Male genital system

Sperms are produced in the testis: 100 million/ ml of 1semen

Female genital system

Semen:
Semen is the penile ejaculate.
It consists of the sperms swimming in the viscid fluid secreted by the
accessory sex glands.
Seminal fluid composition:
Seminal vesicles 50 percent (fructose and coagulant)
Bulbourethral glands 10 percent (lubricate and flush the urethra)
Prostate 30 percent (Alkaline secretion)
Sperms 10 percent
Volume: 2-6 ml
There are 200 to 600 million sperms in one ejaculation.
Sperm speed 2-3mm/min
Vagina acidic pH- slower
Uterus Alkaline faster
Seminal glands fructose- energy source for sperms.

Female genital system: Parts

Ovum is produced in the ovaries: Only one ovum is

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discharged from the ovary at each menstrual cycle

Ovary with different stages of developing

oocytes, Graafian follicle & Corpus luteum

When mature, the oocyte is called a

secondary oocyte or mature oocyte.
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Fertilization and Implantation

Fertilization occurs in the ampulla of the uterine tube

Implantation occurs in the endometrium of the Body of the uterus
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Fertilization age & Gestational age

266 days & 280 days (40 wks) from LNMP
How to calculate the EDD?
Pregnancy: (Latin- graviditas) The period of pregnancy is
divided into 3 stages of 3 months each.
First trimester- from conception to 12 weeks
Second trimester- from 13 weeks to 28th week
Third trimester- from 29th week till the birth of the baby.
Developmental stages:
Pre-embryonic or Pre-organogenesis period of
development
Embryonic period of development (3rd wk- 8th wk)
Fetal period of development (9th wk- birth)
Neonate: is the new born baby. (1- 4 wk after birth)
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Infancy: 1st yr.

Zygote : Totipotent beginning of a new human being

Morula: 16 cell stage
Blastocyst : Implantation occurs at this stage
Inner cell mass: Becomes the embryo
Outer cell mass: Trophoblast
Inner cell mass is divided into three germinal layers
Endoderm, Mesoderm, and Ectoderm
Yolk sac
Amnion
Folding of the embryo : Flat inner cell mass becomes tube like (3 tubes)
Gastrula Period of formation of the 3 germ layers
Neurula Period of formation of the neural tube
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There are around 2 million primary oocytes

in the ovaries at birth.
Of these, only about 40,000 survive at
puberty
Out the these, only about 400 become
secondary oocytes during the entire
reproductive cycle (puberty to menopause)
Menarche- around 13 years
Menopause- around 50 years

Ovary with different stages

of the ovarian cycle

At the beginning of each ovarian cycle 15 to 20 primary

follicles are stimulated to grow under the influence of FSH
FSH also stimulates INHIBIN from granulosa cells.
But only one reaches full maturity and is discharged from the
ovary at each cycle

Ovulation:
Due to LH surge meiosis I is completed and meiosis II is initiated
The high concentration of LH increases collagenase activity, resulting in
digestion of collagen surrounding the follicle.
Prostaglandin levels rise in response to LH surge. This causes local
muscular contraction in the ovarian wall. These contractions extrude the
oocyte.
Oocyte with the surrounding granulosa cells breaks free.
Some of the cumulus oophorus cells then rearrange around the zona
pellucida to form the corona radiata.
Ovulation occurs on day 14 of the ovarian cycle
Middle pain: during ovulation/ rise in basal temperature

After ovulaton, granulosa cells are vascularized

Under the influence of LH these cells form the corpus luteum and
secrete progesterone
Progesterone along with the estrogen helps the uterine
endometrium to grow
If fertilization does not occur, it degenerates and forms the corpus
albicans
When progesterone level decreases, it results in the menstrual
bleeding
If the oocyte is fertilized, degeneration of corpus luteum is
prevented by the human chorionic gonadotropin (hCG) secreted
by the syncytial trophoblast. In this case corpus luteum continues
to grow and forms the corpus luteum of pregnancy.

