The Female

Reproductive System
Lessons:
1. Female Reproductive System
o Anatomy and Physiology
o Diagnostic Tests
o Pathophysiology
2. Pregnancy
o Terminologies
o Physiology
3. Birth Process
o Stages
o Physiology
o Pathophysiology
This transcription presents the knowledge on female
reproductive system anatomy and physiology, and the
processes happening during pregnancy, birth and after
birth. This transcription also presents knowledge on how
female reproductive system works in monthly cycles,
while his does not, and how reproductive systems define
the secondary sex characteristics that contribute greatly to
who people are.
Lesson 1: Female Reproductive System
Introduction:

The female reproductive system unlike the male reproductive system, works in monthly
cycles.

FEMALE REPRODUCTIVE ORGAN (fig 1.1)

Fig 1.1

 Ovaries (fig 1.2)

 Are small, oval organs suspended in the pelvic cavity by ligaments.
 Each ovary measures 3 cm long, 15 cm wide, and 1 cm thick.
 The ovaries are enclosed in a capsule called the tunica albuginea.
 2 basic layers:
o Outer Cortex – it contains bubble-like follicles that enclose gametes.
o Inner Medulla – it contains the ovary’s arteries and veins.

Fig 1.2
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  Ovarian Ligament (fig 1.3)
 Is a fibrous ligament that connects the ovary to the lateral surface of the uterus.

Fig 1.3

 Ovarian Artery (fig 1.4)

 It is an artery that supplies oxygenated blood to the ovary in females. It arises from
the abdominal aorta below the renal artery. It can be found in the suspensory
ligament of the ovary, anterior to the ovarian vein and ureter.

Fig 1.4

 Suspensory Ligament
 Is one continuous tissue that connects the ovary to the wall of the pelvis.
 There are separate names for the two regions of this tissue.
 In the anterior region, the suspensory ligament is attached to the wall of the pelvis via
continuous tissue called peritoneum.
 Follicles (fig 1.5)

 Is a fluid-filled sac that contains an

immature egg, or oocyte.
 These follicles are found in the ovaries.
 During ovulation, a mature egg is
released from a follicle.

Fig 1.5
 Tinea Albuginea
 Is a layer of condensed tissue on the surface of the ovary.
 It is composed of short connective-tissue fibers with fusiform cells between them.

Internal Female Reproductive Anatomy (fig.1.6)

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 Fig.
1.6

 Broad Ligament – is an extension of the peritoneum. It holds the ovaries and uterine tubes in
their relative position to the uterus.
 Suspensory Ligament – attaches the lateral edge of the ovary to the posterior wall of the
pelvic cavity and encloses the ovarian artery and vein.
 Ovarian Ligament (fig. 1.7) – attaches the medial edge of the ovary to the uterus.

(fig. 1.7)

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Secondary Female Reproductive Organs
and Structures

 Internal Secondary Structures (fig.

1.8)
o Uterus -is held in place by the
broad and round ligaments
and is usually tripped over
the urinary bladder.
-is a pear-shaped,
hollow organ with a thick
wall composed of three
layers which are the
perimetrium, myometrium,
and endometrium.
Perimetrium – this is the outermost layer of
the uterine wall, and it may also be called the
visceral peritoneum.
Myometrium – this is the thickest layer of the uterine wall. It is composed of smooth muscle that
contracts to expel uterine contents, whether the contents be the lining that is shed each month
or a fetus during birth. (fig. 1.8)
Endometrium – this is the lining of the uterus. It has two sublayers:
Stratum Functionalis – is the superficial two-thirds of the lining that is typically shed each month.
Sratum Basalis – is the deep one-third of the lining. Its purpose is to generate new stratum functionalis
each month.

Three Areas Describe the Uterus:

Fundus - It the broad superior curve. FIMBRIAE

Body - It is the wide midportion.
Cervix - It is the narrow, inferior portion.

o Uterine Tubes - this tube can also be called a

fallopian tube or oviduct
- it is open-ended and measure
approximately 10 cm from the ovary to the
uterus.

(fig.1.9)

The uterine tubes flared end (infundibulum) near the ovary has fingerlike projections called fimbriae.

Fimbriae (fig..1.9)– they are not attached to an ovary, nor do they cover it. The fimbriae sway to coax
an egg released from the ovary into the uterine tube. If that happens, ciliated cells lining the uterine
tube move the egg along the wide part of the tube (ampulla) to the narrow part of the tube (isthmus)
before delivering the egg to the uterus.

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 o Vagina - Is the tube between the vulva and the cervix.
-The vagina is what babies exit through during birth, and what menstrual
blood exits through during period.
- Is also used for insertion, such as with a penis, fingers, female condoms,
sex toys, tampons, or menstrual cups.
- It is an 8-10 cm canal that has three functions:
1. The vagina allows for the flow of the menses (shedding of the
uterine lining) during a monthly cycle called the menstruation. Through
most of the month, the cervix produces a thick mucus to prevent any
microorganisms from entering the uterus from the vagina. However,
during menstruation, the uterine lining is shed from the uterus by
smooth muscle contractions of the myometrium through the cervical
canal, to the vagina, and out of the body.

2. The vagina is a receptacle for semen. The ridges in the vaginal walls
called vaginal rugae. The purpose of these ridges is to provide
increased surface area for extension and stretch.
3. The vagina serves as the birth canal. The vagina is highly extensible
(easily stretched) to be able to accommodate the birth of a baby.

