(endo) pregnancy Flashcards

(54 cards)

1
Q

in males, what occurs in the efferent ducts in the reproductive tract?

A

tubular fluid reabsorption resulting in concentration of fluid, which helps w male fertility

(induced by oestrogen)

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2
Q

in males, what occurs in the epididymis in the reproductive tract?

A

secretion of nutrients (e.g. fructose) and glycoprotein into the epididymal fluid

(induced by androgens)

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3
Q

what are the implications of aromatase deficiency?

A

(very rare!)

= hirsutism, acne, deep voice, primary amenorrhoea, tall (as need E2 to close epiphyseal growth plates), osteoporosis, virilisation of fetus

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4
Q

why is the secretion of nutrients into the epididymal fluid important in men?

A

fructose = provides an energy source for sperm to make their journey through the female reproductive tract

glycoprotein = preotective coating for sperm as they enter a hostile environment

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5
Q

what are the components of semen?

A

1) spermatozoa (15-120 million)
2) seminal fluid (2-5ml)
3) leukocytes

4) potentially viruses e.g. hepatitis B, HIV

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6
Q

what are the contents of seminal fluid?

A
  • fructose
  • fibrinogen
  • fibrinolytic enzymes
  • citric acid
  • bicarbonate
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7
Q

where is seminal fluid secreted from?

A

accessory sex glands

  • seminal vesicles
  • prostate gland
  • bulbourethral gland

small contribution from
- testis/epididymis

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8
Q

what is sperm capacitation?

A

the process of achieving fertilising capability in the female reproductive tract

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9
Q

what is involved in the capacitation of sperm?

A

1) loss of glycoprotein coat
2) changes in surface membrane characteristics
3) development of whiplash movements of the tail

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10
Q

where does capacitation of sperm occur?

A

takes place ONLY in the ionic & proteolytic environment of the fallopian tubes

(i.e. nowhere else in the male reproductive tract/initial parts of the female reproductive tracts)

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11
Q

what is sperm capacitation dependent on?

A

1) oestrogen-dependent

2) Ca2+-dependent

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12
Q

how many chromososme are found in one sperm?

A

23 chromosomes

= haploid

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13
Q

what is the acrosome?

A

organelle within sperm containing enzymes

= can bind to the zona pellucida

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14
Q

what is the zona pellicida?

A

glycoprotein layer surrounding the plasma membrane of the oocyte

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15
Q

explain what happens in the acrosome reaction

A

1) sperm bind to the ZP3 receptor (‘sperm receptor’) of the zona pellucida
2) Ca2+ influx into the sperm (stimulated by progesterone)
3) release of hyaluronidase and proteolytic enzymes from the acrosome

= sperm penetrates the zona pellucida and enters the oocyte

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16
Q

which receptor does the sperm bind to on the oocyte?

A

ZP3 receptor of the zona pellucida

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17
Q

what stimulates the calcium influx into the sperm during the acrosome reaction?

A

progesterone

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18
Q

why are hyaluronidase and proteolytic enzymes released from the acrosome?

A

to break down polysaccharides in the zona pellucida

= to allow sperm to enter the oocyte to enable fertilisation & fusion of gametes

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19
Q

where does fertilisation occur?

A

within the ampulla of the fallopian tube

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20
Q

what does fertilisation subsequently trigger?

A

the cortical reaction

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21
Q

what is the cortical reaction?

A

following fertilisation (i.e. once the sperm enters the egg), cortical granules release molecules that degrade the zona pellucida (e.g. ZP2 & 3)

= to prevent polyspermy

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22
Q

where are cortical granules found and why are they important?

A

in the oocyte

= release molecules upon fertilisation to degrade the zona pellucida
= so no polyspermy w no available receptors

23
Q

as the conceptus travels down the fallopian tube to the uterus, how does it receive its nutrition?

A

receives nutrients from uterine secretion

= during the 3-4 days it takes to travel from the fallopian tube to the uterus

24
Q

what are the two phases of implantation?

