Daniel Lim PMG (a) describe the histology of the mammalian. ovary and tests; U. Human Reproduction ~ Moy Faboalor chrucures 1. Semivifertus fabules 1. Teter sitio\ ota ‘Mammalian Testis Seninifaras upues “Have lanen Hake. sperms YY aiebing tatu? Spee geq Fe Tpterstiticl area —Suwaards seminderors fubues ~ Have lev’s cot, SS Mabe teshctorereA Meee, Sermioal epi Sorte ell Sptrnetosses — \ abe Hes freee ls =(iaceos ward aid int ~ Gant Fam geraioall —beyinieg of tube = : f , Uk ct rowrsh the spemebcytes|_ fie eels Baca - pee ‘a Germinal re aalls (tn) Spe hes 2 Se retn can Maepe - lreae Hyde cee (2) i ie ive by iyi, wats = = Primoyy int te Gothty Fife cancuily 40 replace Wes a seommatomen Secentery specech cys (0) ‘ nea ig Spesmatids (1) i Dittereehintin, Spermab zea (0) Mammalian Ovary Far bemen tye te mature, ct invoies 2 growth s s — Docwtes ~ Foffculor growth Sa seat geeslte flied inset l wi li emerging from the ovary for the first time, eee int) captured by chance Gre route operon.Pein Germinal Getwinal epitetal (xe) 1 isi quem rolore wary Oagunin (24) Pie by wii, nels cxtes (dr) agit ~Unly one Ayre frinoyy Secandory oocytes (s) Mens 1 fatwa avom (nx) (b) outline gametogenesis in a male and female human as a process involving mitosis, growth, meiosis and maturation; GAvele genwis = Process whore gues et deelped — Mags begin in aeat epitilian fre fun ether mon i thea) ~ Pret eall that 4 ails r Gametogenesis + Gametes develop in the {gonads (sex cells) Tn alts, He pacts develys since nber we ap born a tous Meme 9892 a a in he Aes, Hoveer, eg a fy prom ioe Mee gees ei o a it L ar Le (i ig oe Peal penn iissTe Fest Wsis asd sand _—> Segoresis petisis, por bodies are fines. Ty de mt hae ay Finctign. Spermatogenesis + Oncurs in the testes. + Meiosis occurs and he results four, nonsentical cas. yeh, ‘each with 23 chromosomes that wil develop into sperm. Paty ay, eter, : ~ Thy firm ban ipic Crsyns Kt Plnetate He Oy. Kegosi Aya pase Mospment requis ATP which VE vided by meena dla in riddle piece. i Oogenesis Oogenesis + The process of eag formation starts + Each primary oocyte has started to before birth divide by melosis but the process stops + The outer layer of the ovary, the germinal ‘nce the chromasomespa'r up in epithelium, produces many eogoria Prophase T + Gogenia grow to form primory oocytes (2n) + By the time the baby is born, about 2 + Ttalso produces follicle cells rnillion primary follicles are present = inultiply and cluster around the oocytes Each witha primary oocyte in + forming primary follicles prophase T‘Oogenesis + Once a human female is sexually mature, cone primary follicle per month is stimulated to complete development into ‘an ovarian follicle Oogenesis + The primary oocyte then finally completes meiosis T and divides unequally into two ‘haploid cells "The smaller daughter cell - polar body + The larger daughter cell - secondary oocyte. oocyte + surrounding follicle cells = ovarian follicle - Mature ovarian follicle cause a blister-tike swelling on the surface of the ovary Follicle maturation & development; iE [ 1 Oogenesis + Occurs in the ovaries and in the eviducts. + After Telophase | and I the cytoplasm is not equally divided + One of the new cells gets the majority and it survives, while the other one, a polar body, gets ‘broken down, ae HERO ‘Oogenesis + During ovulation, the secondary oocyte is released into the oviduct + If the secondary oocyte is fertilised, it completes meiosis II + Tf