EXTERNAL SECONDARY STRUCTURES (fig 1.1)

 Vulva (fig 1.10)

 A collection of reproductive structures in the female perineum.

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 (fig 1.10)

 Mons Pubis (fig 1.11)

 This is a mound of adipose tissue, covered with pubic hair, and is superficial to the
pubic symphysis.

(fig 1.11)

 Labia (fig 1.12)

 These are folds of skin and adipose tissue that frame the vestibule, which is an area
that contains the urethral and vaginal openings.
o Labia Majora (lateral folds)
 Are thicker and have hair
o Labia Minora (medial folds)
 Are thinner and are hairless
o Prepuce
 It is a fold formed where the labia minora meet anteriorly
 It forms a hood over the clitoris

 Clitoris (fig 1.13)

 This structure is similar to the male penis in that it is composed of two columns of
erectile tissue (corpus cavernosa) and includes a glans (fig.1.14) that has many nerve
endings for sexual stimulation.

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  It does not enclose the urethra as does the penis, and so it does not have any urinary
function

(fig 1.12)

 Hymen
 It is a fragile membrane that usually has some holes in it by puberty to allow for
discharge of the menses, but it may not be totally ruptured until intercourse.
 The status of a hymen is not an indication of virginity as it can also be ruptured by
strenuous exercise or tampon use.

 Vestibular Bulbs (fig 1.16)

 These bulbs become engorged with
blood during excitement, so they
tighten around the penis. This further
increases the sexual stimulation of the
penis.

 Vestibular Glands
 They secrete a lubricating fluid during
excitement to make sexual intercourse
easier. The fluid is released into the
lower part of the vagina and the
vestibule.
 These glands are similar to the bulbourethral glands in the male.

(fig 1.16)

BREAST

 Breasts (fig 1.17)

 Is the tissue overlying the chest (pectoral muscles).

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  Women’s breasts are made of specialized tissue that produces milk (glandular tissue)
as well as fatty tissue.
 The amount of fat determines the size of the breast.
 The milk-producing part of the breast is organized into 15 to 20 sections, called lobes.
 Within each lobe are smaller structures called lobules, where milk is produced.
 The milk travels through a network of tiny tubes called ducts.
 The ducts connect and come together into larger ducts, which eventually exit the skin
in the nipple.
 Connective tissue and ligaments provide support to the breast and give it its shape.
 Nerve provide sensation to the breast.
 The function of a mammary gland housed in a breast is to produce milk to nourish an
infant.
 There is no correlation between breast size and the amount of milk that can be
produced.
 Each breast is superficial to a pectoralis major muscle an is composed mostly of
adipose tissue and collagen.

 Suspensory Ligaments
 These support the shape of the breast and attach the breast to the fascia of the
pectoralis major muscle deep to it.
 Bras can give added support to these ligaments.
 Nipples
 Contains no fat, hair or sweat glands.
o Areola
 Is a dark, circular layer around the nipple.
 This area has many nerve endings sensitive to cold and touch and
responsive to sexual arousal.
 Smooth muscle deep to the areola is responsible for erecting the
nipple.
 Deep to the areola, each duct has a dilated part called the lactiferous
sinus, in which milk can accumulate and remain in the nursing
mother.
o Areolar Glands
 These are bumps in the areola that secrete a substance to prevent
chafing and cracking of the nipple during nursing.
 The special glands in the breast are called Tubalveolar Glands.
 Each of these glands end in a lactiferous duct (2-4 mm in diameter)
and opens up through a small hole onto the nipple.
 Cells which are important in contraction movements, called
myoepithelial cells, are present in the gland and help in secreting
fluids.

 Mammary Gland
 Although a mammary gland is present in young girls and enlarges during puberty, the
mammary gland of each breast does not fully develop until the first pregnancy.

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  Each mammary gland is divided into 15 to
20 lobes that are further divided into
lobules in a lactating breast (one producing
milk)
o Milk
 It is produced by secretory
cells in the lobules, released
through the action of
myoepithelial cells, and
drained by lactiferous ducts
that widen to form lactiferous sinuses fig 1.17
before reaching the nipple.

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Physiology of Female Reproductive System
 Hormonal Control at Puberty

Puberty begins between the ages of 8 and 10

Hypothalamus releases GnRH, which triggers the anterior pituitary to release FSH and LH.
FSH targets follicles in the ovary to produce estrogen.
Estrogen is a steroid hormone based on a chemically modified cholesterol. There are
several forms of estrogen: estradiol, estriol and estrone that targets most tissues to
produce the female secondary characteristics
 Female Secondary Sex Characteristics

 Breast Development - this is usually the first sign that puberty started. The breast
enlarged and lobules and ducts form, beginning at Puberty.
 Development of Axillary (armpit) and Pubic Hair - the ovaries produce small amount of
androgens, which are responsible for this sex characteristics and the libido - (sex drive) in
women
 Widening of the pelvis - the female pelvis has a rounded pelvic brim and a large pelvic
opening to accommodate the birth of a baby
 Fat Deposition - Estrogen causes a girl's body to deposit more adipose tissue. This
deposition typically takes place in the breasts, hips, mons pubis and buttocks. A woman's
body fat needs to be at a minimum of 22% to sustain pregnancy.
 Menstruation - it is the monthly shedding of the uterine lining. Menstruation cannot begin
unless the girl's fat reaches 17%. Typically, it starts at the age of 12

o Ovulation - the release of an egg from ovary, is the result of hormone LH but does
not usually occur during the first year of menstrual cycle.