A

1) attachment phase

2) decidualisation phase

25
what is the attachment phase of implantation?
outer trophoblast cells contact uterine surface epithelium
26
what is the decidualisation phase of implantation?
changes in the underlying uterine stromal tissue
27
what does implantation require?
requires progesterone domination in the presence of oestrogen = as progesterone 'PROmotes GESTATION' and prepares endometrium for implantation
28
which three molecules promote implantation?
LIF & IL11 (LIF = leukaemia inhibitory factor) = + need progesterone (!!!!)
29
what is the function of LIF in implantation?
produced by endometrial cells, LIF stimulates adhesion of blastocyst to the endometrial cells
30
which cells produce LIF?
endometrial cells
31
which cells produce IL11?
endometrial cells (release into uterine fluid)
32
how do hCG levels change during pregnancy and why?
highest in the initial 10 weeks, and then fall to lower levels rapidly for remainder = initially high as syncitiotrophoblast cells produce hCG to maintain CL production of progesterone + oestrogen (in the absence of an actual placenta)
33
how do oestrogen levels change during pregnancy and why?
rise continuously = produced initially by the corpus luteum and then the placenta (but to a lesser degree compared to progesterone production)
34
how do progesterone levels change during pregnancy and why?
rise continuously = produced initially by the corpus luteum and then the placenta (but to a greater degree compared to oestrogen production)
35
what is human placental lactogen?
hormone made by the placenta that modulates maternal metabolism to provide nutrients for the foetus e.g. causes insulin resistance to increase glucose bioavailability for foetus
36
how does human placental lactogen work?
modulates maternal metabolism to provide nutrients for foetus e.g. causes insulin resistance to increase circulating glucose for foetus
37
how do human placental lactogen levels change during pregnancy?
rise continuously | but to a lesser degree compare to oestrogen and progesterone
38
what controls progesterone and oestrogen production in the first 40 days of a pregnancy?
produced by the corpus luteum (of the maternal ovary) | = stimulated by hCG (produced by syncitiotrophoblast cells) which acts on the LH receptors
39
what maintains the corpus luteum?
either LH or hCG | = both which act on LH receptors to prevent CL degradation
40
what is the impact of oestrogen and progesterone secretion during pregnancy?
inhibits maternal LH & FSH via negative feedback loops
41
what controls progesterone and oestrogen production AFTER the first 40 days of a pregnancy?
placenta takes over | i.e. luteo-placental shift
42
from where does the placenta produce progesterone?
from maternal cholesterol converted into pregnenolone
43
from where does the placenta produce oestrogen?
either from maternal or fetal DHEAS 1) maternal DHEAS = oestrone, oestradiol 2) fetal DHEAS = oestriol
44
in pregnancy, which maternal hormones increase in concentration?
- ACTH - adrenal steroids - prolactin - IGF-1 (stimulated by a placental GH-variant) - iodothyronines - PTH related peptides
45
in pregnancy, which maternal hormones decrease in concentration?
- gonadotrophins (LH, FSH) - pituitary GH - TSH
46
why do iodothyronines increase in pregnancy?
hCG, made by the syncitiotrophoblast cells of the placenta, is similar to TSH = mild stimulation of the thyroid gland to produce more thyroid hormone
47
why do PTH-related peptides increase in pregnancy?
produced mainly by breast tissue | = can increase calcium for fetal skeleton
48
why does IGF-1 increase in pregnancy?
placental GH secretion increases that stimulates the liver to secrete more IGF-1
49
why do gonodotrophins fall in pregnancy?
during pregnancy, oestrogen + progesterone levels rise = so, via negative feedback LH + FSH fall
50
why does pituitary GH fall in pregnancy?
placenta releases placental GH and so pituitary GH levels fall via negative feedback
51
why does TSH fall in pregnancy?
in pregnancy, hCG released by the placenta is similar to TSH and so stimulates the thyroid gland to secrete iodothyronines = resulting in TSH levels falling bc of negative feedback
52
what are the functions of oxytocin in females?
1) uterine contraction (increased oxytocin receptors in late pregnancy) 2) cervical dilation 3) milk ejection
53
where are oxytocin receptors mainly found?
1) myoepithelial cells of the mammary gland | 2) myometrium + endometrium of the uterus
54
explain the endocrine control of lactation
stimulus = suckling of breast suckling stimulates neural pathways that activate the hypothalamus + pituitary gland to release hormones 1) APG releases prolactin = milk PRODUCTION 2) PPG releases oxytocin = milk EJECTION