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Physiology of reproduction system_85e05fed7fa1afcb9720713fefceea68
Physiology of reproduction system_85e05fed7fa1afcb9720713fefceea68
REPRODUCTION SYSTEM
CMM 037 Fundamental Genitourinary System
Sep 19, 2022
1
Asst. Prof. Sitakan Natphopsuk Ph.D.
OUTLINE
1. Overview of Reproductive System
a. Gametogenesis
2. Physiology of male reproductive system
a. Structure and function of glands, organs and ducts
b. Hormonal regulation of male reproductive system
• Control of testicular function
3. Physiology of female reproductive system
a. Structure and Function of glands, organs and ducts
b.Hormonal regulation of female reproductive system
c. Menstrual cycles
2
OUTLINE
4. Physiology of fertilization and implantation
a. Fertilization
b. Move
c. Implantation
5. Functions of placenta
6. Physiological change of hormone during pregnancy
7. Physiology of maternal milk production and excretion
3
FUNCTION OF THE
REPRODUCTIVE SYSTEM
SEXUAL REPRODUCTION
Se lv
ma ma Reproduction is the
biological process by which new
individual organisms –
"offspring" – are produced from
EGG SPERM their “parents"
In sexual reproduction, two
parents contribute genetic
FERTILIZATION material to the offspring.
FERTILIZED EGG
The fusion of female gamete (egg) and
male gamete (sperm) forms a zygote that
potentially develops into offspring.
FIGURE 25-3 In sexual reproduction, two parents contribute genetic
material to the offspring. The fusion of female gamete (egg) and male
gamete
Campbell
What (sperm)
is Life?
biology ©forms
2011
A Guild a zygote
Pearson
To Biology © that W.H.
2011 potentially
Education, Inc. develops
Freeman into offspring.
and Company
OVERVIEW OF
REPRODUCTIVE SYSTEM
·
Primary sex organs (Gonads) -> sturture that can
produce gamete
Spermatozoa
Initial spermiogenesis
toli Secondary
Secondary spermatocyte spermatocyte
in meiosis II
Primary
Luminal compartment spermatocyte
preparing
Basal compartment for meiosis I
Nurse cell
Connective
tissue capsule 404 Spermatogonium
SECTION IV Endocrine & Reproductive Physiology
Mitochondria Acrosome
❖ Ganong's Review of Medical Physiology 24th FIGURE 25–14 Human spermatozoon, profile view. Note the acrosome, an organelle that covers half the sperm head inside the plasma
GAMETOGENESIS
Oogenesis
Results in formation of secondary oocyte which is released during
ovulation
If no
•If no fertilization occurs,
fertilization occurs,meiosis
meiosisII will not occur.
II will not occur.
Stages of oogenesis
1. Oocytogenesis
Forms oögonia
During fetal development starting at week 10 and completing
around birth
Results in formation of primary oocytes (~1/2 million)
2. Ootidogenesis
• Results in the formation of secondary oocytes
• These are dictyate in prophase I
3. Formation of ovum (if fertilization occurs)
MALE
REPRODUCTIVE
STRUCTURES
14
●
STRUCTURE AND FUNCTION OF TESTIS
680
Part X / Reproductive Physiology
Spermatogonium
Spermatozoon Leydig cell
Basement membrane
surrounding seminiferou
tubule
Spermatogonium
Basal compartment
Tight junction
Adluminal compartment
300 !m
Lumen
Spermatocyte
Spermatid Nucleus
Nucleus
o Intratubular compartment
Sertoli cell Intercellular space
Spermatid Nucleus
Nucleus
Intercellular space
Spermatozoon
Lumen
·
●
&
Figure 36.5 Sertoli cells. Sertoli cells are connected
by tight junctions, which divide the intercellular space
Spermatocytes are formed from
into a basal compartment and an adluminal compartment.
