physiology of reproduction 1

describle the hypothalamic pitutary acsess

hypothalamus has arcuate nuculus that release gonadotropin releaseing hormotone to anterior pitutary through hypothalamic hypopheseal portal circulation for pit to release gonadotropin hormones (fsh and lh)

gonadortopin releasing hormone characters

deca peptide (10 aa)

what are gonadotropins

released from pitutary

fsh and lh

are glycoprotiens

2 polypeptide chains connected by carbohydrate links

function of gonadotropins

sent to ovary to make steroidogenisis and ovulation

describe steroidogenis

ovary forming hormones (esctrogen and progesteron and androgens )

what is the needed criteria for ovary to have 2 functions

the gonadorophins need to be in correct level and rythm (irregular)

if one only is correct then only one function can be done

what are 2 examples of only steroidogenis function of ovary without ovulation

early menarche at 9 years

pco

due to amount but no rythm

end product of female genital system cyclic changes

menstruation

pregnancy

asherman syndrome c/p and pathology

uterus dont perform cyclic changes result in

infertility

recurrent preg loss

ammenoreha , hypomenohrrea

what are inhibitory and arucate nuclues of hypothalamus

increase dopamine

beta endorphin

melatonine

inhibitory

chatecolamin and chatecolestrogen

what is effect of melatonin on menarche

released from pineal body in large amount before menarche and inhibit gonadrotropin releaseing hormone

at puberty is released less from pineal body in irregular way so the hypo thalamus release in irregular way so result in irregular release of gonadotrophins causing only telarche no ovulation

what is the regular way GNRL

pulsatile manner every 90-120 mins

very short lived

function can be assesed by level of LH and FSH

how is pitutary gonadotrophin effect on ovary controled

by positive and negative feed back mechanism

1ry oocyte in prophase lag of 1st miotic division (perimordial follicle ) affected by FSH and LH (in correct amount to be fully matured ) and low levels of estrogen have positive feedback released from ovary

estrogen stimulate formation of estrogen receptor on ova so it stimulate multiple layers of granulosa cells and have theca interna and theca externa and form fluid spaces (filled with estrogen) forming preantral follicle

preantral follicle relaase estrogen and cause negative feed back mechanism and this result in FSH decrease and develop in to antral follicle theca interna and theca externa and granulosa and zona pellucida to become preovulatory follicle (mature grafian follicle)

development of preovulatory follice to ovulator follicle

need LH surge to ovulate stimulated by e2 >200picogram for 50 hours (2 days and 2 hr) negative feedback turn into positive feedback to release LH SURGE and lower FSH SURGE leading to ovulation

what is the function of FSH surge along with LH surge

to inc LH receptors

and finalise maturation of follicle

effect after LH surge

ovulation

corpus luteum

make it proliferation and leutinization (deposit of cholesterol and leutin)

and vascularisation

detailes of ovulation due to LH surge

stimulate release prostaglantin and porteases so ovulation occur

corpus leuteum

release progesterone that increase till 10ng for 7 days after ovulation : 3 days in tube and 7 in uterus

progesterone form sercretory endometrium

what is the

10 ng above this it is negative feed back so FSH and LH are decreased so corpus leutem degenerate and is nor called corpus albicans (hyaline degeneration) to be corpus fibrosum

overian cycle duration

21-35 days

1) follicular phase (1-growth 2- selection )from 1-3 weeks (according to fsh receptor)

2) ovulation phase 1day

3)leuteal phase 14 days ( 7 inc 7 dec )

leutealleuteal phase insufficency duration

<14 days

curves GTH

fsh low then inc then dec then surge(14) decrease (2 peaks 2nd peak at day 14)

lH all time normal then 1 surge(day 14)

steroid hormones (1 peak)

steroid hormones curve

estrogen: low then inc till 200ng decrease and inc again (2nd peak at day 21)with proges (2 peaks )

progesterone:increase after lH surge and does SURGE (day 21) and then dec (1peak)

premenuposal bleeding curve

weak follicles that dont stay until it release enough estrogen for 50 hours (only 10 for ex) and no lh surge

effect of hormones on endometrium during overian cycle

in follicular phase estrogen inc (proliferation and vascularziation) so endometrium thickness inc from 0.5 ml to become 5-8 ml(0.5-1 cm) and columnar cells become psuedostratifeid

in ovulation inc progesterone (stimulate secretory activity and inhibit proliferative activity of estrogen) endometrial gland is distended with secreations and become tortous