 Oogenesis (fig. 1.18)

 Egg production
 Forms gametes (ova, eggs) that have a haploid number of chromosomes.
 Oogenesis produces one viable ovum from each oogonium (germ cell)
 Each ovum is developed by the follicle that surrounds it.
 Follicle is a group of surrounding cells responsible for caring for the oocyte by providing
nutrients and removing wastes. It isolates and protects the egg from the mother's immune
system.
 Oogonia undergoes mitosis in the ovaries before birth.
 It will begin to go through Meiosis I to become primary oocyte
 At adolescence, FSH stimulates some primary oocyte each month to finish meiosis I. Each
primary oocyte produces two daughter cells: secondary oocyte and First polar body
 Secondary oocyte continues Meiosis to mid-meiosis II. It will be ovulated, if and only if, a
sperm fertilizes the egg, meiosis is completed and the second polar body is expelled.
 A primordial follicle is a simple layer that surrounds the primary oocyte
 As the follicle develops, fluid is produced in which the secondary follicle floats
 A mature follicle eventually ruptures to release the egg and its fluid during ovulation

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 Then the follicle changes to a yellow color called corpus luteum. If the egg is fertilized the
corpus luteum will remain and continue to secrete hormones to support the pregnancy
for 90 days.
 Hormonal Control in the Adult Female (fig. 1.18)

 The female reproductive cycle has two parts: ovarian cycle, which affects the follicles and
oocytes in the ovary and the menstrual cycle, which affects the endometrial lining of the
uterus.
 Events in the ovarian cycle affect events in the menstrual cycle
 Menstrual phase. On day 1, the uterine lining begins to shed. This is the first day of the
woman's period. The menstrual flow will continue 4-5 days
 Follicular Phase. The anterior pituitary secretes FSH, which targets the primordial follicle
in the ovary that develop and secrete estrogen.
 The increasing amount of estrogen secreted by the follicle target the anterior pituitary to
inhibit FSH production, so FSH level go down on day 5. Estrogen does not inhibit the
anterior pituitary’s production of LH, so LH levels continue to rise at day 14.
 Proliferative Phase - the estrogen also targets the uterine line, causing it to thicken
 The peak of estrogen combined with LH causes mature follicle to rupture and release its
egg on day 14.
 Luteal Phase. The rupture follicle remains in the ovary but it changes to corpus luteum
that releases 2 hormones: estrogen and progesterone
 Secretory Phase. High levels of estrogen and progesterone cases the uterine lining to
thicken. This phase is a preparation for a possible pregnancy.
 Involution - if a sperm does not fertilize the egg the corpus luteum will go to involution
(shrinkage). This happens on day 22 and competed on day 26
 Drop in estrogen and progesterone
signals the anterior pituitary that
fertilization does not occur and will
trigger the production of FSH for a new
primordial follicle.

THE FEMALE SEXUAL RESPONSE (Fig

1.19)

● The female sexual response goes

through four stages: arousal, plateau,
orgasm, and resolution

● It may be initiated by thought, touch,

sound, or smell

1. Arousal - during this stage,

the innermost part of the vagina
dilates and the vaginal lining secretes
a fluid that lubricates the vestibule
and vagina to make intercourse easier.

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 2. Plateau - During this
stage, the uterus assumes a
more upright position
instead of being tipped over
the urinary bladder. The
vestibular bulbs become
engorged to constrict the
vagina around the penis and
the clitoris becomes
engorged.
3. Orgasm - The vagina
rhythmically contracts during
this stage. The uterus
undergoes peristaltic
contractions that may cause
the cervix to dip down into
the possible pool of semen.
i. Resolution- during this
fig 1.18 stage, the reproductive
anatomy returns to pre-
arousal state. The vagina
relaxes, the clitoris and
vestibular bulbs are drained
of excess blood, the uterus
once again tips over the
urinary bladder and nipples
are no longer erect.

(Fig 1.19)

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EFFECTS OF AGING ON THE FEMALE REPRODUCTIVE SYSTEM
 Like the male, a female goes through climacteric in midlife (typically in her 50’s. this stage of
her life is often labeled menopause, but that is only one event of a broader condition. Her
climacteric begins due to a decreased number of follicles (1000 or less) and their decreased
sensitivity to FSH and LH. Because of this insensitivity, the remaining follicles in her ovaries
release less and less estrogen and progesterone until eventually the secretion of these
hormones from the ovaries cease altogether. Her anterior pituitary initially responds to the
lack of estrogen and progesterone by secreting more FSH and LH in a negative feedback effort
to keep the system going. The higher levels of FSH and LH are a means of determining that
the climacteric has begun.

The diminished levels of estrogen and progesterone have significant effects on a woman’s anatomy:

 Her ovaries stop releasing eggs, and her menstrual periods eventually stop (menopause). At
this point, few if any follicles with oocytes remain. Her periods might become more irregular
before they stop altogether. Menopause is determined to have occurred when there has been
a lack of menses for a year.

 Hot flashes (intense feeling of warmth accompanied by sweating) are common as blood
vessels constrict and then dilate due to changing hormone levels. They cease once menopause
is complete and hormones have stabilized.

 The tissues of the vagina, labia minora, clitoris, uterus, uterine tubes, and breast atrophy.
The thinning of the vagina and decreased secretions from it may cause dryness and make
intercourse uncomfortable. If this is the case the use of lubricant can facilitate more
pleasurable intercourse. However, the effects of aging do not have to have an effect on a
woman’s enjoyment of a sexual relationship.