Spermatogonia are located in the basal compartment and
the spermatogonia and cross the
maturing sperm in the adluminal compartment. Spermato-
cytes are formed from the spermatogonia and cross the tight
tight junctions into the adluminal
junctions into the adluminal compartment, they mature into
spermatozoa.
system does not recognize spermatozoa that develop in the
adluminal compartment as “self.” Consequently, males can
develop antibodies against their own sperm, resulting in
FUNCTIONS OF SERTOLI CELLS ร
EXOCRINE
Production of fluid to move immobile sperm out of testis toward epididymis
Production of androgen-binding protein
Determination of release of spermatozoa (spermiation) from seminiferous tubule
ENDOCRINE
Expression of androgen receptor and follicle- stimulating hormone receptor
Production of mu ̈llerian-inhibiting substance, also called antimu ̈llerian hormone
Aromatization of testosterone to estradiol-17b (this has local effect, not strictly endocrine)
STRUCTURE OF A SPERMATOZOON
Here you can see the Structure of a Spermatozoon
distinctive, specialized
spermatozoon. The acrosome (AK-rō-sōm), or acrosomal
Unlike other, lessUnlike other, less
specialized special-
cells, a cap, is a membranous compartment
ized cells, alacks
mature containing enzymes essential to fertilization.
mature spermatozoon an
spermatozoon
endoplasmic reticulum, lacks an
a Golgi
endoplasmic reticulum, a The head is a flattened ellipse containing a
apparatus, lysosomes, peroxisomes, nucleus with densely packed chromosomes.
Golgi apparatus, lysosomes,
inclusions, and many other intracellular
peroxisomes, inclusions,
The neck contains both centrioles of the
structures.
and many other intracellular original spermatid. The microtubules of the
structures. The loss of these distal centriole are continuous with those of
organelles reduces
The loss of these organelles reduces thethe
cell’s the middle piece and tail.
size and
cell’s size and mass; it ismass; it is essentially
essentially a
mobile carriera mobile
for thecarrier
enclosedfor the The middle piece contains mitochondria
enclosed chromosomes, and arranged in a spiral around the microtu-
chromosomes, and extra weight would
extra weight would slow it bules. Mitochondrial activity provides the
slow it down. ATP required to move the tail.
&
The tail is a flagellum, a whiplike organelle
that moves the sperm.
·AddLack
-
Vas
deferens
2
64 days life days in man
Seminal
Bladder 16 days => meiosis I
vesicle
Penis 16 days => meiosis II
Ejaculatory
duct 24 days => spermiogenesis
Prostate
Bulbourethral
3 24-48 hrs lifespan after ejaculation
gland
Urethra
At ejaculation, approxi-
mately 300 million sperm
cells are expelled as part
Normal count; 200-300 million
Normal amount; 2-5 ml
1 of a fluid, called semen.
Epididymis Testes
Scrotum
Low sperm count (<20 million/ml)
=> Oligospermia
1 MATURATION
No sperm count =>
Sperm mature in the epididymis.
3 DELIVERY
Sperm move through the ejaculatory duct into the urethra,
where they can be expelled.
FIGURE
What is Life?25-10
A GuildThe pathway
To Biology taken
© 2011 by Freeman
W.H. sperm during ejaculation.
and Company
Effect of Temperature TABLE 25–4 Composition of human semen.
Spermatogenesis requires a temperature considerably lower
Color: White, opalescent
than that of the interior of the body. The testes are normally
maintained at a temperature of about 32 °C. They are kept cool Specific gravity: 1.028
by air circulating around the scrotum and probably by heat ex-
pH: 7.35–7.50
change in a countercurrent fashion between the spermatic ar-
}
teries and veins. When the testes are retained in the abdomen Sperm count: Average about 100 million/mL, with fewer than 20%
or when, in experimental animals, they are held close to the abnormal forms
body by tight cloth binders, degeneration of the tubular walls Other components:
and sterility result. Hot baths (43–45 °C for 30 min/d) and in-
sulated athletic supporters reduce the sperm count in humans, Fructose (1.5-6.5 mg/mL)
in some cases by 90%. However, the reductions produced in Phosphorylcholine
this manner are not consistent enough to make the procedures From seminal vesicles
COMPOSITION
reliable forms of male contraception. In addition, evidence Ergothioneine (contributes 60% of
total volume)
suggests a seasonal effect in men, with sperm counts being Ascorbic acid
greater in the winter regardless of the temperature to which
OF HUMAN
the scrotum is exposed. Flavins
}
Prostaglandins
Semen
SEMEN
The fluid that is ejaculated at the time of orgasm, the semen,
contains sperms and the secretions of the seminal vesicles,
Spermine
Citric acid
prostate, Cowper’s glands, and, probably, the urethral glands Cholesterol, phospholipids
From prostate (contributes
(Table 25–4). An average volume per ejaculate is 2.5 to 3.5 mL 20% of total volume)
Fibrinolysin, fibrinogenase
after several days of abstinence. The volume of semen and the
sperm count decrease rapidly with repeated ejaculation. Even Zinc
though it takes only one sperm to fertilize the ovum, each mil-
Acid phosphatase
liliter of semen normally contains about 100 million sperms.
