REPRODUCTIVE SYSTEM 10 marks MENSTRUAL CYCLE ~ Refers to cyclical changes that takes place in the women - Preparatory step for fertilization and Pregnancy Duration - 25~35 Days Average — 28 Days Changes include: Ovarian Cycle Uterine Cycle Cervical Cycle Vaginal Cycle ian Cycle Follicular Phase Ovulation Luteal Phase 1, Follicular Phase Involves the development of a follicle - One follicle matures each month - During the lifetime of a female only 400 folticles mature Stages of follicular development: Primordial follicle > Primary Follicle > Secondary follicle -> Tertiary follicle (Involves addition of granulosa cells surrounding the oocyte & also formation of theca cells) Antral follicle(Having fluid filled space) > Matured Graatian follicle 2. Ovulatory Phase ‘The process of expulsion of secondary oocyte from ovary into peritonial cavity following rupture of mature graffian follicle ‘Timing: 14° day of sexual eycle Events of Ovulation = _ Rapid swelling of follicle Formation of stigma Release of proteolytic enzymes Dissolution of capsular wall Rupture of graffian follicle 3.Luteal_Phase (15! - 28" Dav} Event Formation of corpus hemorthagicum (ruptured follicle filled with blood) Formation of corpus luteum (clotted blood replaced with yellow colored lipid rich luteal cells) Formation of corpus albicans ( regression of corpus luteum)Uterine (Endometrial) Cycle Menstrual (Bleeding) Phase Proliferative phase Secretory phase [Link] The lining of the uterus (endometrium) breaks down and is lost from the body. This is called menstruation or a period Duration - Days 1-5 Components: - 30-50 ml blood (75% Arterial) = Ovum - unfertilized ~ Mucus ~ Endometrial debris — damaged endometrial tissue, serous fluid, a large amount of prostaglandins & fibrinolysin Mechanism of menstruation steroid production declines, . shrinking of endometrial tissue reduction in blood flow to superficial layers — ischemic hypoxia & damage to the epithelial and stroma cells & constriction of spiral arteries Individual arteries re-open > tearing and rupturing the ischemic tissues, 5. Bleeding into the cavity - About 50% of degenerating tissues is resorbed and 50% is lost as ‘menstrual bleeding’. 2. Proliferative Phase ~ Days 6-13 ~ increase in estrogen causing the endometrium to thicken (from Imm to 4 mm) - angiogenesis - stimulation of endometrial glands to grow 3. Secretory Phase Days 15-28 : increase in progesterone causes ~ endometrial thickness - increased vascularity - secretion of endometrial glands (in preparation for the developing embryo) Cervical Cycle 1. Preovulatory Phase - Estrogen is predominant hormone ~ Cervical mucus - Thin, Watery & Alkaline 2. Postovulatory Phase - Progesterone = Cervical mucus ~ Thick & Tenacious Vaginal Cycle 1. Preovulatory Phase - Estrogen predominance Thick & Comified Epithelium 2. Postovulatory Phase - Progesterone predominance Thick & viscid secretion Infiltrated with LeucocytesHormonal Control of Sexual Cycle Gonadotropins from Anterior pituitary, FSH - development of follicles (Follicular phase) LH - triggers ovulation Ovarian Hormones Estrogen — influences proliferative phase of endometrial cycle Progesterone ~ influences secretory phase of endometrial cycle Softee Hyptalamus Anterior Fear tase CORSA pany toa phase cores acu opus ae ‘ Progesterone and estogens) mt Trt N12 13.14 15-16 47 18 19 20 21 22 29 24 25 26 27 281 2 aun % pecate ; 2 Days 1 Mensinai ——Preovlatory ’ Postouatory phase phase Oniaton pase = Saat WU Hormonal equation of changes in th ovary and uterus ‘Menstrual Disorders Premenstrual Syndrome Amenorrhoea - Absent = Primary - Secondary ~ Pregnancy Menorrhagia — Excess bleeding ‘Metorrhagia ~ intermenstrual bleeding Oligomenorrhoea — decreased frequency Dysmenorrhoea — painful menstruation2. CONTRACEPTION ~ Refers to prevention of Conception ‘Methods of Contraception ‘Temporary Permanent 1. Barrier Methods, 1. Vasectomy 2. Natural Methods 2. Tubectomy 3. Intrauterine Devices 4, Hormonal Contraception (Oral pills) 1. Barrier Methods Prevention of deposition of sperms in vagina ‘Mechanical Methods Males - Nirodh (Condoms) Females - Pouch (Female condom) Diaphragm Cervical Cap Chemical Methods ‘Spermicides - Kill the Sperms Jelly Cream Sponge ‘Combined (Mechanical & Chemical) - More Effective Natural Methods