Female Reproductive system

Dr Jyoti Shrivastava

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 Overview
• Introduction
• Oogenesis
• Female reproductive cycle
• Female hormones
• Menopause

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Introduction

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 Introduction
• Female reproductive system(physiological) divided into two
phases:
1. Preparation of female body for conception and pregnancy
2. Period of pregnancy

• Oogenesis (process of formation of ova)

• During fetal life primordial follicle develops from germinal
epithelium, which further grows in ovary and gets surrounded
by granulosa cell of ovarian stroma and is c/a primordial follicle
• Primordial follicle undergoes further division to form primary
oocyte
• During entire reproductive years 400 to 500 of primordial
follicles develop to expel their ova (one each month)
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• During entire reproductive years 400 to 500 of primordial
follicles develop to expel their ova (one each month)

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 Important terms
• Menstrual cycle: The normal reproductive years of female (13
to 46 yrs of age) characterized by monthly rhythmical changes
in the rate of secretion of female hormones and corresponding
changes in ovaries and other sexual organs (uterus)
• This rhythmical pattern is c/a female monthly sexual cycle or
menstrual cycle (duration 28 days; range 20 -45 days)

• Menarche : the time of first menstrual cycle ( normal age 10

-16 years , av 12.5 years)

• Menopause : permanent cessation of menstrual cycles (b/w 40

-50 yrs ,a 47yrs)
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• Menstruation : the process of discharging blood and other
material from the lining of the uterus at intervals of about one
lunar month from puberty until the menopause, except
during pregnancy.

• Ammenorrhea: absence of menstruation

• Anovulatory menstrual cycle: menstrual cycle in which

oulation does not occur

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 Female hormonal system
• Three hierarchies hormonal system:
 Hypothalmic releasing system: gonadotropin releasing
hormone
 The antr pitutary sex hormone: FSH ,LH
 Ovarian hormone: estrogen and progestrone

• All secreted at diff rates and in different phases of monthly

sexual cycle
• GnRH secreted in short pulses averaging once in every 90 min

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 Menstrual cycle
• Two results of female sexual cycle (Menstrual cycle):

1. Only single ovum released from ovaries each month, so that

only single fetus grow at a time

2. Uterine endometrium is prepared in advanced for

implantation of fertilized ovum

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 Monthly ovarian cycle
• Ovarian cycle consist of two phases:

 Follicular phase
 Leutal phase

• In a 28 days cycle
 follicular phase last for 1 – 13 days
 Ovulation occur on 14th day
 Leutal phase last from 15th to 28th day

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 Follicular phase of ovarian cycle

• Female child is born with ovum (primordial follicle)

surrounded by single layer of granulosa cell

• This granulosa cell provide nourishment to ovum in childhood

and also secrete ovum maturation inhibiting factor

• During puberty under the effect of FSH and LH ovum matures

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 Primary follicle
• Primary follicle: first stage of follicular growth
• Ovum enlarges with additional layers of granulosa cells
• 6 -12 primary follicles grow under the effect of FSH n LH (esp
FSH) during 1st few days
• Initially there is rapid proliferation of granulosa cell and also
increased spindle cell of ovarian interstitium forming theca
cells

Theca externa :
Theca interna :
vascular connective
secrete estrogen
tissue capsule of
and progestrone
developing follicle
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 Vesicular follicle/ secondary follicle

• Then larger follicles develop c/a vesicular follicle by;

1. Estrogen: increases growth of granulosa cell and also FSH
receptors. This increases sensitivity of granulosa cell to FSH
by positive feedback mech
2. FSH and estrogen: increase LH receptors on granulosa cell
3. LH and estrogen: cozes proliferation of follicular thecal cells

As follicle grows ovum also enlarges and remains

embedded in granulosa cells at one pole of follicles
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 Ovulation
• Ovulation : release of egg from ovaries
• Occurs on 14th day in normal 28 day cycle

• Only one follicle matures each month: in each cycle only one
follicle matures and releases egg , rest 5 -11 involute

• Cause : unknown, but may be due to increased estrogen

secreted by growing follicle which sends negative feedback
mechanism to hypothalamus to reduce FSH secretion

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• LH surge (importance of LH in ovulation): LH is important for
final follicular growth and ovulation

• LH acts on theca and granulosa cell converting them to

progestrone secreting cells. Thus level of estrogen drops and
progestrone increases

• This increased progestrone helps in ovulation

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• Initiation of ovulation:

• Increased progestrone in response to LH surge makes:

 Theca cells to release proteolytic enzymes which cozes

dissolution and weakening of follicular wall

 Rapid growth of blood vessels into follicle wall and release of

prostaglandin into follicular tissues

• These two effects cozes plasma transudation into follicle

which contributes to follicle swelling

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• Changes in follicle during ovulation:
 outer wall of follicle swells and small area in the center
protrudes c/a stigma

 Fluid oozes out from stigma and finally follicle ruptures at

stigma releasing more viscous fluid and ova

• Released ovum is surrounded by mass of granulosa cell c/a

corna radiata

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 Leutal phase of ovarian cycle

• After expulsion of ovum remaining granulosa and theca cells

change into leutal cell

• Corpus luteum
1. Granulosa cells
2. Theca cells

Corpus albicans
After few weeks it is replaced by connective tissue and later
within months absorbed

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• Luteinizing function of LH: change of granulosa cells and
theca cells to lutein cell mainly depend on LH, this gives its
name ‘luteinizing” meaning “yellowing”

• Secretion of corpus luteum: both progestrone and estrogen

• Once formed lutein cells undergoes proliferation,

enlargement, secretion and degeneration within 12 days

Another hormone with same properties as LH c/a

HUMAN CHORIONIC GONADOTROPIN is secreted by
placenta and acts on corpus luteum to prolong its
life for first 2 to 4 months of pregnancy

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• Involution of corpus luteum:
• Inhibin from lutein cells inhibits FSH n LH secretion from
pitutary. Low FSH n LH cozes corpus luteum to degenerate

• Involution removes inhibition on ant pitutary (by inhibin,

estrogen and progestrone) which again starts secreting FSH n
LH to begin new cycle

• Absence of estrogen and progestrone leads to menstruation

by uterus

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Monthly endometrial cycle and menstruation

• Under the effect of monthly cyclical production of estrogen

and progestrone by ovaries an endometrial cycle in the lining
of uterus operates

• Following stages:
1. Proliferation of the uterine endometrium
2. Secretory changes in endometrium
3. Desquamation of the endometrium(known as menstruation)

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• Menstruation :
• Cozed by reduction of estrogen and progestrone (esp
progestrone ) at the end of cycle , if ovum is not fertilized

• Involution of endometrium to abt 65% of previous thickness

• 24 hrs before onset of menstruation blood vessels in mucosal

layer undergoes spastic vasoconstriction due to release of
some PG

• Vasospasm decreases nutrients to endometrium, this along

with decreased hormones cozes necrosis of endometrium

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• Gradually the necrotic layer separate from uterus and finally
all the superficial layer desquamated

• Desquamated tissue, blood plus PG together initiate uterine

contraction that expel uterine content

• 40ml of bood plus 30ml of serous fluid is lost (menstrual

blood is non clotting bcoz of fibrinolysin released with
necrotic material)

• Normal duration: 3- 7 days

• Numerous leukocytes are released with necrotic material,

making uterus resistant to infection during menstruation
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 Test for ovulation
• Rise in basal body temp: increase in temp of 0.5F due to
thermogenic effect of progestrone

• Physical testing of cervical mucous: spinnbarkeit effect

• Microscopic evaluation of cervical mucous: ferning pattern

• Hormonal test: LH surge and increased progestrone after

ovulation
•

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Female Reproductive system

Lecture 2

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Female Hormones

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 Human Chorionic Gonadotropin (hCG)
• PREGNANCY HORMONE--- glycoprotein

• Half life –24hrs

• Levels peak at 60-70 days then remain at a low plateau for

the rest of pregnancy.

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 FUNCTIONS: (hCG)
 RESCUE & MAINTENANCE of function of corpus luteum.

 Prevents degeneration of corpus luteum

 Stimulates corpus luteum to secrete E + P which, in turn, stimulate

continual growth of endometrium.

 hCG stimulates leydig cells of male fetus to produce testosterone in

conjunction with fetal pituitary

 Gonadotrophins thus indirectly involved in development of external

genitalia.

 Suppresses maternal immune function& reduces possibility of fetus

immunorejection
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 Fertilization

• The process by which male and female gametes fuse,

• occurs in the ampullary region of the uterine tube.

• Spermatozoa may remain viable in the female reproductive

tract for 5-6 days

• Ova remains viable for 24 hrs

• Thus fertilization can occur from 4-5days before and 24 hrs

after ovulation
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 Sperm transport to oviduct
• Primarily by estrogen which hydrates cervical mucus and
facilitates sperm propulsion

• They are assisted by movements of uterine cilia and uterine

contraction stimulated oxytocin from female pitutary and PG
in semen

• The trip from cervix to oviduct requires a minimum of 2 to 7

hours

• After reaching the isthmus, sperm become less motile and

cease their migration.
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• At ovulation, sperm again become motile perhaps because of
chemoattractants produced by cells surrounding the egg, and
swim to the ampulla, where fertilization usually occurs

• Spermatozoa are not able to fertilize the oocyte immediately

upon arrival in the female genital tract but must undergo

• (a) capacitation and

• (b) acrosome reaction

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 CAPACITATION
• Sperm undergoes physiological changes in the oviduct c/a
capacitation.
• The process of capacitation takes 1-10 hours.