Fifty percent of men with counts of 20 to 40 million/mL and
essentially all of those with counts under 20 million/mL are
sterile. The presence of many morphologically abnormal or
Phosphate
Bicarbonate
} Buffers
&
■ FSH acts on the sertoli cells to maintain
spermatogenesis. The Sertoli cells also secrete
<ร
inhibin, which is involved in negative feedback
of FSH secretion.
TESTOSTERONE Pregnenolone
▪ LH increases testosterone
synthesis by Dehydroepiandrosterone
stimulating cholesterol desmolase,
the first step in the pathway
Androstenedione
▪ Accessory sex organs (e.g.,
prostate) contain 5alpha- 17β-OH-steroid dehydrogenase
reductase, which converts
testosterone to its active form,
Testosterone Dihydrotestosterone
dihydrotestosterone 5α-reductase
RE 7-16 Synthesis of testosterone. LH = luteinizing (target tissues)
one.
Synthesis of testosterone. LH = luteinizing hormone. Linda S Costanzo. BRS Physiology, 2014
ACTIONS OF ANDROGENS
Regulation of differentiation of male internal and external genitalia in fetus
Stimulation of growth, development, and function of male internal and
external genitalia
Stimulation of sebaceous gland secretion
Stimulation of erythropoietin synthesis
Control of protein anabolic effects
Stimulation of bone growth
Closure of epiphyses as estrogen
Initiation and maintenance of spermatogenesis
Stimulation of androgen-binding protein synthesis (synergizes with follicle-
stimulating hormone)
Maintenance of secretions of
sex glands
Regulation of behavioral
effects, including libido
h20_483-503.qxd 9/1/10 10:15 AM Page 491
HORMONES OF MALE
REPRODUCTION The Reproductive Systems 491
* In both sexes, testosterone (from the adrenal cortex in women) contributes to sex drive and muscle-protein synthesis.
the wall of the epididymis propels the sperm into the alkaline to enhance sperm motility. The duct of each
ductus deferens. seminal vesicle joins the ductus deferens on that side
to form the ejaculatory duct.
DUCTUS DEFERENS
Also called the vas deferens, the ductus
VALERIE deferens
C. SCANLON,
PROSTATE
ex- essentials
TINA SANDERS.
GLAND
of anatomy and physiology. 2011
FEMALE REPRODUCTIVE STRUCTURES
Pregnenolone Pregnenolone
Basement membrane
3 -HSD 3 -HSD
Thecal
cells Progesterone Progesterone
The two-cell, two-
P45017α gonadotropin hypothesis.
17β-HSD
Corpus
Androgens Androgens
luteum
P450Arom
Estradiol
Ovula!on
(c)
Cholesterol
Aromatase
17β-HSD
to androstenedione
(d) Microglia
because of the lack of
Oligodendrocyte
the enzyme 17α-hydroxylase.
Cholesterol 17β-estradiol
Regulation of the
reproductive tract
in the female.
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Control of LH and FSH in the early and late follicular phases of the
menstrual cycle.
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470
HORMONES OF FEMALE
The Reproductive Systems
REPRODUCTION
Table 20–3 HORMONES OF FEMALE REPRODUCTION
*Estrogen has effects on organs such as bones and blood vessels in both men and women. Estrogen is produced in fat tissue in
the breasts and hips. In men, testosterone is converted to estrogen in the brain.
(a) Control by hypothalamus
Inhibited by combination of
estradiol and progesterone
Hypothalamus –
Stimulated by high levels
+ of estradiol
1 GnRH
2 FSH LH
Follicle-stimulating
LH
start to make estradiol. There is a slow
FEMALE
FSH
toprdavantAl the
follicle to grow ovulation !
root
(c) Ovarian cycle 7 8
5,
CYCLES
Follicular phase Ovulation Luteal phase
Estradiol secreted Progesterone and
4 by growing follicle in estradiol secreted
increasing amounts by corpus luteum
whe Progesterone
implantation .
the
maintaine -o Estradiol level
very low
Progesterone and estra-
diol promote thickening
linving of endometrium
build u containing
The maturing follicle,
uterine ting
Menstrual flow phase Proliferative phase Secretory phase
Campbell biology © 2011 Pearson Education, Inc.