nat it will still be at Me + After owlation, the empty follicles develops into a corpus luteum + The corpus luteum releases progesterone and will degenerate if not fertilized. (c) explain the role of hormones in maintenance of the human menstrual cycle, and link this to the changes in the ovary and uterus during the cycle;NORMAL MENSTRUAL CYCLE nat tne man duration ofthe MC? Mee 2392" Dears i dllfeet pape. ange 2135 hat ite average duration of menses? ai ithe Jee bate gt) (where ina the normal estimates blood ss? ‘oproumatey 30" nen does ovalton occur? Usually doy 14 2G rafter the onset of miheye LH surge Hormonal Control of Oogenesis + How it started GnRH is transported in a special blood vessel GnRH must be present for normal gonad function, Gab stinalety velete af goradshnphin PHASES OF THE MENSTRUAL CYCLE Ovulation divides the MC into two phases: souicuvsnrrase (Pay 0 Pay Ye) saisueeia es tomate ingens ‘Anccnuraen 5H © maturation of cohort of ovarian foticesreratrent” 5 only one reaches maturty every month ‘When FSH sHinulates grote of fille, the grotuosa cells athe fan vd for inka CMAs Om horas and on™ radiata. The Pio fabicle mature aed ‘deutleps file Grafian flute: The Setapdoy vucype ‘6 cavered arene which the spore Nes +p penetrate anving ferdilisation- Hormonal Control of Oogenesis ** ‘The complete menstrual cycle involves the: + hypothalamus + ovaries + uterus + pituitary gland Hormonal Control of Oogenesis Pat ciae ee cr Soe iy en 0 FSH Stimulates guseth of fo Nlice, FSH (5 ghadotrghn Grarulase Cat susending fre primory oo arrested at Prophae T—~ While tach & pit Byery mh, Fi dinutates guedh bet nly are will mative they vache ffl ahiesia LHhey cegoremie ord die Nea. i Vary & Limifed. When ull fillies are elon te temble oct ability th prslice syne humons. The! FOLLCUARPHASE "Tens eric £ gs wnioxernerun Youmans pop as “ tat | alle W sted Sl, 175i primordia folie lite {oocyte arrested nthe prophase of the 1* mete isl pons ‘Stunde by «srg ayer of gromsona cls) © ry folie (ocyte surrounded bya sng ayer of granules calls & ‘Seeman membrane) 3 © 2'y folic or preantral foie icon surounde by son pela , several ayers of (gansoaa car Binet coe) Aedran sa Anid filed Space hat nourished fhe 00 we The follele clues i fteyuit cel tds sate is to fir thea tryna ard Ahem evteinn. Trg Bi if secre sesages i eens pr Wiles nda ha ide BBP (esta pallida yt cht 4 macbsetlyse Pueine genuisatton ol pe peer Alii. f B pauttateot (ler ts acme T point polspamy, Di “y zonq (ee cond fortilisatin) lacie fella i han nd Fire sie ea ta ey atch mene de vat Pr folie aecamulete Mi in enty“antru oer isin eccetr postion surrounded by granuiosa cls "cumalous eophorus* a duster fel (ale cumulus els) hat suround the octet the ovarian folie. The metros ayer ofthese celle te corona radiata. These re the cals that the Sperm hast penetrate before fertization. Maire gatralisa alls release costragen . Level of - ny tee ne leal A ede a vil. nae oie) ye , fi and 40d re ~ve feedback activity on FSH level 2 i BA affeds pitty glan ae oF by. ioe hy a vaste iu fears Kile Oeelegen in ri gland inhibit FI puductin, a ve ba a Ae Sn wert, Se ie ee tall of fers. fo plyace si tu and Uf fed bani shapl? fir enlge 0 pata | level *, 2 Fs eel te Si SH anseen that the af fires nhs eat Folie pinata her fic FA. ay ee pe Of LK keys ow omens weeps vill survive! |PFSH ACTIONS wh pee ee Wik uodtye Ryder ea oe Tene guns ‘ive bela) open No.of panuoscels seuscron 1 tskrecetor