 Vaginal yeast infections become more common, it is a fungal infection that causes, irritation,
discharge and intense itchiness in the vagina and vulva.

 Bone mass declines. The risk for osteoporosis increases during and after the climacteric.

 Muscle and connective tissue decrease. This leads to sagging of the breasts and diminished
support for the urinary bladder, uterus, vagina, and rectum. As a result, these organs can drop
out of position (prolapse). This can lead to loss of control of micturition (incontinence) or
difficult bowel movements. This effect of aging may be increased if the woman has had
children with vaginal deliveries.

 The skin becomes thinner. This is due to decreased fat in the hypodermis.

 Cholesterol levels rise, increasing the risk for cardiovascular disease.

The effects of these changes can be treated with hormone replacement therapy (HRT). However,
estrogen replacement has been associated with increased risks of breast cancer, stroke, and heart
disease.
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 A woman’s adrenal glands continue to produce androgens, such as testosterone, throughout
and after her climacteric. These hormones are responsible for maintain her sex drive and slowing her
loss of bone and muscle mass. Without high levels of estrogen and progesterone to counteract the
masculinizing effects of androgens, a woman’s skin may coarsen and some facial hair may develop.

Diagnostic Tests for the Female Reproductive System

Diagnostic Test Function Image

Tissue is collected and examined for the

Biopsy
presence of abnormal cells.

Involves obtaining a sample of blood and

analyzing its contents. It can reveal hormone
Blood Test
levels, pregnancy and the presence of
infection.

Lighted colposcope is used to visualize the

Colposcopy
vagina and cervix.

Lighted hysteroscope is used to visualize the

Hysteroscopy
fetus.

Laboratory
Involves collecting urine or specimen samples
Tests/
from the female reproductive tract to
Microscopic
Examination of determine the presence of viruses or bacteria
Samples that may cause infection.

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 A lighted laparoscope is used to visualize,
Laparoscopy collect biopsies from or perform surgical
procedures in the abdomen or pelvic region.

X-ray of the breast that is used in screening for

Mammogram
breast cancer or breast disease.

Part of the gynogenic exam that helps detect

Pap Smear
abnormal cells in the lining of the cervix.

Test that detects human chorionic

Pregnancy Test
gonadotropin hormone in pregnant women.

Imaging technique in which sound waves

create visual images of internal structures. It
is used to determine whether a woman is
Ultrasound
pregnant, detect any structural abnormalities
of the reproductive organs and the
developing fetus.

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Female Reproductive System Disorders
Breast Cancer

 Abnormal growth of breast tissue, usually occurring in the Lactiferous ducts of lobules of the
breast.
 Other than skin cancer, breast cancer is the common form of cancer in women.
 Lifestyle choices can increase the risk of breast cancer. Obesity, lack of physical activity and
increased alcohol consumption increased the risk of breast cancer.
 Family history also plays a role. You are more likely to develop breast cancer if a family member
has been diagnosed with it.

Ovarian cancer

 When abnormal cells in the ovary begin to multiply out of control and form a tumor.
 If left untreated, the tumor can spread to other parts of the body. This is called metastatic ovarian
cancer.
 This
form of
cancer
can be
difficult
to

diagnose due to lack of symptoms some women experience.

 An enlarged ovary in postmenopausal women may be a sign of ovarian cancer.
 If ovarian cancer is suspected, physicians can perform an ultra sound, CT, MRI and Laparoscopy to
confirm the diagnose.

Cervical Cancer

 A slow growing cancer that has few symptoms. Is often

cause by human papillomavirus (HPV) infection.
 It is typically detected by swabbing the cervix (Pap smear)
and examining the collected cell for abnormal growth.

Symptoms:

 Blood spots or light bleeding between or following

periods.

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  Menstrual bleeding that is longer and heavier than usual.
 Bleeding after intercourse, douching, or a pelvic examination.
 increased vaginal discharge.
 Pain during sexual intercourse.
 Bleeding after menopause.
 Unexplained, persistent pelvic and/or back pain.

Fibroids

 Non-cancerous growth.
 The tumor is usually composed of muscle and fibrous tissue.
 It is extremely common and can be found either in the uterus in the
endometrium.
 Abnormal growths that develop in or on a woman's uterus.
Sometimes these tumors become quite large and cause severe
abdominal pain and heavy periods. In other cases, they cause no
signs or symptoms at all.
 The growths are typically benign, or noncancerous.
 The cause of fibroids is unknown.

Endometriosis

 Growth of endometrium in places other

than the uterus.
 Most likely located uterine tubes or lining
of the pelvic cavity.
 Often painful disorder in which tissue
similar to the tissue that normally lines
the inside of your uterus
 Grows outside your
uterus. Endometriosis most commonly
involves your ovaries, fallopian tubes and
the tissue lining your pelvis.

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Lesson 2: Pregnancy
Four Basic Requirements for a pregnancy to happen:

1. There must be a sperm and an egg.

Sperm Cell (Spermatozoa) - male reproductive cell
Egg Cell (Ovum) – female reproductive cell

2. The sperm must meet the egg.

On sexual intercourse: The sperm will travel from the Epididymis → ductus
deferens → ejaculatory duct → urethra → vagina → uterus (cervix, body) →
uterine tube (isthmus, ampulla) through the use of its tail or the flagella and the
matured egg will travel from the ovaries where it is captured to the uterine tube
by the fimbriae’s cilia’s sweeping motions, it the travels from the infundibulum →
ampulla using the sweeping motion of the cilia and the contraction of the smooth
muscles of the uterine tube.
On in vitro: The sperms are collected and mature eggs are collected from the
ovaries.
3. The sperm must fertilize the egg.
Fertilization- the union of the sperm and egg cell.