Day
0 5 10 14 15 20 25 28
progesterone
FSH reduction in
LH, stimulated progesterone (with
by surge in absence of
estrogen implantation of
fertilized egg)
11-35
folicula
phas
&
avarian 6 นไ เท
uthers
#change & Intian phase fix Phase 1
estrogen 14 =
eg. 30- =
วั
ม่
วั
are living in a dormitory (or are in prison): when women live THE REPRODUCTIVE CYCLE
in close proximity, over time their reproductive cycles become OVARIAN CYCLE
synchronized so that they menstruate at approximately the same
time and, perhaps less obviously, ovulate at the same time. This Follicle Corpus luteum
issue was first addressed in a scientific publication in 1971,
when Martha McClintock reported findings—inspired by her
own experiences—based on data from 135 female students
living in a dormitory at Wellesley College in Massachusetts. Ovulation
Similar observations have been reported in other animal species, 0 7 14 21 28
and subsequent studies implicate airborne chemicals, called Day
pheromones (probably released from women’s underarms),
MENSTRUAL CYCLE
FEMALE
that can shorten or lengthen the reproductive cycle in other
women. It’s not clear why such synchrony of reproductive
cycles would occur, however. And other researchers have
argued that the different lengths of women’s cycles make it
REPRODUCTIVE
impossible for them to become truly synchronized. The jury is
still out on this hotly contested issue.
CYCLES
0 7 14 21 28
Hormones regulate the timing and development of egg
Day
production, called the ovarian cycle, which occurs
approximately every 28 days. Hormones also regulate HORMONE LEVELS
another aspect of the reproductive cycle, the menstrual
cycle, during which the uterus prepares for the possible Follicle-stimulating Luteinizing hormone (LH)
implantation and nurturing of a fertilized egg, and sheds its hormone (FSH)
lining when fertilization does not occur. We describe each of Progesterone
Estrogen
these cycles and the ways in which each influences the other
(FIGURE 25-15).
https://s-media-cache-ak0.pinimg.com/736x/a5/d5/a5/a5d5a521ac42fdc341bb0a8e3d7e13ed.jpg
follicles in the ovaries to grow and develop, although only developing embryo.
one follicle reaches full maturity.Within this one follicle,
the primary oocyte completes its first meiotic division and At this point, the process can go in one of two directions,
becomes a secondary oocyte. ตา วง -> LH onอย
depending -> แor not the egg is fertilized (FIGURE 25-16).
whether
FIGURE 25-16 Two possible fates for an egg. Shown here: an egg moving down the oviduct.
• Preventing ovulation o
• Thickening cervical mucus
o
estrogen, progesterone
CHECKPOINT of sperm is related to what they do (form fits function). cells. This blockage of other sper
A mature human sperm has a streamlined shape that that is forming contains only the
What is the function of a
sperm’s acrosome? enables it to swim through fluids in the vagina, uterus, mosomes. The chromosomes of
FERTILIZATION
allowing the sperm to penetrate.
dissolve the outer layer of the egg,
and oviduct (Figure 26.11). The sperm’s head contains
a haploid nucleus and is tipped with a membrane-
are eventually enclosed in a s
the diploid zygote, the egg’s met
Answer: It releases enzymes that
enclosed sac called the acrosome. The middle of the sperm from dormancy and gears up in
contains mitochondria that use high-energy nutrients mous growth and development t
2
The sperm’s
acrosomal enzymes
digest the jelly coat 3 ◀ Figure 26.12
surrounding the egg. The plasma
1 membranes of the
entry of the sper
The sperm squeezes egg requires sev
through cells left over sperm and egg fuse. 4
The sperm nucleus enters micrograph (belo
from the follicle.
the egg cytoplasm. surrounded by s
Acrosomal
enzymes
Sperm
Nucleus
Acrosome
n
n
n
Follicle Sperm
cell nucleus 5
The sperm and egg
n chromosomes
Plasma
membrane intermingle.
