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Characteristics of Female Reproductive System

it exhibits restricted periods of fertility it exhibits cyclic changes in hormonal activity gamete production does not occur all throughout life length of the reproductive cycle is variable

Female Reproductive Functions

Two major phases

Preparation of the female body for conception and pregnancy

Period of pregnancy itself

Functional Anatomy

Female Hormonal System

Three hierarchies of hormones


Gonadotropin-Releasing Hormone (GnRH) Follicle Stimulating Hormone (FSH) Leutenizing Hormone (LH) Estrogen Progesterone

CHILDHOOD no FSH/LH 9 to 12 y/o begins to secrete FSH/LH

(-)

PUBERTY

(-) inhibin

(-) MENARCHE

Female Monthly Sexual Cycle

Average 28 days short 20 days Ovarian Cycle long 45 days

Reproductive years

13 46 years
Uterine Cycle

Ovarian Cycle

OVARIAN CYCLE

OOGENESIS

Occurs during the follicular phase 30th week of gestation 6 million ova At birth - 2 million ova At puberty - 300,000 400,000 ova

400 ova develops during reproductive years

LUTEAL PHASE PRIMORDIAL FOLLICLE PRIMARY FOLLICLE

FOLLICULAR PHASE

MATURE FOLLICLE

ANTRAL FOLLICLE

VESICULAR FOLLICLE

OVULATION
LEUTENIZING HORMONE PROGESTERONE
PROTEOLYTIC ENZYMES (COLLAGENASE)

FOLLICULAR HYPEREMIA / PROSTAGLANDINSECRETION

WEAKENED FOLLICLE WALL (STIGMA)

PLASMA TRANSUDATION INTO FOLLICLE

DEGENERATION OF STIGMA FOLLICLE RUPTURE EVAGINATION OF OVUM

FOLLICLE SWELLING

FSH

LH

LH

ESTROGEN

PROGESTERONE

OVARIAN HORMONES

Estrogen (Estradiol)

promotes proliferation and growth of specific cells in the body responsible for the development of 2o sexual characteristics of the female

Progestins (Progesterone)

concerned almost entirely with final preparation of the uterus for pregnancy and breast for lactation

ESTROGEN

mainly bound to albumin and estrogen binding globulin secreted by the ovary and adrenal cortex

PROGESTERONE

mainly bound to albumin and progesterone binding globulin secreted by the ovary and adrenal cortex

Biologic Effects of Estrogen

On the uterus
Promotes proliferation of endometrial tissues Increases the size of the uterus Causes uterine contraction On the fallopian tube Causes enlargement of the fallopian tube Promotes proliferation of the mucosal lining

Biologic Effects

On the vagina

Causes enlargement of the vagina Responsible for the stratified type of vaginal epithelium

On secondary female sexual characteristics.

Promotes the development of secondary sexual characteristics

Biologic Effects

On protein deposition
Causes slight increase in protein deposition Effect on fat deposition

Causes an increase in fat deposition


Promotes proliferation of stromal tissue Causes growth and development of ductile system of the breast.

On the breast

Biologic Effects

On the skeleton

Increases osteoblastic activity of the bone

Biologic Effects of Progesterone

On the uterus
Promotes the development of the secretory functions of the uterus Causes uterine relaxation On the fallopian tube Promotes the development of secretory glands

On the breast

Promotes the development of lobuloalveolar system of the breast.

OOGENESIS

SPEMATOGENESIS

ENTRY OF OVUM IN THE FALLOPIAN TUBE

FERTILIZATION

Sex Determination

involves the determination of genetic sex established at fertilization

TRANSPORT OF ZYGOTE IN THE FALLOPIAN TUBE

BLASTOCYST

IMPLANTATION

DEVELOPMENT OF PLACENTA

Attachment of blastocyst to the uterus

Placental villi (fetal blood) and sinuses (maternal blood)

Growth of blood vessels from the developing embryo

Tropoblastic cells send out more projections (placental villi)