Rhythm Method — Following safe period. Coitus Interruptus Complete abstinence SafePeriod Definition — the period of least fertility during menstrual eycle Duration - 5-6 days after menstruation & 5-6 days before next cycle Significance — rhythm method of contraception 3. Intrauterine Devices Lippe’s Loop CuT 200 Multiload Cu T-250 Progestasert Mechanism of Action Increase tubal motility Prevent implantation Spermicidal act [Link] /Oral Contraceptives Sex Hormones - Oral Pills Mechanism of Action Negative feedback mechanism Suppress FSH & LH secretion Pills Combined Pill - Progesterone & Oestrogen 21 Days - From the day bleeding stopsWithdrawal bleeding occurs ‘Sequential Pill - 15 days Oestrogen + Combination Mini pill - Low dose estrogen Posteoital pill — within 72 hours after sexual intercourse Complications of oral contraceptives ‘Thromboembolic phenomenon Increase in weight Jaundice ‘Avoid in Diabetics, Fibroid Uterus Permanent Contraceptive Methods ‘Vasectomy ‘Tubectomy ‘Medical Termination of Pregnaney (MTP) or Abortion Dilatation & curettage (D&C) ‘Vacuum aspiration Administration of prostaglandins SMARKS 1, SERTOLI CELLS Sertoli cells are the supportive cells found in the seminiferous tubules of testis Functions: 1. Play a role in the maturation of sperms. 2. Provide nutrition to the developing spermatozoa 3. Play a part in the mechanism of blood testis barrier 4. Phagocytize damaged germ cells. 5. Takes part in aromatization of testosterone into estrogen 6. Secretes the following substance ~ MIS (Mullerian Init = Inhibins - Androgen binding protein, 7. Influence Leydig cell secretion through activins & inhibins 2, SPERMATOGENESIS Definition: The development and maturation of spermatozoa (male gametes) is called ting substance) LSpermatocytogenesis: Development of spermatogonia into spermatids 1. Spermatogonium A: Primitive germ cells which are diploid (44+XY) and divide by mitosis to spermatogonium B cells [Link] B: These are also Primitive germ cells which are diploid (4+XY) and divide by mitosis. These cells azive rise to primary spermatocyte 3. Primary spermatocyte: Diploid cells which divide by meiosis to form secondary spermatocyte4, Secondary spermatocyte: These are haploid cells (224X or Y). They undergo second meiotic division to form spermatids 5. Spermatids: Haploid cells which transform into motile spermatozoa, ILSpermiogenesis: Transformation of spermatids into tailed, motile spermatozoa (sperms) Spermatozoa: Matured male gamates, haploid and posses a head, middle piece and a tail. About 512 spermatozoa develop from a single spermatogonium Spermatocytogenesis en —@) © —f\ f\ spermatid —) (@ (@ 0 | 2 a Z Ff Zf Spermiogenesis,Regulation of Spermatogenesis: Hormones: 1. Testosterone: Secreted from Leydig cells of testis. Acts on seminiferous tubules and stimulates the proliferation of spermatogonia into primary spermatocyte timulates proliferation as well as maturation of spermatozoa, Trophic to Sertoli cells which play an important role in maturation, [Link]: Stimulates the Leydig cells to produce testosterone which is required for 2. FSI Spermatogenesis 4. Other hormones which are required for spermatogenesis: Thyroxine, Growth hormone & Insulin Seneral fact remperature: Speramatogenesis requires 2 t0 of the body. 2. Irradiation: Exposure to harmful radiation causes degeneration of seminiferous tubules and leads to sterility 3. Toxins: Bacterial and viral toxins may cause selective destruction of seminiferous ubules. E.g. Mumps 4. Vitamins: Vitamins A, C & E are required for spermatogenesis 3. TESTOSTERO! Secreted from Leydig cells of testis. About 4-9 mg is secreted per day. Mechanism It combines with cytoplasmic receptor and reaches DNA. It acts on DNA and. stimulates mRNA and protein synthesis Functions: 1. In Fetus: a) Sex differentiation: Stimulates the development of Wolffian duct into male accessory sex organs. Development of male external genit requires dihydrotestosterone which is derived from testosterone b) Descent of testes: Along with MIS, testosterone stimulates the descent of testes from abdominal cavity into scrotum through inguinal canal [Link] Puberty: a)_On accessory sex organs: Stimulates the development and growth of the male accessory organs like vas deference, seminal vesicles, prostate, scrotum & penis 5) On distribution of body hair: General body hair increases, Moustache & beard appear-Pubic hair appear & attains male pattern © On voice: Becomes deeper and low pitched due to growth of vocal cords & larynx. 