Jelly
coat
2n
n
Egg Zygote
Cytoplasm nucleus nucleus
First Cleavage Division Day 1: Two-Cell Stage Day 2: Four-Cell Stage Day 3: Early Morula Day 4: Advanced Morula
Day 5
Loss of zona pellucida
and transport to uterus
Day 0
Fertilization
Ovulation
Days 7–10
Implantation in
uterine wall
Visual Anatomy and Physiology, 2nd Edition- Martini, Ober, Nath et al.
notice to
pregnant 7
day safter fertilizatio
Visual Anatomy and Physiology, 2nd Edition- Martini, Ober, Nath et al.
FUNCTIONS OF THE PLACENTA
1. Nutrition:
• Transfer of nutrients and oxygen
from mother to fetus and transfer of
waste products and carbon dioxide
back from fetus to mother
2. Endocrine function:
• Hormone (secreted by
syncytiotrophoblast of chorionic villi)
important during pregnancy are:
• Human chorionic gonadotropin
(hCG)
• Human placental lactogen (hPL)
• Estrogen
• Progesterone
• Relaxin
FUNCTIONS OF THE PLACENTA
Human chorionic gonadotropin (hCG) ①appear in mother blood s trea
appears in the maternal bloodstream soon ↓ after implantation has occurred.
indication of pregnancy.
low = แ
Functionally, hCG resembles LH 7 day
maintains the integrity of the corpus luteum Indicate 8
promotes the continued secretion of progesterone. pregnancy
In the presence of hCG, the corpus luteum persists for 3–4 months before
gradually decreasing in size and secretory function.
The decline in luteal function does not trigger the return of uterine cycles,
because by the end of the first trimester, the placenta is secreting both
estrogens and progesterone.
Human Placental Lactogen (hPL)
helps prepare the mammary glands for milk production
The mammary glands convert from inactive to active status when stimulated by
placental hormones (hPL, estrogens, and progesterone) and several maternal
hormones (GH, prolactin, and thyroid hormones).
ห้
FUNCTIONS OF THE PLACENTA
Relaxin
a peptide hormone that is secreted by the placenta and the corpus
luteum during pregnancy.
Function
(1) increases the flexibility of the pubic symphysis, permitting the pelvis to
expand during delivery;
(2) causes dilation of the cervix, making it easier for the fetus to enter the
vaginal canal;
(3) delays the onset of labor contractions until late in the pregnancy.
Maternal Maternal
arteries veins
Placenta
Maternal portion
of placenta
Umbilical cord
Chorionic villus,
containing fetal
capillaries Fetal portion of
placenta (chorion)
Maternal blood
pool
Uterus
Umbilical arteries
Fetal arteriole Fetal venule Umbilical vein
3. Immune function
▲ Figure 46.16 Placental circulation.
From the 4th week of development until birth,
vessels, enters the placenta through arteries
and passes through capillaries in finger-like cho-
? In a rare genetic disorder, the absence of a
particular enzyme leads to increased testosterone
the placenta, a combination of maternal and rionic villi, where oxygen and nutrients are ac- production. When the fetus has this disorder, the
• IgG antibodies pass through the human placenta, providing protection to fetus.
embryonic tissues, transports nutrients, respira-
tory gases, and wastes between the embryo or
quired. Fetal blood leaves the placenta through
veins leading back to the fetus. Materials are
mother develops a male-like pattern of body hair
during the pregnancy. Explain why.
fetus and the mother. Maternal blood enters exchanged by diffusion, active transport, and
• Placenta and fetus regarded as a foreign allograft inside the mother, must evade from attack
the placenta in arteries, flows through blood selective absorption between the fetal capillary
pools in the endometrium, and leaves via veins. bed and the maternal blood pools.
by mother's immune system.
Embryonic or fetal blood, which remains in
Activates oxytocin
receptors on uterus
Positive feedback
Stimulates uterus
to contract
Stimulates
placenta to make
+
Prostaglandins
1 Dilation
Stimulate more
contractions
of uterus
▲ Education,
Campbell biology © 2011 Pearson FigureInc.46.18 Positive feedback in labor.
fetus Stimulates uterus
Positive feedb
mother‘s to contract Umbilical Cervix
rior pituitary cord
Placenta
Stimulates
placenta to make Uterus
Umbilical +
Positive feedback
Stimulates uterus cord
Prostaglandins
THREE STAGES
to contract Cervix
Uterus
1 Dilation of the cervix
Stimulates
Stimulate more
OF LABOR
placenta to make Cervix
+ contractions
of uterus
Prostaglandins
▲ Figure 46.18 Positive feedback in labor.
