Fertility Flashcards
(66 cards)
Define infertility
Disease of the reproductive system
Failure to achieve clinical pregnancy within 12 months of unprotected sex
Define primary infertility
Woman unable to ever bear a child as unable to become pregnant or carry a pregnancy
- miscarriages, ectopic, abortions and stillborn
Define secondary infertility
Unable to bear/ability to carry a child following previous pregnancy/having ability to carry pregnancy to live birth before
How common is infertility?
1 in 6 couples in UK experience some form of it
What are the causes of infertility and how common are they?
- male factors (30%)
- unexplained fertility (25%)
- ovulatory disorders (20%)
- tubal damage (20%)
- uterine/peritoneal disorders (10%)
How do the testes develop?
On posterior wall
- descends through inguinal canal
- into anterior abdomen wall
- into scrotum
- carries vessels, lymphatic nerves, ducts
What are the testes composed of?
Semniferous tubules
interstitial tissue surrounding tunica albuginea
What is the tunica vaginalis?
Sides and anterior aspects of testes covered by closed sac of peritoneum
What is the epididymis?
SIngle, long coiled lying alongside testes
- efferent ductules (head)
- true epididymis (body/tail continuous with vas deferens)
What is the vas deferens?
Long muscular duct
Transport spermatozoa from tail of epididymis to ejaculatory duct in prostate
What does the spermatic cord contain?
Vas deferens testicular artery Genital branch of genitofemoral nerve Pampiniform plexus Lymphatic vessels Tunica Vaginalis
Where does the spermatic cord run?
Through inguinal canal
Surrounded by fascia
What is the main blood supply to the male reproductive system?
Abdominal artery branches forming gonadal testicular artery
What is the venous drainage of the right testicle?
IVC
What is the venous drainage of the left testicle?
Left renal vein
What is the pampiniform plexus?
Network of small veins found in human spermatic cord
- surrounds artery
- cold as exits scrotum receiving heat from artery as travels back to abdomen
What are the 3 phases of the ovarian cycle and how long are they?
Follicular Phase (1-10) Ovulatory Phase (11-14) Luteal Phase (15-18)
What happens during the follicular phase?
- 5-12 primordial follicles stimulated each month
- 1 grows and matures
- GnRH secreted from hypothalamus stimulating anterior pituitary to secrete LH and FSH
- stimulates follicles to grow
- mature follicle secretes oestrogen
- inhibits LH and FSH secretion by anterior pituitary (negative feedback)
- stimulates endometrium growth
What happens during the ovulatory phase?
Negative feedback temporary
- oestrogen stimulates HPA
- LH and FSH burst
- completion of meiosis I and onset of meiosis II in oocyte
What happens during the luteal phase?
Granulosa cells of mature follicle divide forming corpus luteum
- secretes progesterone and oestrogen
- prepares uterine endometrium for implantation
What are the 3 phases of the menstrual cycle and how long are they?
- menstrual phase (day 1-5)
- proliferative phase (6-14)
- secretory phase (15-28)
What happens in the menstrual phase?
Withdrawal of steroid support (oestrogen and progesterone) = endometrium collapse
- endometrium shed with blood from rupture arteries
- 50-150ml blood loss
What happens in the proliferative phase?
Oestrogen from mature follicle stimulates thickening of endometrium
- glands/spinal arteries form
- oestrogen causes progesterone receptor growth on endometrial cells
What happens in the secretory phase?
Progesterone from corpus luteum acts on endometrium = gland enlargement
- glands secrete mucus and glycogen in preparation for implantation of fertilised oocyte
- no fertilisation = corpus luteum degenerates = corpus albicans and progesterone levels fall