Blood is pumped by the fetal heart at the 16th day

Maternal blood vessels sorround the tropoblastic cord

Nutrition of the Embryo

Uterine milk

nutrients are obtained from the endometrial secretions used by the blastocyst (4th 6th day) contains glycogen, proteins, lipids and other nutrients due to the action of progesterone to the endometrial stromal cells used by the embryo up to 8 weeks

Decidua (decidual cells)

Placenta

Function of the placenta

to provide for the diffusion of foodstuffs and oxygen from the mothers blood into the fetal blood and diffusion of excretory products from the fetus back to the mother. early months of pregnancy (placental membrane)

thick with small surface area

later months of pregnancy

thin with larger surface area

DIFFUSION OF OXYGEN THROUGH THE PLACENTAL MEMBRANE


PRESSURE GRADIENT

30 mmHg

20 mmHg

50 mmHg

SIMPLE DIFFUSION

Fetal blood transport oxygen at low PO2 (30 mmHg)


Hemoglobin of the fetus is mainly fetal hemoglobin (20 to 50%) Hemoglobin concentration of the fetal blood is about 50% greater than that of the mother Bohr effect

Hemoglobin carries more oxygen at low PCO2. Fetal blood ------ alkaline DOUBLE BOHR EFFECT Maternal blood ------ acidic

DIFFUSION OF CO2 THROUGH THE PLACENTAL MEMBRANE


PRESSURE GRADIENT

47 - 48 mmHg

2 -3 mmHg

45 mmHg

CO2 (20X) DIFFUSION COEFFICIENT THAN O2

SIMPLE DIFFUSION

DIFFUSION OF FOODSTUFFS THROUGH THE PLACENTAL MEMBRANE


CONCENTRATION GRADIENT

LOWER Glucose Fatty acids Ketone bodies electrolytes

HIGHER Glucose Fatty acids Ketone bodies electrolytes

SIMPLE DIFFUSION FACILITATED DIFFUSION

EXCRETION OF WASTE PRODUCTS (PLACENTAL MEMBRANE)


CONCENTRATION GRADIENT

HIGHER
Urea Uric acid creatinine

LOWER Urea Uric acid Creatrinine

SIMPLE DIFFUSION

Hormonal Factors

Hormones secreted by the placenta


Human Chorionic Gonadotropin (HCG) Estrogen Progesterone Human Chorionic Somatomammotropin Relaxin Human Chorionic Thyrotropin

Human Chorionic Gonadotropin


secreted by syncytial tropoblastic cells glycoprotein (FSH, LH and TSH) measured in the maternal blood

Ist ------------ 8 9 days peak -------- 10 12 weeks low level ----- 16 20 weeks

Functions

prevent involution of the corpuz luteum at the end of monthly sexual cycle

main function

it causes corpuz luteum to secrete large amount of estrogen and progesterone (prevent menstruation and leads to the formation of decidual cells) it stimulates the interstitial cells of fetal testis to secrete testosterone (growth of male sex organ and descent of the testis)

Corpuz luteum

normal involution during pregnancy --- 13 to 17th week if removed before 7 12th week -----spontaneous abortion

Estrogen

secreted by syncytial tropoblastic cells almost entirely from androgenic steroid DHEA and 16 hydroxy DHEA (mother and fetal adrenal gland) converted to estradiol, estriol and estrone.

Functions

enlargement of the mothers uterus enlargement and development of the mothers breast (ductal structure) enlargement of the mothers external genitalia it relaxes the mothers pelvic ligament affect the general aspect of fetal development

Progesterone

secreted by syncytial tropoblastic cells Functions

causes the development of decidual cells in the endometrium. decreases the contractility of the pregnant contributes to the develoment of conceptus even before implantation helps in breast development during pregnancy (lobular structure)

Human Chorionic Somatomammotropin

known as placental lactogen secreted in greatest quantity at about the 5th week of gestation and increases progressively throughout the remainder of pregnancy.