• Location: in the uterus and oviducts

• The acrosomal reaction cannot occur until capacitation has

occurred.

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 CHANGES DURING CAPACITATION

 Uterine and fallopian tube fluids wash away the inhibitory

factors that surround the sperm in male genital tract

 Excess cholesterol present in acrosomal membrane is lost.

 Membrane of sperm becomes permeable to calcium ions

which facilitates hyperactivated movement /whiplash
movement required for movement in oviduct and penetration
through zona pellucida.

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 The phases of fertilization include

• phase 1: penetration of the corona radiata

• phase 2: penetration of the zona pellucida and

• phase 3: fusion of the oocyte and sperm cell membranes

• The acrosome reaction must be completed before the sperm can

fuse with the secondary oocyte

• The acrosome reaction is associated with the release of

acrosome enzymes that facilitate fertilization

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Fertilization

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 Fertilization facts:
• Completed within 24 hours of ovulation

• Approximately 400 to 600 MILLION sperms are deposited at

cervical opening
– Most human sperms do not survive longer than 48 hours
in the female genital tract.

• Only about 200 sperms reach the fertilization site; most

degenerate and are absorbed by the female genital tract.

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 The results of fertilization:
• Stimulates the secondary oocyte to complete meiosis.

• Restores the normal diploid number of chromosomes (46).

• Results in variation of human species as maternal and paternal

chromosomes intermingle.

• The embryo contains only maternal mitochondria because the sperm

mitochondria are dispersed into the egg cytoplasm and discarded.

• Determines the sex of the embryo.

– The sex chromosome (Y or X) carried by the successful sperm
determines embryonic sex.
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Female Reproductive system

Lecture 3

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 Cleavage of Zygote
• Begins about 30 hrs after
fertilization

• Zygote divides first into 2 then

4 then 8 & 16 cells(morula)

• Zygote is within the thick zona

pellucida during cleavage

• Zygote migrates in the uterine

tube from its lateral end to its
medial end.
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 IMPLANTATION
• It is the process by which the Blastocyst (100 cell stage)
penetrates the superficial (Compact) layer of the
endometrium of the uterus.

• Site:
• The normal site of implantation is the posterior wall of uterus
near the fundus
• .
• Time:
• It begins about the 6th day after fertilization.
• It is completed by the 11th or 12th day.

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• Mechanism:
• The Morula reaches the uterine cavity by the 4th day after
fertilization, & remains free for one or two days

Fluid passes from uterine cavity to the Morula through the zona
pellucida.

• Now the Morula is called Blastocyst, its cavity is called blastocystic

cavity, its cells divided into Embryoblast & Trophoblast.

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 Zona pellucida degenerates by the 5th day to allows the blastocyst
to increase in size and penetrates the endometrium.

• By 6th day(ie 20th day of 28 day menstrual cycle) the blastocyst

adheres to the endometrium

• By 7th day, Trophoblast differentiated into 2 layers:

Cytotrophblast, inner layer, mitotically active.
Syncytiotrophoblast (outer multinucleated mass, with indistinct
cell boundary.
• By 8th day the blastocyst is superficially embedded in the
compact layer of the endometrium.
• Penetration results from proteolytic enzymes (eg.COX-2)
produced by trophoblast.

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• Uteroplacental circulation is established by 11th or 12th day.

• Implantation
can be detected by:
1- Ultrasonography.
2- hCG (human chorionic gonadotrophin which is secreted
at about the end of 2nd week

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 Ectopic Pregnancy
• Ectopic Pregnancy
• It means implantation
outside the uterus.
• 95 to 97% of ectopic
pregnancies occurs in the
uterine tube.
• Most are in the ampulla &
isthmus.
• Placenta previa:
Implantation occurs in the
lower uterine segment.
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 Menopause
• Def: means cessation of menstrual cycle
• Mean age: 45 – 50 yrs
• Phases : premenopause
• perimenopause
• postmenopause

• Premature menopause:
• Premature ovarian failure

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Menopause

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 Symptoms of menopause

• Hot flushes
• Cardiovascular changes
• Psychological changes
• General symptoms

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