CC LAB | GONADDO & DRUG TESTING

androgens, estrogens

The testes and ovaries produce sex steroids such as _____ and _______ from cholesterol.

estradiol, estrone

The ovary converts testosterone to _______and androstenedione (endogenous weak androgen) to ______.

dihydrotestosterone, estriol, testosterone, estrone, estradiol

Peripheral tissues (including those targeted by androgens) reduce testosterone to_______ (DHT), hydroxylate estradiol to _____, convert adrenal androgens to _______ and androgens to ______ and _____.

• sex-hormone-binding globulin (SHBG)

• corticosteroid-binding globulin (CBG)

• albumin.

Major transport protein:

SHBG (sex-hormone-binding globulin)

transport androgens and estrogens.

CBG (corticosteroid-binding globulin)

delivers progesterone and glucocorticoids.

Testosterone

It is the principal androgen hormone in the blood – most potent male androgen.

Testosterone

It is synthesized by the Leydig cells of the testis of the male, also derived from progesterone.

Testosterone

It is controlled primarily by FSH and LH.

Testosterone

Function: growth and development of the reproductive system, prostate and external genitalia.

Albumin

50% of transport proteins for testosterone are

Hormone binding globulin

45% of transport proteins for testosterone are

Pretesticular infertility (Secondary hypogonadism)

• It is due to hypothalamic or pituitary lesion.

• Normal or decreased levels: Testosterone, FSH and LH

Testicular infertility (Primary hypogonadism)

• Congenital: cryptorchidism, klinefelter’s syndrome and 5-alpha reductase deficiency

• acquired: varicocele, tumor, orchitis

Post-testicular infertility

• it is due to disorders of sperm transport and function

• Normal blood level: Testosterone, FSH and LH

Testicular feminization syndrome

• Most severe form if androgen resistance syndrome, resulting in lack testosterone action in the target tissue.

• The physical development pursues in female phenotype with fully developed breast and female distribution of fat and hair.

• There is utility or no response of EXOGENOUS Testosterone.

• Lab test: normal level testosterone, elevated FSH and LH levels.

Sertoli cell-only syndrome

• Lack of germ cells

• The primary sign of Sertoli cell -only syndrome (SCO syndrome) is a lack of production of sperm cells azoospermia

• Testicular biopsy is the only procedure to confirm this diagnosis.

Kallman’s syndrome

• It is a result of an inherited, X linked recessive trait.

• Hypogonadism during puberty.

• Associated defects: Anosmia (inability to smell) and midline defects (cleft palate and lip)

Dehydroepiandrosterone

• Principal androgen formed by adrenal cortex; weak androgen.

• Androgen is primarily derived from the adrenal gland.

Dehydroepiandrosterone

• Valuable assessment of adrenal cortical function

Estrogen

• Arises through structural alteration of the testosterone molecule.

Estrogen

• It is not produced by the ovaries after menopause

Estrogen

Functions:

• Promotion of breast development

• Maturation of the external genitalia

• Deposition of body fat and termination of linear growth (secondary sexual characteristics in the female)

Estrogen

In conjuction with progesterone, they function in uterine growth and regulation of menstrual cycle and maintenance of pregnancy.

Estrogen

• Deficiency: irregular and incomplete development of the endometrium o Precursor: acetate, cholesterol, progesterone and testosterone.

Estrone (E1)

• most abundant estrogen in post-menopausal women.

Estradiol (E2)

• Most potent estrogen secreted by the ovary; MAJOR ESTROGEN

Estradiol (E2)

• Low levels in the menopausal stage

• Synthesized from the testosterone, then diffuses out of the thecal cells of the ovaries in female.

Estradiol (E2)

• Precursor of e1 and e3

Estradiol (E2)

• Used to assessed ovarian function, negative feedback for fsh.

• Transport proteins: albumin 60% shbg 38%

Estriol (E3)

• Metabolite of estradiol (E2)

Estriol (E3)

• Estrogen found in maternal urine.

Estriol (E3)

• Major estrogen (secreted by the placenta during PREGNANCY)

Estriol (E3)

• Formation in a pregnant woman is dependent on fetal and placental function.

Estriol (E3)

• It is used to assess the fetoplacental unit (fetoplacental viability), postdate gestations and intrauterine retardation.

Estriol (E3)

• It promotes uteroplacental blood flow as pontently as other estrogens.

Estriol (E3)

• Used as marker for Down syndrome (together with AFP and HCG) o Preferred specimen: Plasma

Progesterone

• Produces mainly by the granulose (lutein) cells of the corpus luteum in the female.

Progesterone

• Prime secretory product of the ovary

Progesterone

• Dominant hormone responsible for the luteal phase cycle among female.

Progesterone

• Single best hormone to determine whether the ovulation has occurred.

Progesterone

• Evaluation of fertility in females.

Progesterone

• Serves to prepare the uterus for pregnancy and breast for lactation.

Progesterone

• Deficiency: Failure of implantation of embryo

Menstruation

The menstrual cycle phase: when you have your period. This is your body shedding your uterine lining from the previous cycle in the absence of pregnancy.

Follicular phase

The menstrual cycle phase: overlaps with menstruation for the first few days, release a mature egg.

Ovulation

The menstrual cycle phase: when the mature egg is released

Luteal phase

The menstrual cycle phase: begins as the egg starts traveling down the fallopian tube, ends when your next period begins.

CORPUS LUTEUM

Once the follicle has released its egg, the egg travels down the fallopian tube, where it may come in contact with sperm and be fertilized. The follicle itself then changes. The empty sac closes off, turns yellow, and transforms into a new structure called the______

CORPUS LUTEUM

releases progesterone and some estrogen.

Progesterone

thickens the lining of your uterus so that a fertilized egg can implant. Blood vessels grow inside the lining. These vessels will supply oxygen and nutrients to the developing embryo

human gonadotropin

This hormone maintains the corpus luteum.

Placenta

HCG enables the corpus luteum to keep producing progesterone until around the 10th week of your pregnancy. Then the ____ takes over progesterone production