4. The fertilized egg must implant in the uterus.

Implantation- the attachment of the blastocyst or the fertilized egg on the wall of
the uterus.
Note:
 The mother and father need not be present for the first three requirements. Eggs and sperm can be
collected from the parents and fertilized in a lab. But there is no substitute for a uterus to house the
developing fetus.
 The mature human ova are arrested in metaphase II until fertilization and hence do not actually possess
a condensed nucleus. However, nuclei are typically included in biological drawings of egg cells to
represent the presence of haploid DNA material.
Ways to Prevent Pregnancy:

• Family Planning - the practice of controlling the number of children in a family and
the intervals between their birth

• Natural Method

o Withdrawal Method: also called “pull-out method”, a form of birth control

in which a man takes their penis out of a woman's vagina before they ejaculate
so fewer sperm get inside.
o Fertility Awareness Method: a method of contraception where a woman
monitors and records different fertility signals during her menstrual cycle
to work out when she's likely to get pregnant.

• Artificial Method

o Hormonal Methods: the use of hormones to avoid pregnancy.

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  Combined oral contraceptive pill - This pill contains two hormones,
estrogen and progestogen; it works by mimicking pregnancy thus
preventing ovulation.
 Progesterone only pill or mini-pill - This pill contains only one
hormone called progestogen. It works by thickening the vaginal
mucus thus preventing the sperm reaching the ovum. It also changes
the lining of the womb and fallopian tubes, making implantation
difficult and in some women may prevent the release of the ovum.
 Implantable contraception - A single rod is inserted subcutaneously in
the inner, upper arm. It releases progestogen slowly, thereby
preventing ovulation.
 Intra-uterine system - A small plastic or copper device is inserted in to
the cavity of the womb which prevents fertilization or may prevent
implantation.
 Injectable contraception - This injection slowly releases progestogen
and stops ovulation.

o Barrier Methods: block sperm from entering the uterus.

 Male condoms - are a fine rubber covering that is rolled on to the
penis before sex. Polyurethane condoms are available for people who
are allergic to rubber
 Female condoms - are a polyurethane cylinder with one open end. It
is held in place by a ring at either end. The closed end of the female
condom covers the cervix and the open end is positioned at the
entrance of the vagina.
 Diaphragm - is a dome-shaped device made of silicone that is put into
the woman’s vagina.
o Spermicide: a chemical that you put deep into your vagina right before
sex. It prevents pregnancy two ways: blocking the entrance to
the cervix so sperm can’t get to your egg, and stopping sperm from
moving well enough to swim to your egg.

o Hysteroscopic sterilization - a nonsurgical form of permanent birth control

in which a physician inserts a 4-centimeter (1.6 inch) long metal coil into
each one of a woman's two Fallopian tubes via a scope passed through
the cervix into the uterus (hysteroscope), and from there into the
openings of the Fallopian tubes. Over the next few months, tissue grows
over the coil to form a plug that prevents fertilized eggs from traveling
from the ovaries to the uterus.

• Surgical Method – birth control method that involves surgery.

o Vasectomy – the surgical procedure wherein the vas deferens from each
testicle is severed. The open ends are then closed off.
o Tubal Ligation - Fallopian tubes are closed off by using a clip, tying and
cutting, or cauterizing (burning) the tubes.
o Hysterectomy - the surgical removal of a woman's uterus.

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 Pathway for Sperm to Meet an Egg

•sperm maturation (head and body of epididymis) and sperm storation (tail of epididymis)
•during ejaculation, sperms are propelled by either the contactuction of the muscles or the continual
swaying motions of cilia.
Epididymis •sperms acquire high concentrations of potassium, sodium, and a substance known as
glycerylphosphorylcholine, which is an energy source for sperm.

•propels sperm forward with smooth muscle contractions.

•its ampulla where semen is stored prior to ejaculation, secretes ergothioneine, a substance that
Ductus reduces chemical compounds, and fructose, a sugar and nutrient on the sperm.
Deferens

•Mixes the sperm stored in the ampulla with fluids secreted by the seminal vesicles.
Ejaculatory
duct

•The bulbourethral glands secrete a small amount of clear fluid into the urethra before the ejaculate
is expelled. The functions of this fluid are not entirely known but are suggested to aid in lubricating
Urethra the male urethra in preparation for the semen during ejaculation.

•Approximately, 200 million sperms are ejaculated in a vagina, most sperms flowback or are killed by
the acidic fluids in the vagina.
Vagina

•Approximately 2 million sperms, cervical mucus filters out sperm with poor morphology and motility
and as such only a minority of ejaculated sperm actually enter the cervix.
•In the uterus, muscular contractions may enhance passage of sperm through the uterine cavity but
Uterus (Cervix, sperms are attacked and absorbed by white blood cells, which start to appear in force as soon as
body)
sperm enter their defensive perimeter.

•A few thousand sperm are stored in a reservoir, or at least maintained in a fertile state, by
interacting with endosalpingeal (oviductal) epithelium. As the time of ovulation approaches, sperm
become capacitated and hyperactivated, which enables them to proceed towards the tubal
Uterine Tube
(Isthmus. ampulla. Sperm may be guided to the oocyte by a combination of thermotaxis and chemotaxis. It
Ampulla) also enables them to penetrate the ovum.