1 Dilation of the cervix
? Predict the effect of a single dose of oxytocin on a pregnant woman
Stimulate more
at the end of 39 weeks gestation.
contractions
of uterus
1 Dilation of the cervix
ack in labor. the body. Once labor begins, local regulators (prostaglandins)
and
e of oxytocin on hormones
a pregnant (chiefly estradiol and oxytocin) induce and reg-
woman
ulate further contractions of the uterus (Figure 46.18). Central
to this regulation is a positive-feedback loop (see
Concept 45.2) in which uterine contractions stimulate secre- 2 Expulsion: delivery of the infant
cal regulatorstion
(prostaglandins)
of oxytocin, which in turn stimulates further contractions.
and oxytocin) Labor
induceisand reg- described as having three stages
typically
e uterus (Figure 46.18)
(Figure . Central
46.19) . The first stage is the thinning and opening
Uterus
eedback loopup (dilation) of the cervix. The second stage is the expulsion,
(see
contractionsorstimulate
delivery,secre-
of the baby. Continuous strong delivery
2 Expulsion: contractions
of the infant
Placenta
force the
stimulates further fetus out of the uterus and through the vagina. The
contractions. (detaching)
finalstages
as having three stage of labor is the delivery of the placenta.
is the thinningOneand aspect
opening of postnatal care unique to mammals is
Uterus
second stagelactation, the production of mother’s milk. In response to
is the expulsion, Umbilical
2 Expulsion: delivery of the infant and changes in estradiol levels after
nuous strongsuckling by the
contractions newborn cord
birth, Placenta
s and through thethe hypothalamus
vagina. The signals the anterior pituitary to
(detaching)
secrete prolactin, which stimulates the mammary glands to
ery of the placenta.
e unique produce
tobiology
Campbell mammals milk.
© 2011 Suckling
isPearson also
Education, stimulates the secretion of oxy-
Inc. 3 Delivery of the placenta
Uterus
■ The endometrium is sloughed because of the abrupt withdrawal of estradiol and
progesterone.
1. Fertilization
■ If fertilization occurs, the corpus luteum is rescued from regression by human chorionic
gonadotropin (HCG), which is produced by the placenta.
1. Fertilization
If fertilization occurs, the corpus luteum
is rescued from regression by human P L
ro
n e
Hormone level
H
s te
chorionic gonadotropin (HCG), which Pr
oge
iol
is produced by the placenta Es
t r
2. First trimester
10 20 30 40
The corpus luteum (stimulated by HCG) is Weeks of pregnancy
PHYSIOLOGICAL CHANGE OF ■ is characterized by steadily increasing levels of estrogen and progesterone, which main-
tain the endometrium for the fetus, suppress ovarian follicular function (by inhibiting FSH
and LH secretion), and stimulate development of the breasts.
Hormone level
interplay of the fetal adrenal gland and o g es
t
Pr
the placenta. The fetal adrenal gland Es
t riol
synthesizes dehydroepiandrosterone-sulfate
(DHEA-S), which is then hydroxylated in the
fetal liver. These intermediates are transferred
to the placenta, where enzymes remove 10 20 30 40
Weeks of pregnancy
sulfate and aromatize to estrogens. The
major placental estrogen is estriol. Corpus Placenta
FIGURE 7.20 Hormone levels during pregnancy.
▪ Human placental lactogen
HCG = human chorionic gonadotropin; is
HPL = luteum
human placental lactogen.
produced throughout pregnancy. Its actions are
similar to those of growth hormone and
prolactin. HCG = human chorionic gonadotropin; HPL = human placental lactogen.
PHYSIOLOGICAL CHANGE OF tain the endometrium for the fetus, suppress ovarian follicular function (by inhibiting FSH
and LH secretion), and stimulate development of the breasts.
1. Fertilization
HORMONE DURING PREGNANCY ■ If fertilization occurs, the corpus luteum is rescued from regression by human chorionic
gonadotropin (HCG), which is produced by the placenta.
4. Parturition
Throughout pregnancy, progesterone
increases the threshold for uterine HP
L
one
Hormone level
er
st
contraction. Pr
og e
iol
Near term, the estrogen/progesterone Es
t r
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REFERENCES
• Martini, Ober, Nath et al. Visual Anatomy and Physiology, 2nd
57
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