2 cenarios in test hormonal release from ovary by giving 5 day progesterone and stoping it

if bleed so means ovary release estrogen and no prog

if no bleeding then there is no estrogen

what are the 3 secretory phases

1-early subluminlar vacule

2-mid increase

3-late nutbuch layer and spongosium and basalis and compact form

when does bleeding occur in end of cycle (menstruation)

corpus fibrosum doesnt release hormones so mestruation occur

do both ovaries work simultaneously

one month on

one ovary temporary off for 1 month

can both work at same time to get 2 ovas and twins

how to measure the time of ovulation

ask if regular cycle

it is the LMP (1st day of overian cycle )

add length of cycle

minus 14

add it to LMP

mechanism of menstruation

when corpus leuteum degenerate destruction of secretory cells release lysosymes contatin prostaglandin synthtase that work onarachidonic acid turn it into prostag f2 alpha (that cause vasoconstriction in endometrium) then in the cascade of prostag release of pgi2 (ccause VD) that disrupt the bV and explode causing separating heamatoma (that devide spongy layer to basal layer)(between separated spongy and basal layers are bv torn that cause bleeding ) with fibrinolytic system break down clots

what is heavy menstraul bleeding and its cause

clots more than >3mm

severe bleed and pain

cervixs cause bleed and form it self blood clots

how does menstruation decrease

some enzymes that release PGi2 are consumed so the upper hand went to PGf2 alpha that cause VC to stop menstruation a blod clot forms above and stops

when does menstruation stop

when reepithelization occur

what can stop heavy menstrual bleeding

anti prostaglandin

antifibrinolytic

how to predict and diagnose ovulation

predict by calender method , uriniray LH kits , basal body temp(dt progesterone) and cervical muscus ( dryer)

diagnose by Trans vag folicometry and mid leuteal estrogen

cervical cycle

proliferative (dt estrogen) prolif and vascularity and bl supply inc so release watery cervical mucus

criteria of cervical muscus

profuse mucus

low viscosity

highly elastic (by shpin parke test

how to test cervicas mucus in proliferative phase

by spin parke test

and positive fern test ( acellular)

secretory phase of cervical

secreation become heavieer

with leukocytes and mucus bemoce thicker

and amount little

and viscosity high

elasticity low

how to test cervical mucus in secretory phase

negative spin parke

negative fern ( cellular )

what is the physiology of cervical cylcle

ealry watery and more desire and easy fertilization peak at e2 >200

then after ovulation progesterone become thick dry and many leukocytes

describe proliferative phase in vaginal cycle

more proliferation and vascularisation and forms basasl and parabasal cells and an intermediate layer (proliferate away from blood supply ) which has picnotic nuculus and with ratio 70:30:0(superfacial: 30 intermediate) in this area more glycoprotien that break down to become acidic 3.5

secretory phase in vaginal cycle

progesterone causes less proliferation and superfacial layer fall and not regenerate having a ratio 30:70:0 and ph with increase to 4.5

diffrence between effect of GRTH pulsatileand continious manner

GTRH is pulsatile from hypothalamus stimulate pit (for induction)

if continuous causes downgrade the receptors in pitutary (to treat fibroid )

aa in GRHs

alpha 92

beta in LH 118 in FSH 101

anerior pit cells and functions

chromopohbe (reserve cell)

basophil ( GRH,ACTH,TSH)

acidophil (GH ,Prolaction)

estrogen types and origin and transport and strongest

e1 (estrone) (never stops) (from adipose)

e2 (esterdiol) (from ovaries) (strongest)

e3 (estertriol) (from placenta)

on sex hormone binding protien

systemic effect of estrogen

-bone stimulate osteoblast and inhibit osteoclast ( inc growth in puberty)

-breast form fats and BV and ducts

-inc prolactin but not its effect

-periphral VD

-salt and water retention

- anti insulin

- inc HDL and dec LDL

- anabolic

-2ry sex characters

types of progesterol and origin

progesterol mincronised (ovary and placenta)

17oh progesterone (adrenal)

effect of progesterone

-basal body temprature

-salt and water retention

-smooth muscle relax

-increase resp deapth

-secabeous secreateion