4) On skin: Thick with more sebaceous secretion, Acne appears on face €) Mental behavior: More aggressive 3. Spermatogenesis: Stimulates the proliferation of spermatogonia into primary spermatocyte in seminiferous tubules. 3°e less than the core temperature 4. On growth: Stimulates skeletal growth, But finally it causes fusion ofepiphyseal plates and arrest growth 5. On musele mass: Testosterone is a protein anabolic hormone. It increases, protein synthesis. This increases the muscle mass and muscle power in males. 6. On erythropoiesis: Stimulates the production of erytropoietin there by increases RBC count, Hence males have higher RBC count than females 4, PLACENTA, Nutritive Function Transport of Glucose, Amino a to foetal blood - Storage of Glycogen, Lipids, Fructose Respiratory Function -Diffusion of Oo from maternal blood to foetal blood -Diffusion of COs from foetal blood to maternal blood Double Bohr effect - Increased affinity of Foetal Hb (Hb F) shifts the ODC of foetal blood to left - Increased Level of COs shifts the ODC of maternal blood to right (Both the effects increase the O2 content of foetal blood) Excretory function: Transport of metabolic waste products like urea, uric acid, creatinine from foetal blood to maternal blood ids , Fatty acids & Vitamins from maternal blood Endocrine function Placental Hormones -Human Chorionic Gonadotrophin (HCG) = Human Placental Lactogen (HPL, HCS - Human Chorionic ‘Somatomammotrophin) -Human Chorionic Thyrotrophin (HCT) -Oestrogen , Progesterone -Relaxin Human Chorionic Gonadotrophin (HCG) Growth of Corpus Luteum Presence in Serum & Urine _- Diagnostic of Pregnancy Growth of Testis / Ovarian Follicles in Fetus Human Placental Lactogen = Maternal Growth Hormone of Pregnancy Growth of Breast glands Retention of Nitrogen, Calcium , Sodium Makes Glucose & Fats available to the Fetus Oestrogen ~ Growth of ducts of Breast glands = Increases the sensitivity of uterus to Oxytocin Progesterone Growth of alveoli of Breast glands = Maintenance of Pregnancy Relaxin - Relaxes Pelvic joints & Pubic symphysis }Softens and dilates the uterine cervix Facilitates delivery 6. INDICATORS OF OVULATION 1, Basal Body Temperature- A rise of 0.5°C after ovulation Billings Method - Cervical Mucus : Before ovulation- Elastic, Stretchable upto 10 cms (Spinnbarkeit effect) After ovulation — Thick and can not be stretched 3. Fern Test Before Ovulation cervical mucus produce a fern pattern when dried on a glass slide After Ovulation — Fern pattern disappears Biopsy of the endometrium —checking for the secretory phase Endoscopy Blood Gonadotrophins Level Ultrasound Abdomen JEUROENDOCRINE REFLEXES Uterine contraction + Baby moves __, Pressoreceptors ,Afferent deeper into’ = “in cervixof impulses to uterus excited hypothalamus + Hypoth. eee sends efferent impul ) posterior itary, Sear” Posterior pituitary releases oxytocin to blood: oxytocin targets mother’s uterine musc! Uterus responds by contracting more vigorously Positive toeaback fo Syste Gnu inter rupted by birth of babyMilk let down or suckling reflex Suckling of breast by the baby Stimulation of mechanoreceptors on nipple & areola 4 Aferents (somatic nerve) ’ spinal cord + Hypothalamus Anterior pituitary Posterior pituitary (Lactotrops) (Paraventricular nucleus) 4 4 Prolactin Oxytocin 8. FETO PLACENTAL UNIT - Fetus & Placenta function as a unit in synthesising estrogen & progesterone - Helps to maintain the level of steroids which inturn maintain the pregnancy ‘Maternal blood. Placenta Foetal Adrenal Progesterone 4—} Progesterone Cortisol, Corticosterone Acetate + Pregnenolone —_———|_»DHEAS 16~OH DHEAS «———}—16- OH DHEAS. LBstrogen 9. HCG jecreted by syncytiotrophoblast of placenta -Reaches its maximum level at 60" -70" day of pregnancy Functions: Growth of corpus luteum. Secretion of progesterone & estrogen from Corpus Luteum. Growth of testes & testosterone secretion in male foetus Androgen production from fetal adrenal cortex Formation of primordial follicle in fetal ovary Growth of breast High level in urine ~ diagnosis of pregnancy