Reproductive system

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 Introduction
Reproductive system is made up of several organs. It is
divided into two parts:
• Male reproductive system- testis, prostate, penis etc.
• Female reproductive system- ovary, uterus, fallopian
tube, vagina

Function: it’s main function is reproduction (প্রজনন).

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 Male reproductive system
Parts of male reproductive system
 External parts:
 Penis (পেনিস)
 Scrotum (ইস্ক্রটাম): which includes
testis (টেস্টিস) and epididymis and
the part of vas deferens
 Spermatic cord
 Internal parts:
 Seminal vesicle (সেমিনাল
ভেসিক্যাল)
 Vas deferens (ভাস ডিফারেন্স)
 Prostate (প্রোস্টেট)
 Ejaculatory ducts (ইজাকুলেটরি ডাক্ট)
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 Scrotum

The scrotum is a cutaneous bag containing testis,

epididymis, the part of spermatic cords

Function:
• It regulates the temperature of testis

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 Testis
The testis are pair of mixed gland which is suspended within the
scrotum and is surrounded by the testicular capsule which is
composed of three layers:
 Tunica vaginalis (outer layer)
 Tunica albuginea (middle layer)
 Tunica vasculosa (innermost layer)
The hormones of mature testis:
 Testosterone
 Estrogen (small amount)
 Inhibin

Sperm (স্পার্ম): It is the male reproductive cell which comes from

testis
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 Prostate
The prostate is an accessory exocrine gland of male reproductive
system. The secretions of this gland add bulk to the seminal fluid
along with those of seminal vesicles and the bulbourethral glands
Function: Produces seminal fluid.

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Common diseases male reproductive system

• Orchitis (অরকাইটিস): Inflammation of testis

• Prostatitis (প্রস্টাটাইটিস): Inflammation of prostate
• BPH (Benign prostatic hyperplasia) / BEP (Benign
enlargement of prostate): Enlargement of prostate usually
after 50 years.

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 Female reproductive system

Parts of female reproductive system

 Primary sex organ:
• Ovary (ওভারি)
 Secondary sex organ:
• Fallopian Tube (ফেলোপিয়ান টিউব)
• Uterus (ইউটেরাস)
• Vagina (ভ্যাজাইনা)

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 Ovary
The ovaries (ডিম্বাশয়) are pair of mixed gland which are part of
female reproductive system.
• Number: 2 (1 on each side)
• Ovary produce and discharge an ovum in each month.
(During a lifetime a woman release 400 to 500 fully matured
ovum for fertilization)
Function :
a) Produce ovum (Ovum is the female reproductive cell which
comes from ovary)
b) Produce hormone
- Estrogen (ইস্ট্রোজেন)
- Progesterone (প্রজেস্টেরন)

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 Fallopian tube/uterine tube
The fallopian tube transports ovum from ovary to uterus.
Number: 2 (each side of uterus)
• It has two opening- One opening opens in the uterine cavity
and the other opening opens in the abdominal cavity
Function: It is the main site of Fertilization. (mainly in ampulla)

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 Uterus

The uterus is a major female

reproductive organ
It has three parts :
1. Fundus (ফান্ডাস)
2. Body (বডি)
3. Cervix (সারভিক্স)

Note: Normal size of uterus is 8 to 10

cm. The uterus expands up to 20 times
to its normal size during pregnancy

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 Layers of uterus
Three basic layers:
– Perimetrium (পেরিমেট্রিয়াম): Outer layer
– Myometrium (মায়োমেট্রিয়াম): Middle layer
– Endometrium (এন্ডোমেট্রিয়াম): Inner layer

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 Menstruation

Menstruation (মেন্সট্রুয়েসন) is the periodic (নির্দিষ্ট সময় অন্তর-অন্তর

ঘটে এমন) discharge of damaged endometrial tissue, unfertilized
ovum and blood through the vagina.

Menarche (মেনারকি): Initiation of menstruation. It begins at the

age of 9 to 13 years of age.

Menopause (মেনোপজ): Stop of menstruation. It occurs between

45 to 55 years of age.