THE FEMALE REPRODUCTIVE CYCLES

Degeneration of this corpus luteum is prevented by hCG, a
hormone produced by Syncytiotrophoblast.
The Corpus Luteum is functionally active in the first 20 wks of
pregnancy , then the placenta assumes the production of
estrogen and progesterone required for the maintenance of
pregnancy.
If the ovum is not fertilized the corpus luteum degenerates in
10 to 12 days and is called corpus luteum of menstruation
which is a white scarred tissue called Corpus Albicans.
Anovulation: is due to inadequate FSH and LH. It causes infertility
Administration of gonadotrophins or ovulatory agents like clomiphene
citrate induces ovulation, but incidence of multiple pregnancies is much
higher with such drugs

THE ENDOMETRIUM and MENSTRUAL CYCLE

The 3 layers of Endometrium is

grouped into 2 at each cyclestratum Functionalis and
stratum Basalis:

The superficial layer is

Functionalis because it grows
reforms and sloughs during
each menstrual cycle. It become
7mm thick before menstruation
and 1 mm. After menstruation.

The deep layer is Basalis. This

does not slough during
menstruation and the new
functionalis layer is formed from
basalis after menstruation

THE FEMALE REPRODUCTIVE CYCLES

THE MENSTRUAL CYCLE

The Cyclic changes in the endometrium of the Uterus caused by
estrogen and progesterone constitute the menstrual cycle.
The average menstrual cycle is 28 days, but may vary.
Although menstrual cycle is a continuous process it can be divided
into three phases.

THE PHASES OF MENSTRUAL

CYCLE

Menstrual phase

Begins on the first day of menstruation and lasts for 4-5 days,
where menstrual flow has blood and small pieces of endometrial
tissue, where the functional layer of uterine wall is sloughed off.

THE PHASES OF
MENSTRUAL CYCLE

The Proliferative Phase

Lasts for about 9 days with an increase in estrogen secretion

with the growth of ovarian follicles.

Thickness of the endometrium increases, endometrial glands

increase in number and length of spiral arteries elongate.

 The Secretory Phase

It is initiated by the formation of the

corpus luteum after ovulation.
This phase lasts for about 13 days.

The progesterone produced by the

corpus luteum stimulates the glandular
epithelium.

If the oocyte released at ovulation is

fertilized, the blastocyst begins to
implant in the endometrium on the 6th
day of the secretory phase.

THE FEMALE REPRODUCTIVE CYCLES

The basal layer regenerates during the subsequent

proliferative phase.
If pregnancy occurs the menstrual cycle stops.
The menstrual cycle resumes in 6-8 wk after pregnancy.
If pregnancy does not occur the reproductive cycles continue,
till the end of reproductive life (MENOPAUSE) which varies
from 47-52 years.

Fertilization

Fertilization:
Occurs in the ampulla of the uterine tube

Phases of fertilization
1. Penetration Of Corona Radiata
2. Penetration Of Zona Pellucida
3. Fusion Of The Oocyte And
Sperm Cell Membranes

Clinical correlates:
Infertility - 15 30 % of the couples
Male infertility may be a result of insufficient number of sperms i.e decreased
sperm count, decreased motility or increase in the number of abnormal
sperms.
Normal ejaculate has about 100 million sperms/ ml (in a total volume of 3-4
ml). Males with 20million sperms/ ml are usually fertile.
Oligozoospermia is a condition in which very few live sperms are present
in an ejaculate.
Azoospermia No live sperms are present in the ejaculate
Infertility in a woman is mainly due to occluded oviducts, hostile cervical
mucus, immunity to spermatozoa, absence of ovulation and others.