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 Fertilization to Implantation

1. The capacitated sperm release their

acrosomal enzymes to penetrate
through the cells surrounding the egg.

2. A sperm fuses with the egg’s plasma

membrane.

3. The sperm nucleus enters the egg, and

the egg immediately prevents any
further sperm from gaining access by
forming a fertilization membrane that
sperm cannot penetrate. Granules inside
the egg form this membrane. The
fertilization membrane is important to
establish the correct number of
chromosomes in the fertilized egg (just
46).

4. The nuclei of the sperm and egg

rupture within the fertilized egg, and the
chromosomes mix to form a single
nucleus.

Terms to be used during Pregnancy

Blastocyst- implantation to week 3

Embryo- week 3 to 9
Fetus- week 9 until birth
Gestation- fertilization to birth

Hormonal Control of Pregnancy

 During Pregnancy, hormones play a significant role in triggering changes in the Mother and
Fetus.
 Hormones maintain the lining of the Uterus and prevent Menstruation.
 Hormone increases Flexibility of the Pubic Symphysis.
 Hormone determine the timing of Birth.

• Human chorionic gonadotropin from the developing blastocyst causes the corpus luteum to
continue to secrete estrogen and progesterone.

• Estrogen levels from the corpus luteum and later the placenta rises to 30 times normal during
a pregnancy. Over the length of the pregnancy, this hormone causes breasts to double in size,
encourages her external genitalia and uterus to grow, causes her uterus to be more irritable (prone to
contract), and causes her pubic symphysis to become more elastic.

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 • Progesterone is produced first by the corpus luteum and then by the placenta. Along with
estrogen, this hormone suppresses FSH and LH secretion so that no additional eggs are developed
during the pregnancy. Progesterone suppresses uterine contractions, promotes a rich lining of the
uterus for the developing blastocyst and embryo to feed upon, and promotes the development of
mammary glands and ducts.

• The placenta produces human chorionic somatomammotropin (HCS), which regulates

carbohydrate and protein metabolism so that glucose and amino acids are available in the blood for
the developing fetus. However, this is not a self-sacrificing gesture. Although HCS also reduces
sensitivity to insulin so that more glucose stays in her bloodstream for the fetus, it also increases ability
to use fatty acids as a fuel substitute for glucose.

• Thyroid hormone levels rise. This hormone increases the metabolism for both Joan and the fetus.

• Woman secretes more parathyroid hormone as her fetus takes more and more calcium from
her blood. PTH increases osteoclast activity to keep calcium levels at homeostasis.

• Adrenocorticotropic hormone levels rise so that more glucocorticoids are produced by her
adrenal glands. This results in protein breakdown to produce more glucose for the fetus.

• Woman’s aldosterone levels increase for fluid retention to increase her blood volume. So, what
are all the effects of these hormones on body? In the next section, you will explore how her body
adjusts to a pregnancy.

These are following Hormones which are controlled in Pregnancy:

1. Estrogen Hormone – helps the uterus grow, maintains its lining and helps the
fetus’ organs to develop. Activated and regulates production of other hormones.

2. Progesterone Hormone – stimulates growth of blood vessels that supply the

womb and inhibits uterus contraction and strengthens pelvic wall muscles.

3. Relaxin Hormone – is produced by the placenta. It inhibits uterus contraction,

preventing premature birth.

4. Human Chorionic gonadotropin Hormone – is produced by the placenta after

implantation.

5. Corticotrophin Hormone – activates the synthesis and release of

adrenocorticotropic hormone and helps with stress response.

Role of Estrogen Hormone in Pregnancy

o Estrogens play a vital role in Pregnancy.

1. The estrogenic group of hormones comprises three hormones

a) Estradiol: It is the most active hormone present in almost all vertebrates.

b) Estrone: It is a circulating hormone.

c) Estriol: It is found in the Urine of Pregnant women and in the Placenta.

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 EFFECTS OF ESTROGEN
•Estrogen helps to maintain body temperature.

Brain •Estrogen may delay memory loss.

•Estrogen helps to regulate parts of the brain that prepare the body for sexual and
reproductive development.

Heart & •Estrogen helps to regulate the liver’s production of cholesterol, thus
decreasing the build-up of plaque in the coronary arteries.
Liver
•Estrogen stimulates the maturation of the ovaries.
Ovary •Estrogen stimulates the start of a woman’s menstrual cycle– an indication
that a girl’s reproductive system has matured.

•Estrogen stimulates the maturation of the vagina.

Vagina •Estrogen helps maintain a lubricated and thick vaginal lining.

Breast •Estrogen stimulates the development of the breasts at puberty and

prepares the glands for future milk production.

Uterus •Estrogen stimulates the maturation of the uterus.

•Estrogen helps to prepare the uterus to nourish a developing fetus.

Bone •Estrogen helps to preserve bone density.

ROLE OF PROGESTERONE AND RELAXIN HORMONE IN PREGNANCY

Pregnancy puts a strain on many of the mother’s body systems. Some of the effects are due to
hormones, and other effects are simply due to the growth of the fetus putting pressure on the
mother’s anatomy. These effects are described in the following list:

 Progesterone is a luteal hormone which is synthesized by Corpus luteum, adrenal cortex,

placenta.

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  Progesterone is a pregnancy hormone which acts on genital tissue and induces proper
functioning of breast.

