female reproductive tract anomalies 2

With Regards

This is being Reproduced for the benefits of Student.

Our sincere thanks and warm regards to the Author of this article,

Prof. M.C.Bansal. prof Veena Acharya.

Uterus

The uterus in pregnancy

www.udel.educellbio.utmb.edu

Thick layer of interlacing muscle

fibers

stratum functionalis: •sloughed off during menstruation and regenerated each cycle •grows to 6mm thick in about 10 days

stratum basalis: • not sloughed off during menstruation• approximately 1mm thick• Contains bases of glands and blood vessels

Endometrium

Lutz Slomianka, Univ. West. Australia

Endometrium

Proliferative phase Straight glands

Secretory phase Sacculated glands

Menstrual phase Disrupted glands

Basal

RER

Basal

RER

+

Apica

l glyco

gen

Apica

l glyco

gen

Quies

cent

Quies

cent

Glycogen is produced and secreted cyclically

cellbio.utmb.edu

Proliferative

Secretory

Menstrual

Endometrium

www.endotext.orgOrig. From Noyes RW, Hertig AW, Rock J.

Dating the endometrial biopsy. Fertil Steril 1950; 1:3

Gland mitoses

Pseudostratification of nuclei

Basal vacuolation

Secretion

Stromal edema

Pseudodecidual reaction

Stromal mitoses

Leukocytic proliferation

Endometrial tissue growing outside uterus

Causes pain as tissue responds to hormones

Can be treated with hormones or surgery

Allows the body to control its fertility by:

• controlling the maturation of oocytes

• altering the readiness of the uterus for implantation

•Menarche – age 9-14•Onset of menstruation

•Menopause – age 45-55•Oocytes no longer produced•Hormone production reduced

BUT, see: http://www.snopes.com/pregnant/medina.asp

Menstruation

Clinical correlation: Menstruation may cease with anorexia, high amounts exercise, or hypothalamic disorders. The amount of body fat is signaled to the hypothalamus by substances such as leptin and insulin, and menstruation will not occur unless some minimal amount of body fat is present. The age of menarche is also affected by the same mechanism.

Comparative medicine: Humans ovulate continuously throughout the year, but many mammals ovulate seasonally (during “estrus” – e.g. rats, cats), or only upon sexual stimulation (e.g. ferrets).

day:

||||||||||||

|___________________________________________________________________|<--menstrual-->|<--------- proliferative ------->|<-----------|----- secretory -----|------->|1 5 15 20 25 28

|-ovul.-| |<--implantation-->|

http://www.wisc.edu/ansci_repro/

anterior pituitary

FSH LH

estrogens

estrogens +progesterone ovaries

Menstrual Cycle: I

corpus luteum

GnRH

LH

FSH

progesterone

estrogens

++

+

+

+

+

+

-

+

| | | | | | | | | | | | |___________________________________________________________________ |<--menstrual-->|<--------- proliferative ------->|<-----------|----- secretory -----|------->| 1 5 15 20 25 28 |-ovul.-| |<--implantation-->|

day:

estrogensFSH progesteroneLH+ ++- -

estrogens

horm

on

e levels

-

| | | | | | | | | | | | |___________________________________________________________________ |<--menstrual-->|<--------- proliferative ------->|<-----------|----- secretory -----|------->| 1 5 15 20 25 28 |-ovul.-| |<--implantation-->|

day:

Pituitary Corpus Luteum

horm

on

e levels

Ovarian Follicle (Placenta)

FSH

Estrogen

LH

EstrogenProgesterone

hCG

Charting menstrual cyclebody temp - raises 0.1-0.5 deg in secretory phase (progesterone)cervical mucus – becomes slippery and stretchable at ovulationcalendar method – least effective method

Taking advantage of hormones:birth control pills – progesterone 50-150ug (& estrogen 20-35ug)ovulation test – detects LH surgepregnancy test - hCG

pituitary gland

uterus

ovaries

Menstrual Cycle: IIIOvaries, Pituitary, Uterus

FSHprolactin

GnRH

oxytocin

LH

progesterone

estrogens

hCG, estrogens, progesterone, etc.

Menstrual: Days 1 - 5– the corpus luteum degenerates

• estrogen and progesterone levels drop• spiral arteries degenerate

– the endometrium is sloughed off– FSH is produced

The ovary: menstrual phase

Low estrogen levels mean FSH levels rise. In response, 15 -20 primordial follicles begin to mature.

The corpus luteum stops producing hormones anddegenerates.

A corpus albicans forms.

The Pituitary: menstrual phase

anterior pituitary

posterior pituitary

hypothalamus

GnRH

Low levels of estrogens induce FSH production

The endometrium: menstrual phase

Day 28 Day 3 Day 5

Proliferative (follicular): Days 6 - 15

- ovarian follicles develop- estrogen levels increase

- the endometrium regenerates

- LH is produced

- FSH levels drop

The ovary: proliferative phase

estrogens

At the end of the proliferative phase, high levels of LH induce ovulation

Pituitary Gland: proliferative phase

anterior pituitary

posterior pituitary

hypothalamus

GnRH

High levels of estrogen from developing ovarian follicles stimulate LH production.

The endometrium: proliferative phase

Day 10

Secretory (luteal): Days 16-28

– corpus luteum forms, estrogens and progesterone are produced– the endometrial gland become sacculated and begin to secrete fluid– FSH and LH production is suppressed

The ovary: secretory phase

after ovulation, the remaining follicle cells form a corpus luteumestrogens +

progesterone

Pituitary Gland: secretory phase

anterior pituitary

posterior pituitary

FSH

hypothalamus

LHhigh progesterone levels inhibit LH production.

high estrogen levels inhibit FSH production

The endometrium: secretory phase

Day 25

But what if pregnancy occurs?

hCG

Hormones of pregnancy

corpus luteum

GnRH

LH

FSH

progesterone

estrogens

+

-

-

hCG

X

X

X

+

+

+

+

+

+

The ovary: pregnancy

hCG made by the developing embryo causes the corpus luteum to continue making estrogens and progesterone to maintain the pregnancy

estrogensprogesterone

The pituitary Gland: pregnancy

anterior pituitary posterior

pituitary

FSH

hypothalamus

LH high progesterone levels inhibit LH production.

high estrogen levels inhibit FSH production

The endometrium: pregnanacy

undergoes decidualization

is called ‘decidua’

is a topic for the next lecture

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