Possible functions

cause development of the breast but does not promote lactation has effect similar to growth hormone (weak effect) ---- protein synthesis decreases insulin sensitivity and glucose utilization it provides release of fatty acids from the fat stores of the mother general metabolic hormone

Other Hormonal Factors

Pituitary secretion (pituitary enlargement 50%)


ACTH, TSH and prolactin FSH and LH glucocorticoid and mineralocorticoid thyroxine (HCG and HCT)

Corticosteroid

Thyroid gland secretion

Parathyroid gland secretion

PTH secretion

Relaxin

secreted both by placenta and ovary

Response of the Mothers Body to Pregnancy

Enlargement of the various sexual organs


Uterus ------- 50 1100 grams Breast -------- 2X Vagina

Development of edema, acne and musculine and acromegalic features

Weight gain (24 pounds)


Fetus ------------------------------ 7 pounds Amniotic fluid, placenta and fetal membranes --------- 4 pounds Uterus -------------------------- 2 pounds Breast --------------------------- 2 pounds ECF ---------------------------- 6 pounds Fat accumulation ------------- 3 pounds

Increased desire for food

Increased basal metabolic rate (15%)

hormonal secretions (T4, adrenocortical hormones and sex hormones) needs calcium, iron, phosphate, vitamin D and vitamin K supplements absorption during pregnancy

Nutrition during pregnancy

Circulatory System

Increased cardiac output (30 40%) Increased uterine blood flow Increased total blood volume (30%)

Aldosterone and Estrogen erythropoeisis

Respiratory System

Increased oxygen consumption ( BMR) Increased carbon dioxide production Increased minute ventilation (progesterone) Total excursion of the diaphragm is decreased.

Urinary system

Increased urine formation


fluid intake and excretory load Na+, chloride and water reabsorption ( steroid hormone production) Increased GFR

Preeclampsia

also known as toxemia of pregnancy rapid rise in arterial blood pressure to hypertensive levels during the last few months of pregnancy characterized by

excess salt and water retention weight gain and development edema hypertension impaired vascular endothelium and vasospasm renal blood flow and GFR

Eclampsia

extreme degree of preeclamsia characterized by generalized vascular spasm throughout the body, tonic clonic seizures in the mother sometimes followed by coma

Parturition

means birth of the baby due to intense contraction of the uterus

progressive hormonal changes that cause increased excitability of the uterine musculature progressive mechanical changes

Hormonal factors that increase uterine contractility

increased ratio of estrogen and progesterone effect of oxytocin on the uterus

distension of the cervix

effect of fetal hormones on the uterus


fetus ------------ oxytocin fetal adrenal gland -- cortisol fetal membrane --- prostaglandin

Mechanical factors that increase uterine contractility


stretch of the uterine musculature stretch or irritation of the cervix

Onset of Labor

Braxton Hicks Contraction

periodic episodes of weak and slow rhytmical contraction strong contractions that result in final parturition

Labor Contraction

Positive Feedback Mechanisms

Oxytocin secretion

MECHANICS OF PARTURITION

CONTRACTION OF FUNDAL AREA

CONTRACTION OF THE BODY

COMBINED CONTRACTION OF THE UTERUS AND ABDOMINALMUSCULATURE

DELIVERY OF THE BABY

Lactation

development of the breast

Estrogen (growth of the ductal system and deposition of fats)


growth hormone insulin prolactin Glucocorticoid

Progesterone (development of the lobule-alveolar duct

prolactin

initiates lactation breast development promotes milk production and secretion

Colostrum

fluid secreted during the last few days before and first few days after parturition.

COMPOSITION OF MILK
CONSTITUENT HUMAN MILK (%) COWS MILK (%)

Water Fat Lactose Casein Lactalbumi and other proteins Ash

88.5 3.3 6.8 0.9 0.4 0.2

87.0 3.5 4.8 2.7 0.7 0.7

HYPOTHALAMUS
PIF

ANTERIOR PITUITARY
(-) PROLACTIN

BREAST

LACTATION

Oxytocin

synthesized by the hypothalamus causes


uterine contraction milk ejection