Menstrual Cycle and Ovulation

Question 1

What cycles make up the menstrual cycle?

Answer 1

Ovarian cycle + Uterine/endometrial cycle

Question 2

What are the phases of the ovarian follicle cycle?

Answer 2

1. Follicular phase
2. Ovulatory phase
3. Luteal phase

Question 3

A primordial follicle contains what type of oocyte and what structure of granulosa cells surrounding it?

Answer 3

Primary oocyte

Surrounded by a single layer of pregranulosa cells

Question 4

What does the primordial follicle release?

Answer 4

Paracrine factors

Question 5

What type of follicle represents most of the ovarian reserve?

Answer 5

Primordial follicles

Question 6

What happens to a majority of the primordial follicles?

Answer 6

Follicular atresia

Question 7

A primary follicle contains what type of oocyte and what structure of granulosa cells surrounding it?

Answer 7

Primary oocyte

Surrounded by a single layer of granulosa cells - simple cuboidal

Question 8

At what follicle stage are the glycoproteins for the zona pellucida beginning to be produced? - (ZP1,2,3,4)

Answer 8

Primary follicle

Question 9

A secondary follicle contains what type of oocyte and what structure of granulosa cells surrounding it?

Answer 9

Primary oocyte

Surrounded by layers of granulosa cells - stratified cuboidal

Question 10

What do secondary follicles release to stromal cells and what does that do?

Answer 10

Release paracrine factors to stromal cells so they differentiate into thecal cells (interna and externa)

Question 11

As the follicle matures towards the secondary follicle, what is increased?

Answer 11

Vascularization

Question 12

The follicle can release ______ to promote the development of 1-2 arterioles for vascularization on its way to the secondary follicle

Answer 12

Angiogenic factors

Question 13

The zona pellucida has binding sites for?

Answer 13

Sperm

Question 14

Preantral follicles have _____ endocrine function

Answer 14

Minimal

Question 15

Are granulosa cells or thecal cells producing hormones during the preantral phase?

Answer 15

NO

Question 16

Even during the preantral phase, granulosa cells do have a ____ receptor

Answer 16

FSH

Question 17

Even during the preantral phase, thecal cells do have a ____ receptor

Answer 17

LH

Question 18

As the antrum develops and fills with follicular fluid, the antral phase begins. What cell types increase during the antral phase?

Answer 18

Granulosa cells with subpopulations

Question 19

As the follicle continues to grow and so does the antrum, growth at this stage becomes responsive to what?

Answer 19

Gonadotropins! - LH and FSH

Question 20

LH will stimulate the theca interna cells to release?

Answer 20

Androstenedione

Question 21

FSH will stimulate the granulosa cells to do what?

Answer 21

Convert the theca interna produced androstenedione into estrogen and progesterone

Question 22

At the antral stage, the follicle is competent to eventually complete meiosis 1 at ovulation. When will the oocyte come out of cell arrest and continue the cell cycle?

Answer 22

With the LH surge at mid-cycle

Question 23

How is cell cycle arrest achieved in the oocyte at the antral stage?

Answer 23

Elevated cAMP levels in the oocyte

Question 24

What does a follicle need to become the dominant follicle for that particular cycle?

Answer 24

Largest follicle with the MOST FSH receptors

- highest FSH sensitivity

Question 25

What is the periovulatory period and how long is it?

Answer 25

Time between the LH surge and ovulation | - 32-36 hours

Question 26

What 3 things occur in the theca and mural granulosa cells during the periovulatory period?

Answer 26

1. Prepare for luteinization 2. Formation of corpus luteum 3. Increased production of progesterone

Question 27

The LH surge induces?

Answer 27

Luteinization = granulosa cells --> granulosa lutein cells

Question 28

LH surge induces a shift in steriodogenic activity and increases ____ availability to produce progesterone

Answer 28

Cholesterol

Question 29

List 4 LH surge induced structural changes

Answer 29

1. Breakdown of follicle wall, tunica albuginea, ovarian surface epithelium 2. Cumulus-oocyte complex detaches 3. Basal lamina of mural granulosa cells degraded to increase blood flow 4. Oocyte progresses to metaphase 2

Question 30

During the luteal phase, what does the antral cavity fill with?

Answer 30

Blood and cell debris

Question 31

During the luteal phase, what collapses into the antral cavity?

Answer 31

Granulosa lutein cells filled with cholesterol esters, theca interna cells, etc.

Question 32

The corpus luteum will remain viable if ____ is present

Answer 32

hCG

Question 33

The corpus luteum will become ____ if no pregnancy occurs

Answer 33

Corpus albicans - CT scar tissue

Question 34

If pregnant, the corpus luteum will secrete?

Answer 34

Progesterone

Question 35

Transient decrease in estrogen following the LH surge rebounds when?

Answer 35

Midluteal phase

Question 36

What will return the LH levels back down to normal?

Answer 36

Progesterone and estrogen

Question 37

Lutein cells secrete _____ to inhibit _____

Answer 37

Inhibin A to inhibit FSH

Question 38

What is the predominant process in the ovary?

Answer 38

Follicular atresia

Question 39

With follicular atresia, what cells undergo apoptosis?

Answer 39

Granulosa cells and oocytes

Question 40

With follicular atresia, what cells do NOT undergo apoptosis?

Answer 40

Theca cells

Question 41

When does follicular atresia occur?

Answer 41

Anytime during development

Question 42

Describe the hypothalamus-pituitary-ovarian axis

Answer 42

``` Hypothalamus - GnRH Anterior pituitary - LH to theca and granulosa cells - FSH to granulosa cells Theca - androgens and progestins Granulosa cells - progestins, estrogens, inhibins, activins ```

Question 43

The granulosa cell releases inhibins that do what?

Answer 43

INHIBIT FSH release from the anterior pituitary

Question 44

The granulosa cell releases activins that do what?

Answer 44

ACTIVATE FSH release from the anterior pituitary

Question 45

What can have negative or positive feedback on the anterior pituitary and hypothalamus?

Answer 45

Progestins and Estrogens

Question 46

What has a greater negative feedback, progestins or estrogens?

Answer 46

Estrogens

Question 47

When is negative feedback by estrogens and progestins the greatest?

Answer 47

At luteal phase

Question 48

When is positive feedback by the estrogens and progestins the greatest?

Answer 48

At end of follicular phase to promote LH surge

Question 49

In the follicular phase, what cells are producing estrogens?

Answer 49

Theca and granulosa

Question 50

In the luteal phase, what cells are producing estrogens and progestins?

Answer 50

Corpus luteum = theca lutein and granulosa lutein

Question 51

What and when is the basal body temperature decreased during the menstrual cycle?

Answer 51

Increased estrogen at the follicular phase = DECREASED BBT

Question 52

What and when is the basal body temperature increased during the menstrual cycle?

Answer 52

Increased progesterone at the luteal phase = INCREASED BBT

Question 53

If no pregnancy, the corpus luteum disintegrates and does what to the BBT?

Answer 53

Decreases it

Question 54

Menopause

Answer 54

12 months after last period

Question 55

When does LH surge?

Answer 55

After follicular phase and before luteal phase of ovarian cycle

Question 56

When does FSH increase?

Answer 56

At ovulatory phase as well

Question 57

When does progesterone increase?

Answer 57

Luteal phase

Question 58

When does estradiol increase?

Answer 58

At the end of the follicular phase and during the luteal phase