Replied aide Sotetrnea rine cessor ort den i fhe (eign ier camel eens pe tehtescarayemeneses be moan Wm, len ctford rao nite omc i _cuuitining SOLQnte) Ae inaipettrwihret to ‘Waste fobicle mature t estrogen se LESH ny) Induce LH receptors eee as WN ann “ic Freeform Tan ote fos Yat were ere ‘ 9 ska cas 2 tate of cestrt § OL ees androstenedione &texosterone Wlafion accwrs. Faticle rejhes and release ihe van, Me Dastragen and pragtcterone evel rst. Pager duum has hiyer & cians radiata oth sean: de pedis gi aed ules, Beth prgtrine me at Mefphue £ yntil it is Sid 4 tp gpem and woh ibis pany glint fom in vided. Kel owlttn, the gramlica cafe at bribes. 4, 1H, Ja el yoculed ANisheng the sal wi sorte aastuger. sheen kal al ail be rm’ mer ee weatl- TE y ite tts the Tena 6 filide be cap hfeum-HLE aipdans © is made, Congas ledeum bre ips Ieteun. Cops rteun mabss pregecnne on) os tagen. ett en spp fale. The wah 4 TWO CELL THEORY S| FOLLUCULOGENESIS This lends fh méstestion. (OTHER FACTORS THAT PLAY AROLEIN FOWUCULOGENISIS inn * local pene nthe feel Fis + -ve feos backonptultary FSH sereaton * Local enhances Lr induced andostenedone production ‘actin * Foundin flirtPREOVULATORY PERIOD | NEGATIVE FEEDBAGK ON THE PWUTARY, “tesa inhibin 4 fed back on pltutary 1 SH “This mechaniaroperaing sce dhidhood \¥postrve FEEDaACK ON THE PTUTARY + 1 eseadil facing tna concert) © 4 fee back on the puta (actstedy owe ot eee) (surge 9 Secretion of progestane + Operates ster puberty + sve feed bck on pturary <> 1 FSH OVULATION +The dominant folic protrudes fom the ovaran cortex * Gente leas ofthe eceye surrounded bythe curls anulosa els + Mechanism ofl rupture 1-1 Folie pressure ‘Changes in composition ofthe antral Mu = cll cosmote pressure 2 mymatlerupute of the foc wa {U4 GSH © granuos cals producon of plasminogen aanator 12 plasmin 1 ibxinoi activity = brake down of Fall Lt Tprostgandin = T plasminogen actor 13 TPG 2a T isos under Flic? wal LUTEAL PHASE + Marked tin progestrone eretion -thermogencacoty $1 basal body temp, “enorme mation Progesuone peak § dys ater ovation (022 MC) ‘Corpus tem is suntaed by LH + flooses its senstty to gonadotopns © lutea <> Lstogen & rogenone lee = desqumation ofthe PREOVULATORY PERIOD. vwisuase Lasts for ies ‘ovttion outs ater 36 1s + Accompanied by ap fallin estrail evel “agers the resumotion of metoss fects fleur wal = flea rupture Granulosa cals = lterizatonc>progestronesyahess, LUTEAL PHASE uusrsaais (Doy 154 Day 28) FORMATION OF THE CORPUS LUTEUM + Alter onsation he point of rupture inthe flicular wal seals + Vascular capitares oss the basement membrane grow Inve the pamsors cle 21 aeniobiny of BL chlesree HST LDL Binng to receptors 121140 steroid dehyrogenase acy 21 progestrone LUTEAL PHASE + estrogen & progesrone 1 FSH LH +The new cycle star with the beginning of menses + tfprgrancy occurs NOS secreation =? manta the comps tuteum |& HORMONAL PROFILES DURING THE MENSTRUAL CYCLE ENDOMETRIAL CHANGES OURING THE MENSTRUAL EVCLE ‘tot proferative phase trogen © mitotic acti inthe glands & stroma 2 ‘enometraltheknss fom 20 8am (om besos to opposed nasal ayer teal secretory phase Progestrone <- Mitotic acti severay restcted Endometrial lod produce then secrete ycopen rich aces Stromal edema Stromal els enlargement Spiral artres deal, lengthen & ca! HYPOTHALAMIC ROLE IN THE MENSTRUAL CYCLE “The hypothalamus eeetes GR in a pulse fasion Gan act fst evden at puberty Folclarphase Gn utes occur hourly tea phase Gm pulses