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 Menstrual cycle (MC)
• The regular cyclic changes of the uterus regarded as periodic
preparation for implantation and pregnancy is known as
menstrual cycle.
• Duration of the MC : Normally 28 days
Range 21-35 days
• Normal estimated blood loss during MC :
Approximately 20-80 ml

• Duration of mensuration: 3 to 5 days

• Menstruation does not occur in pregnancy

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 Menstrual cycle (MC)

Menstrual Cycle can be divided as:

 Ovarian cycle (in the ovary)
 Follicular phase
 Ovulation
 Luteal phase
 Uterine cycle (in the uterus)
 Proliferative phase
 Secretory phase
 Menstruation

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 Ovarian cycle
Hypothalamus begins to secrete gonadotropins- releasing
hormone(GnRH)

Which stimulates secretion of LH and FSH from pituitary

LH causes secretion of estrogen and progesterone from

ovary and FSH stimulates development of follicles in the
ovary(folliculogenesis)

Although many follicles are recruited for development in

early folliculogenesis, a leading follicle is selected for
development into a mature graafian follicle
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 Around day 14, LH surge (mid cycle peak of LH secretion by
high estrogen levels) stimulates ovulation from the ovary

After ovulation, remaining part of rupture graafian follicle is

called corpus luteum.corpus luteum secrets progesterone

Estrogen initially and then progesterone cause uterine

endometrial proliferation in preparation for possible
implantation

If implantation does not occur corpus luteum regress and

progesterone level falls. So that the endometrium is shed and
menustration occurs.
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 Uterine cycle
Menstruation (1 to 4 day)
 Hormonal support of endometrium withdrawn (no estrogen or
progesterone)
 Constriction of uterine artery which supplies stratum
functionale (endometrium)
 Stratum functionale becomes ischemic
 Uterine artery become necrotic and then rupture
 This blood from rupture blood vessels, damaged tissue of
endometrium comes through vagina and that is menstruation

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 Cont..
Proliferative phase/ estrogen phase (5- 14 day)
(Under the influence of estrogen secreted from ovary,
following changes occur in the endometrium of uterus)
 The endometrial surface re-epithelized
 The gland increase in number and become large
 The blood vessels become large and tortuous
 Endometrium become 3-4 mm thick

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 Cont..
Secretory phase/Progesterone phase (15-28 day)
(Under the influence of progesterone secreted from corpus
luteum following changes)
 Glands increase more in number and secretory character
appear in them
 Blood vessels become large and highly tortuous
 Increase fat deposition
 Endometrium becomes 5-6 mm thick

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Menstrual cycle
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 Some disorders of menstruation

 Dysmenorrhea (ডিসমেনোরিয়া): Pain during

menstruation.
 Amenorrhea (এমিনোরিয়া): Absence of menstruation.
 Menorrhagia (মেনোরেজিয়া): Heavy and prolonged
bleeding during menstrual period.

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 Pregnancy
 Definition: Carrying a developing embryo or fetus within the
uterus is called pregnancy.
 Pregnancy lasts for about nine months, measured from the
date of the woman's last menstrual period (LMP).

• Pregnancy is divided into three trimester (ট্রাইমেস্টার):

1. First trimester (1 to 3 month)
2. Second trimester (4 to 6 month)
3. Third trimester (7 to 9 month)

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 Some important point about pregnancy
 Ovulation (অভুলেশন) : Discharging of matured ovum from
ovary to fallopian tube is called ovulation. Ovulation occurs
usually on the 14th day of menstrual cycle.
 Fertilization (ফারটিলাইজেশন) /conception: It is the process
where an ovum and sperm is fused to form an embryo.
 Implantation is the very early stage of pregnancy in which
the conceptus adheres to the posterior wall of the uterus.
 Embryo (এমব্রায়ো): First eighth week of development after
fertilization, the product of conception is called embryo.
 Fetus (ফিটাস) : After eighth week of development till
delivery, the product of conception is called fetus.

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 Placenta (প্লাসেন্টা)
Placenta is a temporary organ that
develops in the uterus during
pregnancy, consisting of a fetal part
(chorion) and a maternal part
(decidua basalis).

Function:
• It provides nutrition and oxygen to the
baby from mother
• Removes waste products from the baby
• It produces hCG (Human chorionic
gonadotropin) hormone

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 Umbilical cord (আম্বিলিকাল কর্ড)
The umbilical cord connects the fetus to the placenta through
which the fetal blood flows to and from the placenta.
• Our ACI has Hexicord preparation to prevent infection of the
umbilical cord.