 Progesterone belongs to a group of steroid hormones called progestogens. It is mainly

secreted by the corpus luteum in the ovary during the second half of the menstrual cycle. It
plays important roles in the menstrual cycle and in maintaining the early stages of pregnancy.

 Relaxin is also produced by the corpus luteum which is causes softening of Epiphysis and
facilities delivery.

 Small quantity of relaxin also occur in the placenta.

HUMAN CHORIONIC GONADOTROPIN HORMONE

 Human chorionic gonadotropin from the developing blastocyst causes the corpus luteum to
continue to secrete estrogen and progesterone.

 The hormone human chorionic gonadotropin (better known as HCG) is produced during
pregnancy.

 It is made by cells that form the placenta, which nourishes the egg after it has been fertilized
and becomes attached to the uterine wall.

 Levels can first be detected by a blood test about 11 days after conception and about 12-14
days after conception by a urine test.

 In general, the HCG levels will double every 72 hours.

 The level will reach its peak in the first 8-11 weeks of pregnancy and then will decline and level
off for the remainder of the pregnancy.

FUNCTIONS OF HCG HORMONE

 Human chorionic gonadotropin hormone (HCG) enhances maternal breast growth by

increasing protein synthesis.

 HCG increases maternal fatty acid for ATP production, leaving more glucose available for
Fetus.

 HCG helps to maintain pregnancy and affects the development of baby (fetus).

 HCG targets the corpus luteum so that it continues to produce estrogen and progesterone to
support a pregnancy for 90 days, at which time the placenta takes over hormone production

 The amount that HCG increases early in pregnancy can give information about your pregnancy
and the health of your baby. Soon after delivery, HCG can no longer be found in your blood.

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CORTICOTROPIN HORMONE-RELEASING HORMONE

 Corticotropin- releasing hormone (CRH) also known as corticotropin-releasing factor (CRF) or

corticoliberin is a peptide hormone and neuro transmitter involved in the stress response. It
belongs to corticotropin- releasing factor family.

 In humans, it is encoded by the CRH gene.

 CRH is secreted by the para ventricular nucleus (PVN) of the hypothalamus in response to
stress.

FUNCTION OF CORTICOTROPIN HORMONE- RELEASING HORMONE

 CRH is also synthesized by the placenta and seems to determine the duration of pregnancy.

 In the placenta, CRH is a marker that determines the length of gestation and the timing of
parturition and delivery.

 CRH may act as a trigger for parturition.

OXYTOCIN HORMONE

 The hormone oxytocin plays a key role in labour.

 Often called the “love hormone”, oxytocin is associated with feelings of bonding and
motherhood.

 This is also true of another hormone released during labour called prolactin.

 If labor needs to be induced (brought on artificially), oxytocin or a synthetic oxytocin

equivalent is often administered to “kick-start” the process.

 Oxytocin levels rise at the onset of labour, causing regular contractions of the womb and
abdominal muscles.

 Oxytocin induced contractions become stronger and more frequent without the influence of
progesterone and oestrogen, which at high levels prevent labour.

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A WOMAN’S ADJUSTMENT TO PREGNANCY Figure: A full-term fetus in the uterus.

Pregnancy puts a strain on many of the

mother’s body systems. Some of the effects are
due to hormones, and other effects are simply due
to the growth of the fetus putting pressure on the
mother’s anatomy. These effects are described in
the following list and shown in the Figure:

 There is decreased motility (movement) in

the digestive system, especially in the first
trimester. This may cause nausea (morning
sickness).

 Pressure builds on mother’s stomach from

the growing fetus. This causes pressure on
the cardiac sphincter of the stomach,
which may then leak. The reflux of
stomach acid to the esophagus causes
heartburn for the mother.

 The mother’s cardiac output increases 30%

due to her increased blood volume. She has more blood volume because the fetus uses oxygen
from her blood too. This decreases the mother’s blood oxygen levels, so her kidneys respond
by secreting EPO to boost her red blood cell production.

 Pressure from the weight of the uterus may cause hemorrhoids or varicose veins.

 The mother’s kidneys produce more urine because her blood volume is increased, and they
are filtering more waste– waste from the mother and the fetus.

 Although more urine is produced, the growth of the mother’s uterus limits the amount of
urine the mother’s urinary bladder can hold. This causes more frequent micturition, which
often interrupts the mother’s sleep as the pregnancy progresses.

 The mother’s respiratory ventilation increases 50%. This is because the high level of
progesterone makes the mother more sensitive to carbon dioxide. The mother’s respiratory
rate increases because the depth of her breaths cannot increase due to the pressure on her
diaphragm from the growing fetus.

 The integumentary system is affected in several ways: Stretch marks may appear on the
other’s rapidly expanding abdomen and breasts, her linea alba ay darken and be referred to
as the linea nigra, and melanocytes may increase melanin production, producing a mask of
pregnancy that is visible on her face.

 Increased thyroid secretion raises the mother’s basal metabolic rate by 15%. She may feel
overheated and have an increased appetite.

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NUTRITIONAL REQUIREMENTS FOR A PREGNANCY

It is important not to gain too much weight during a pregnancy thus a balanced diet is essential.
A balanced diet during pregnancy must consist of the following nutrients:

 Folic acid is important to prevent birth defects, especially those concerning neural
development. Sources of folic acid include leafy green vegetables, citrus fruits, cereals, and
beans.

 Calcium is necessary for bone development in the fetus and bone maintenance in the mother.
Dairy products are a good source of calcium.

