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Y2 Endocrinology > Endocrinology of Pregnancy > Flashcards

Endocrinology of Pregnancy Flashcards

1
Q

What is induced by oestrogen and androgens in the male reproductive tract

A

oestrogen - Tubular fluid reabsorption

Androgens - nutrients (e.g. fructose) and glycoprotein secretion into epididymal fluid

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2
Q

What is semen made up of

A

Spermatozoa (15-120 million/ml)
Seminal fluid (2-5ml)
Leucocytes

Potentially viruses e.g. hepatitis B, HIV

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3
Q

What proportion of spermatozoa enter the ovuum

A

1/100 enter the cervix
1/10,000 cervix to ovum
1/million reach ovum

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4
Q

Where is seminal fluid produced

A

Mainly from accessory sex glands:
seminal vesicles
Prostate
Bulbourethral glands

Small contribution from epididymis/testis

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5
Q

Describe the capacitation of sperm

A

Achieves fertilising capability in the female reproductive tract
Takes place in ionic & proteolytic environment of the Fallopian tube
Oestrogen-dependent
Ca2+-dependent

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6
Q

What occurs in the capacitation of sperm

A
  1. Loss of glycoprotein coat
  2. Change in surface membrane characteristics
  3. Develop whiplash movements of tail
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7
Q

Describe the acrosome reaction

A
  1. Sperm binds to ZP3 (sperm receptor)
  2. Ca2+ influx into sperm (stimulated by progesterone)
  3. Release of hyaluronidase + proteolytic enzymes from acrosome
  4. Spermatozoon penetrates the Zona Pellucida
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8
Q

Where does fertilisation occur and what does it trigger

A

Fallopian tube
Triggers a cortical reaction
Cells from haploid to diploid

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9
Q

What happens in the cortical reaction

A

Cortical granules release molecules which degrade zona Pellucida (e.g. ZP2 + 3)
Prevents further sperm binding - no receptors

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10
Q

Describe the development of conceptus

A

Continues to divide as it moves down Fallopian tube to uterus (3-4 days)

Receives nutrients from uterine secretions

This free-living phase can last for ~ 9-10 days

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11
Q

Describe the process of implantation and what does it require

A
  1. Attachment phase - outer trophoblast cells contact uterine surface epithelium
  2. Decidualisation phase - changes in underlying uterine stromal tissue (within few hours)

Requires progesterone domination in the presence of oestrogen

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12
Q

Which molecules are involved in the attachment process

A

Leukaemia inhibitory factor (LIF) from endometrial secretory glands stimulates adhesion of blastocyst to endometrial cells

Interleukin-11 (IL11) from endometrial cells is released into uterine fluid and may be involved

HB-EGF

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13
Q

What endometrial changes are stimulated by progesterone

A

Glandular epithelial secretion
Glycogen accumulation in stromal cell cytoplasm
Growth of capillaries
Increased vascular permeability (→oedema)

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14
Q

Which factors are involved in endometrial changes due to progesterone

A

Interleukin-11 (IL11)
Histamine
Prostaglandins
TGF-beta (angiogenesis)

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15
Q

What are the hormone changes during pregnancy

A

Early rice in human chorionic gonadotrophin

Slow rises in Progesterone, oestrogen and human placental lactogen which peak later (in order of height of peak)

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16
Q

Describe progesterone and oestrogen producing in the first 40 days of pregnancy

A

Produced in the corpus luteum, stimulated by human chorionic gonadotrophin

Essential for developing fetoplacental unit
Inhibits maternal LH and FSH (-ve feedback)

17
Q

What is human chorionic gonadotrophin produced by and what does it act on

A

Trophoblasts

Acts on LH receptors

18
Q

Describe progesterone and oestrogen producing after the first 40 days of pregnancy

A

Placenta takes over production

19
Q

Describe those oestrogen and progesterones are produced for the foetus by the mother

A

Mother cholesterol -> pregnenolone -> DHEAS

DHEAS produce by mother, adrenals and liver.

20
Q

What is the significance of DHEAS IN pregnancy

A

Maternal and fetal DHEAS is converted into oestrogen

Produced by the adrenal glands and liver of the foetus from pregnenolone

21
Q

Which maternal hormones increase in pregnancy

A 
ACTH
Adrenal steroids
Prolactin
IGF1 (stimulated by placental GH-variant)
Iodothyronines
PTH related peptides
22
Q

Which maternal hormones decrease in pregnancy

A

Gonadotrophins
Pituitary GH
TSH

23
Q

Describe endocrine control of parturition (labour)

A

Foetal oestrogen, Maternal cortisol and Maternal oxytocin binds to the oxytocin receptor
Causes uterine myometrial contraction, cervical dilation and milk ejection

24
Q

What does oxytocin stimulate

A

Uterine contraction
Cervical dilation
Milk ejection

25
Q

Describe the endocrine control of lactation

A
  1. Suckling stimulates the neural pathway
  2. +ve feedback to hypothalamus
  3. Stimulation of pituitary to release oxytocin (neuro) and prolactin (Adeno)
  4. Milk synthesis (prolactin)
  5. Milk ejection (oxytocin)
26
Q

Describe the blastocyst

A

-

27
Q

Which pituitary hormones decrease during pregnancy

A

Growth hormone

TSH

Y2 Endocrinology (19 decks)

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