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 Pregnancy Disorder
 Pre-eclampsia (প্রি-একলাম্পসিয়া): Hypertension (BP- 140/90 mm
Hg) and proteinuria after the 20th week of pregnancy in a
previously normotensive and non protienuric woman

 Eclampsia (একলাম্পসিয়া): Pre eclampsia when complicated with

convulsions (খিঁচুনি) during pregnancy is called eclampsia

 Gestational diabetes mellitus (GDM): First appearance of

diabetes during pregnancy is called Gestational diabetes mellitus
(GDM). Baby with GDM mother may have diabetes after birth

 IUGR: Intrauterine Growth Retardation

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 Abortion (অ্যাবোরশন)

Abortion is the expulsion or extraction from its mother

of an embryo or fetus before the age of viability
(before 28th week of pregnancy).
• Threatened Abortion: Discontinuation of
pregnancy occurs in the first 20 weeks of pregnancy
is called threatened abortion.
• Habitual abortion: Discontinuation of pregnancy
occurs three or more consecutive (পর পর) times is
called habitual abortion

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Common female reproductive system diseases

• Premenstrual Syndrome (PMS) (প্রি-মেন্সট্রুয়াল সিনড্রম)

• Dysfunctional uterine bleeding (DUB) (ডিসফাংশনাল ইউটেরাইন ব্লিডিং)
• Pelvic inflammatory disease (PID) (পেলভিক ইনফ্লামেটরি ডিজিজ)
• Endometriosis (এনডোমেট্রিওসিস)
• Adenomyosis (এডিনোমায়োসিস)
• Fibroid uterus (ফাইব্রোয়েড ইউটেরাস)
• Ectopic pregnancy (এ ক টপিক প্রে গ ন্ যা
ন্‌
সি)
• Mastitis (ম্যাসটাইটিস)
• Climacteric syndrome (ক্লাইমেকট্রিক সিনড্রম)
• Molar pregnancy (মোলার প্রেগনেন্সি)
• Utero vaginal prolapse (ইউটেরো ভ্যাজাইনাল প্রোল্যাপস)
• Vaginal discharge(ভ্যাজাইনাল ডিসচার্জ)
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 Pre-menstrual syndrome (PMS)
Premenstrual syndrome (PMS) is a set of specific physical and
psychological features that may occur in luteal phase of menstrual
cycle.
Clinical features
 Physical features  Psychological features
• Fatigue (ক্লান্তি) • Anger and irritability
• Bloating (পেট ফুলে যাওয়া) • Anxiety (উদ্বেগ)
• Weight gain • Tension (দুশ্চিন্তা)
• Breast tenderness • Depression (বিষন্নতা)
• Acne (ব্রণ) • Crying
• Sleep disturbances • Mood change
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 Dysfunctional uterine bleeding (DUB)

• Dysfunctional Uterine Bleeding (DUB) is irregular

uterine bleeding that occurs in the absence of pelvic
pathology, general medical disease, or pregnancy.
• It is usually due to hormonal imbalance mainly
reduced levels of progesterone.
• The bleeding may be excessively heavy or light and
may be prolonged, frequent or random.

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 Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is infection or inflammation

of female reproductive organ (ovaries, fallopian tubes, uterus)

It includes:
• Oophoritis (ওফোরাইটিস) : Inflammation of ovaries
• Salpingitis (সালপিনজাইটিস): Inflammation of fallopian
tubes
• Endometritis (এন্ডোমেট্রাইটিস): Inflammation of uterus
• Cervicitis (সারভিসাইটিস): Inflammation of cervix

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 Endometriosis
Presence of endometrial (uterine) tissue outside the uterus.

 Common sites:
• Ovary (commonest site)
• Pelvic peritonium
• Fallopian tubes
• Uterine ligaments such as the broad or round ligament
• Intestine

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 Ectopic pregnancy 

It is a condition where pregnancy (implantation) occurs

outside the uterus.
 Common site:
Almost all ectopic pregnancies occur in the fallopian
tube.

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 Mastitis
Inflammation of breast is called Mastitis.

 Clinical features
• Breast pain
• Breast swelling
• Pain or a burning sensation continuously or while
breast-feeding
• Skin redness over the breast
• Fever

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 Climacteric syndrome

• Climacteric syndrome is the most common symptom of

menopausal women which occur between pre-menopause,
peri-menopause and early postmenopausal.

• Clinical feature: Menstrual irregularity, hot flushes (হঠাৎ গ রম

লাগা, ঘেমে মুখ লাল হয়ে যাওয়া), increased weight, painful
breasts,, dyspareunia (বেদনাদায়ক যৌন মিলন) increased or
decreased libido (যৌন কার্যকলাপ করার জন্য ইচ্ছা), atrophy of
skin, MI, strokes, osteoporosis, endometrial and breast cancer,
hypertension.

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