occur every 90 mines Loss of pusaity oun regulon of ptutery receptors secretin of gonadotronins Release of Grits modulates by ve eee by steroee onadtropins| + Release cf GnRH is modulated by external maul igrale ENDOMETRIAL CHANGES DURING THE MENSTRUAL CYCLE: ata ayer ofthe ensrin “Aejaset tothe mometrum -Uneesponsive to harmon simslaon -femalns inact throughout the menstrual yee 2-Functonal layer of he endometrium ‘comsoeed of two ayers: -aone compacta © superil “Spongiosum ayer MENSTRUATION + Period desquamation of the endometrium + The external hallmark of the menstrual oee + Just before menses the endornetivm nitrated with leucocytes + Prostaglandins are maximo the endometrium just before + Prostaglondins constriction of the pal arterioles ischemia & desauamaton ‘olowed by artatlarrelaason, beeing & tesue ‘renown (4) outline the biological basis of the effect of ‘oestrogen/progesterone contraceptive pills;‘Contraception > juis Agron “Taking action to avoid conception [At present, no ideal contraception Humans, as a species, are able to intervene, with their own reproduction Contraception The biological bait of cet prapetere oom Contains oestrogen and progesterone. ~[lo alike car martwre ~ {he yetcon Will be wibhout Otic. So, There will be pa ay or Sperns 4u fertilise - {e) discuss and evaluate the biological, social and ethical implications of the use of contraception ~ Wsing pil hat antes bath of Fede bre t take it Gi —Th es oe th fits i) ae is Ite ple fee cenit + Methods: Ast, ere 5K =Natural =Borrier Sear = Hormonal ~Post-fertilisction Hormara) athe) ehegth 403 pavtteny I 2 days oh rensieal et ete ret < te = hag | lon wi ? a high Onstegen and rieclal + The biological basis of the’pill aes ‘ond progesterone ‘the hormone Belonce in ~TReTRSSY Grimes the tea pases = Owslation doesnot toke place = Thickemucus ot the cervie = Lining of the uterus thinner Contraception + The use of contraception — Biological implications = Social implications —Ethical implicationsContraception + The use of contraception Biological implications Benefits: Reduce risk of developing ovarian oysts “Reduce risk of developing ovary or uterus cancer More regular menstruation “Reduce risk of pelvic infection Contraception The use of contraceprion ‘Social implications + Family planing "Tilden cotomn Famibes to es of poverty * Qverpopuation may strain resources of Contraception + The use of contraception ~ Ethical impicotions + Benefits of using contraception “Avorn te decide when ond she wil Gaim a contra tee popoian ~To avoid medical or psychological risk of pregnancy Reduce chance of unplanned pregnancy Contraception + The use of contraception = Biological implications + Side effects and possible risks: May develop nausea and headaches Tiredness and mood changes =Rise in blood pressure Increased risk of thrombosis Small increased risk of breast cancer ~Brtact tenderness Contraception + The use of contraception Ethical implications Ethics —What is consider ‘right’ and ‘wrong! There are no ‘right’ solutions ~Puble need to be well informed ‘Biological knowledge Willingness to listen with respect to ‘he views and experience of others Contraception + The ae of contraception = Ethical implications + Birth control a God-given way + Sexual activity is God-given for the purpose of reproduction Contraception morally wrong + Teabortion a less acceptable solution than ‘contraception?In vitro fertilization (f} outline the technique of in-vitro