Assisted reproductive techniques

IVF : In vitro fertilization in a laboratory, "test tube baby.
GIFT: Gamete intrafallopian transfer oocyte and sperm is introduced into the
ampulla of the uterine tube
ZIFT: Zygote intrafallopian transfer Fertilized oocytes are placed in the
ampulla of the uterine tube
ICSI: A procedure called intracytoplasmic sperm injection (ICSI) utilizes a
manipulation technique that must be performed using a microscope to inject a
single sperm into each egg. The fertilized eggs can then be returned to the
uterus, as in IVF.
This procedure is adopted to overcome the Oligozoospermia and
Azoospermia.

Cleavage: series of mitotic division

Morula:
16 cell stage is called as the morula
morula shows: Inner cell mass
Outer cell mass
The inner cell mass will form the embryo proper (embryoblast) and outer cell mass
forms the trophoblast which later forms the placenta.
Blastocyst formation:
Fluid penetrate through the zona pellucida into the intercellular spaces of the inner
cell mass.
Spaces filed with fluid unite to form blastocele
At this time the embryo is blastocyst
the embryonic pole inner cell mass
Zona pellucida disappears approximately around the 5th day
Implantation: Occurs at 6th day after fertilization
Normal Implantation site: in the endometrium of the posterior wall of the body of
the uterus
Abnormal implantation:
ectopic pregnany
tubal pregnancy

When the embryo implants, the syncytial trophoblast cells secrete human chorionic
gonadotropin (hCG) which supports the corpus luteum and thus maintains the
progesterone supply.
The trophoblast expresses glycoprotein receptors on their surface called integrins that
help in attachment and invasion of the trophoblast into the endometrium.
On day 10 the blastocyst is more deeply embedded in the endometrium and the
penetration defect in the endometrium is closed by a fibrin deposit. It is called as the
closing plug.

Implantation Bleeding: Occurs in some pregnant women at the time of the first missed
period (about 2 weeks after fertilization). This may lead to miscalculation of EDD.

Abnormal implantation:
Blastocyst may implant outside the uterus. - result in ectopic pregnancies
Most ectopic pregnancies occur in the ampulla and isthmus of uterine
tube - tubal pregnancy
Blastocysts that implant in the uterine tube may be expelled into the
peritoneal cavity where they commonly implant in the rectouterine pouch.
The expelled blastocyst may get implanted in the ovary resulting in
ovarian pregnancy.
Sometimes the abdominal conceptus dies and remains undetected in the
abdominal cavity. It might get calcified and form a stone fetus. It is
called the lithopedion(Litho-stone and pedion meaning child).
Implantation of a blastocyst near the internal os of the uterus results in
placenta previa. It is the cause of excessive bleeding at the time of delivery.

The blastocyst is formed in the 1st week

by the

appearance of fluid filled cavity in the morula.

Inner cell mass is called the embryoblast
Outer cell mass is called the trophoblast.
The blastocele separates the embryoblast from the outer
trophoblast cells.
The trophoblasts provide nutrition to the embryo.
Blastocyst begins implantation by 6th day

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WEEK 2: week of 2s
1. the cells of the embryoblast
divides into two layers:
bilaminar germ disc.
a.
b.

Epiblast- a layer of high

columnar cells adjacent to the
amniotic cavity
Hypoblast- a layer of small
cuboidal cells adjacent to the
blastocyst cavity

2. Differentiation of the trophoblast

a. Cytotrophoblast
b. Syncytiotrophoblast
3. Formation of 2 cavities
a. amniotic cavity
b. Yolk sac cavity
4. Formation of the yolk sacprimary and secondary
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The syncytial trophoblast

erodes the maternal tissues

Trophoblast

Lacunae appear in this

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the second week:

Week of Twos

The embryoblast splits into two germ layers: the

epiblast and hypoblast
The trophoblast is divided into two layers: inner
cytotrophoblast and outer syncytiotrophoblast
The extraembryonic mesoderm splits into two layers:
the somatopleure and splanchnopleure
Two cavities appear- the amniotic cavity and the
yolk sac cavity
The blastocyst cavity is remodeled twice to form the
primary and secondary yolk sacs
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Clinical:
Abortion: termination of pregnancy before 20 weeks gestation, before
the viability of the embryo or fetus. Most occur spontaneously during
the first 3 weeks of pregnancy. More than 50% of the abortions result
from chromosomal abnormalities.
Abonrmal Blastocysts:
Most of the abnormal blastocysts (trophoblastic hypoplasia, absence of
embryoblast, abnormal germ disc orientation,) probably would have
aborted with the next menstrual flow.
Hydatidiform Mole:
It is a rare mass or growth that may form inside the uterus at the
beginning of a pregnancy. It appears as a bunch of grapes inside the
uterus. The mole exhibits variable degrees of trophoblastic proliferation.
They produce excessive amount of hCG.
The hydatidiform mole occur when the abnormal blastocyst or embryo
dies but the trophoblast continues to develop.
Two types: complete and partial.
Paternal origin.
Complete hydatidiform mole results from fertilization of an oocyte in
which the female pronucleus is absent or inactive. Partial hydatidiform
mole results from fertilization of an oocyte from two sperms (dispermy).
They may develop into malignant trophoblastic lesions32
Choriocarcinoma.

EMBRYOGENESIS- WEEK 3
Characterised by three events Appearance of primitive streak
Development of notochord
Differentiation of three germ
layers
A. Formation of the Third Germ
Layer-GASTRULATION
BMPs
1. Migration of epiblast cells to form
the mesoderm and endoderm
2. Formation of the primitive streak,
pit and node
3. Formation of the notochord
4. The remaining epiblast gives rise to
the ectoderm
B. Derivatives of the Germ Layers
1. Ectoderm
2. Mesoderm
3. Endoderm

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Primitive streak

Cephalic end

Caudal end

34

Primitive streak

35

Trilaminar germ disc Mesoderm sandwich

36

Sacrococcygeal teratoma
- May contain all three germ layers
37

Primitive node
- formation of the notochord
38

Prechordal cellsbuccopharyngeal
membrane
Primordial axis

Formation of the Notochord

-cranial migration of the mesenchymal cells from the
primitive node
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Functions of the Notochord:

-primordial axis & rigidity
-Inductor: induces ectoderm to form neural plate
-basis of axial skeleton
-future site of vertebral bodies
Fate:
-Nucleus pulposes
-Apical ligament

40

Allantois
41

Connecting stalk

Allantois
42

Patent urachus
43

Neural crest

Neurulation

44

Cranial
neuropore

Caudal
neuropore

Neural tube and neural crest

45

Neural crest
derivatives

46

Most neural tube defects occur during

3rd and 4th weeks of development.
Neural tube defects can be detected
by the presence of elevated level of
alpha-fetoprotein in the amniotic
fluid.
Failure of the cranial neuropore to
close leads to anencephaly.
Polyhydramnios is often
associated with anencephaly
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Fate of the germ layers

48

Embryonic ectoderm gives rise to:

Epidermis of the skin, hairs, nails, cutaneous (sebaceous & sweat) glands
and mammary glands
Central and peripheral nervous systems
Neural crest derivatives
Pituitary gland
Parotid gland
Medulla of suprarenal gland
Lining of the cheek
Enamel of teeth
Lens & Retina of the eye
Endoderm gives rise to:
Epithelium of gastrointestinal tract, respiratory tract
Parenchyma of liver and pancreas
Thyroid gland (except C cells which are derived from neural crest)
Parathyroid glands
Thymus
Tonsils
Urinary bladder
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Mesoderm derivatives

50

Mesoderm gives rise to:

Dermis of the skin
Connective tissue
Teeth with the exception of enamel
Muscles
Bone and cartilage
Cardiovascular system, lymphatic system
Urogenital system including gonads, ducts and accessory glands
except prostate & urethra
Suprarenal cortex
Serous cavities- pleural cavity, pericardial cavity and peritoneal
cavity

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