days before and the day of ovulation (egg is able to be fertilized 12-24 hours after release, sperm can live inside female reproductive tract up to 5 days)
Endometriosis
When a tissue similar to the uterus’ lining tissue grows on the outside of the uterine cavity, the condition is termed endometriosis.
Treatment for ovulatory disorders may include:
- Weight loss or gain may be enough to stimulate ovulation
- BMI too high (27 or above) or too low (below 17) can contribute to oligoovulation (infrequent or irregular ovulation) or anovulation (no ovulation).
- Clomid (Clomiphene Citrate)
- Aromatase Inhibitors (Letrozole)
- Gonadotropin therapy
Tubal Infertility
May be the result of an ascending infection that causes scarring, adhesions, and occlusion of the tubes
Hysterosalpinogram
imaging test used to assess the fallopian tubes and uterus
Luteal Phase Defect
- Luteal phase is the period of time between ovulation and menstruation. Duration is typically 12 to 16 days.
- During this time, progesterone levels increase and the uterine lining thickens to create a healthy environment for potential egg implantation. With a shortened luteal phase, some women will experience lower progesterone levels and thinner uterine lining
- Historically treated with progesterone supplementation
Cervical Factor Infertility
- Cervical secretions are thin or scant and may impede the passage of sperm
- May be treated with intrauterine insemination (IUI) to bypass the cervix
Male Infertility May be caused by:
Hypothalamic pituitary disease
Primary hypogonadism (low sperm or testosterone production)
Disorders of sperm transport
Dysfunction of the seminiferous tubule
Other things that may impact male fertility:
Infections
Drugs and environmental exposure, including chemotherapy, toxic chemicals, radiation therapy, anabolic steroids, and alcohol
Age (over 50 years) may diminish fertility
Male infertility is most often treated by conventional methods that includeone or more of the following:
Medications to help increase sperm production
Antibiotics to heal infection
Hormones to improve hormone imbalance
Lifestyles changes, such as quitting smoking or obtaining a healthy body weight
Temperature adjustments: Avoiding long hot showers, usinghot tubsor saunas; Wearing looser underwear such as boxer shortsversus jockey shorts
Surgical options may be available
Intrauterine insemination (IUI)
sperm is introduced directly into the upper uterine cavity
In Vitro Fertilization (IVF)
ovaries are stimulated and eggs are collected and mixed with sperm. Embryo is deposited into upper uterine cavity
Intracytoplasmic Sperm Injection (ICSI)
like IVF, but a single spermatozoon is injected directly into the egg