fertilisation + ag cells are fertilized outside the woman’ s body. (IVF) and discuss its ethical implications; * The process involves hormonally controling the ‘ovulatory process, removing ova (eggs) from the woman's ovaries and letting sperm fertilise them in medium. The fertilised egg (zygote) is then ‘transferred to the patient's uterus with the intent to cestablish a successful pregnancy. en Anterti lity problems 7 Steps for an .V.F procedure1. Evaluation *+ Ovarian Follicles *+ Vaginal Ultrasound + Blood Tests + Seminal Fluid + Fallopian Tube + Uterus US—9 those eee 3. Egg retrieval ag retoval is done 3 to 37 hours post HCG Injection This procedure Is considered as minor surgery, tis done under general snestnesa, using uitraound guide. It takos 1 10 20 minutes. Not more than two hours are required forthe patent fo recover ‘Thon, the patent can leave the hosptal. needle is Used to aspirate athe flies uid is passed over tothe embryologit, who — Female iy plicel ander ancestesia ~ May es 1 he ures ooo o00 5. Fertilization After preparing the sperm, and the eggs are put in the same dish, in cases of failed fertilization we use ICSI procedure. ~ Tete -cyh plac. Sperm injedion 2. Ovarian Induction 1 Producing many good ‘tices tobe Fortizes Short or Long protocols: Is done by daily Injections of onadotopins. Regular motoring by ultrasound scan is done. 1D Following the folcuae devoloprent and ‘adjust the dove ofthe injections accordingly, 1 After reaching estan sie, the fal Imation of hose ices one by ha i — Simulates pedvition of 6-8 ful'cls per month 4, Sperm and Egg Preparation The ops ae prepared an gee torte sureundhg ce. ‘Attranme espe epanon one cy apd {es spr sare cote on be dy of op cotecton, Inset tar opp stot, Sal city may earned Pe vstrent ye Sherwas ore than dora iso car ay oe son aay ‘Wermws te 10,0010 060 mote sor be put ese ‘och egg na apeaal seh, te cas raat Teaser toms cfowome sser meson (CSL a Ra Ree Stu aad et io gy ‘ie samen tl ee ct conan open, © 0 oo oo 6. Blastocysts Stage ‘Afr 16 0 18 hours ater the eggs, called zygotes, are ‘erties, OThey ate ctr in special ncubators to support division and development. {in tis sop, the coupe has a history of certain genetic ‘disease and the gone that is causing that problem is dented, ‘wo may do pre-Implantation gonatic agnosie (PCD). [UGrading ofthe embryos is done using specie criPreimplantation Genetic Diagnosis (PGD) + Can test embryos for genetic Implantation + Has been successfully used in diagnosing and preventing inherited genetic diseases ike Cystic Fibrosis, Tay Sach’ s, Thalassemia, Sickle Cell ‘Anemia and may be potentially used to screen for ‘cancer mutations. + Uses single coll (blastomere) at 8cell stage normalities prior to i rea ~ Making pregnancy a technological process Failure could be devastating Risk of multiple pregnancy ~ Expensive + Couples could be exploited —Fate of unused embryos + Disposal - murder? + Freezing and long-term storage + Research? ~The potential to select and modify embryos (are we playing G00?) toe 7. Embryo Transfer 1D. The Embryos are transforred nto tho usr ator 2 to 8 days fram the date oF pick up, 1D Depending onthe quality and quantty ofthe embryos. 1D Usinga spec omyo transir catheter | The pattie given crugs tc holp support the implantation procedure. |. There i no need fora lengthy hospital tay ater the embryo transfer procedure (usvaly oe hour i ufc), Rosidonts of ther count can tavel he nex doy if they wish,