 Protein is very important for fetal growth, especially during the second and third trimesters.
Good sources of protein include lean meat, poultry, fish, eggs, dried beans, peanut butter, and
dairy products.

 Iron is important for increased hemoglobin production to maintain the increased blood
volume. Sources of iron include lean red meat, poultry, fish, nuts, and dried fruit.

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Lesson 3: Birth Process
INITIATING THE BIRTH PROCESS

STAGE 1
Stress causes the fetal hypothalamus to release Corticotrophin-Releasing Hormone
(CRH) targeting the fetal anterior pituitary.

STAGE 2
The fetal anterior pituitary releases adrenocorticotropic hormone (ACTH) targeting
the fetal adrenal cortex.

STAGE 3
The fetal adrenal cortex releases adrenal glucocorticoids targeting the placenta.

STAGE 4
The placenta levels off production of progesterone and increases production of
estrogen and prostaglandins.

STAGE 5
Stretching the uterine muscles sends nerve signals to the mother’s hypothalamus.

STAGE 6
The stimulated mother’s hypothalamus sends signals to the mother’s posterior
pituitary to release oxytocin.

STAGE 7
Oxytocin and estrogen with prostaglandins cause more uterine contractions resulting
in a positive feedback mechanism.

THE BIRTH PROCESS

THE THREE STAGES OF

PARTURITION

Stage 1
 During this stage, the DILATION
(widening of cervical canal) and
EFFACEMENT (thinning of the
cervix) happens.
 Stage 1, ends when the cervical canal reaches 10 cm
 The amniotic sac, in which the fetus floats, often
ruptures. This is called the “Breaking of the Waters”

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Stage 2
 The baby is expelled. The crowning of the baby’s head is usually seen first because a fetus
most often assumes a head-down position in the seventh month.
 The baby is expelled. The crowning of the baby’s head is usually seen first because a fetus
most often assumes a head-down position in the seventh month.
 The episiotomy is angled away from the anus to prevent the perineum tearing into the anus
as the baby is born
 The head is the most difficult part to expel. But once it is delivered, the rest of the body is
expelled more easily.

Stage 3
 The placenta detaches from the uterus and is
expelled during this stage.
 Further contractions of the uterus ensure that all of
the placenta and its associated membranes are
expelled.
 The contractions also help close blood vessels that
had led to the placenta.
 About 350mL of blood is normally lost when the
placenta detaches.

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LACTATION

Once the placenta is delivered, the major source of pregnancy hormones is gone.

ESTROGEN AND PROGESTERONE

 These two hormones’ levels drop drastically.

 All through the pregnancy, these two hormones caused breast development but also
suppressed the effects of PROLACTIC released from the anterior pituitary.

PROLACTIN

 Prolactin is a hormone that stimulates milk production (lactation) in the mammary glands.

 The increased prolactin at birth (without suppression by estrogen & progesterone) causes
milk production within a few days.

COLOSTRUM

 A thin, watery fluid containing protein, lactose (milk sugar), and many other antibodies but
one-third less fat than breast milk.

 Produced by the mammary glands during late pregnancy.

 Production of Colostrum is all right for the first 1 to 3 days after birth because the newborn
has plenty of fat. By day 3, prolactin causes the mother’s milk to come in.

MILK EJECTION REFLEX

 Caused by suckling on the breast.

 When suckling the breast, the sensory endings in her nipple send signals to her
hypothalamus for oxytocin release. Oxytocin causes myoepithelial cells in her mammary
lobules to contract to release milk to the lactiferous ducts in the breast. This causes the milk
to travel to the nipple for the baby. The reflex is repeated every time the infant nurses.
OXYTOCIN

 Oxytocin causes myoepithelial cells in the mammary lobules to contract to release milk to
the lactiferous ducts in the breast.

 This causes milk to travel to the nipple for the baby. The MILK EJECTION REFLEX is repeated
every time the infant nurses.

Prolactin levels also surge each time the infant nurses. This ensures that there will be ample milk
production to meet the needs of the infant.

On average, 1.5 L of milk is produced each day.

If a mother chooses not to nurse or stops nursing, the surges of prolactin cease and her milk
production ends.

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SOME REASONS WHY A MOTHER MAY CHOOSE TO NURSE A NEWBORN:

1. Breast Milk provides good nutrition.

2. Breast Milk contains many of the mother’s antibodies to provide passive natural immunity to
the baby
3. Breast Milk has a laxative effect.
4. Breast Milk helps colonize helpful bacteria in the infant’s intestines.

DISORDERS OF PREGNANCY
Ectopic Pregnancy
 Ectopic Pregnancy Occurs when the fertilized egg implants anywhere other than the uterus
 The most likely location is the uterine tube.
 The Uterine Tube cannot support the pregnancy and the developing embryo cannot be
relocated. The developing embryo will eventually cause the uterine tube to rupture, causing
a potentially life-threatening situation for the mother.

Preeclampsia
 Preeclampsia is a pregnancy-induced hypertension accompanied by protein in the urine that
usually occurs after 20 weeks in the pregnancy
 The mother’s blood pressure and weight are closely monitored throughout pregnancy to
detect this disorder
 Preeclampsia can lead to serious, potentially fatal consequences for the mother and the
baby.

Placental Abruption
 A condition in which the placenta become prematurely detached from the uterine wall.
 This is a serious condition that can potentially cause bleeding, lack of oxygen to the
developing fetus, shock, and death for the mother.

Placenta Previa
 A condition in which the placenta is positioned over the cervix, blocking the opening to the
uterus.

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