Male Reproductive system

The reproductive functions of male can be divided

into three major subdivisions wchich includes:
1 . Spermatogenesis-formation of sperm
2. Performance of male sexual act
3.Regulation of male reproductive functions by
various hormones
 Seminiferous tubules:
 The stratified epithelium consists of 2 types of cells: germ cells &
sertoli cells.
 Germ cells (spermatogenic cells):
· They are the precursor cells of spermatozoa. They occupy the
spaces btwn basement membrane & lumen of seminiferous
tubules.
· In children, only primitive germ cells called spermatogonia
are present.
· With the onset of puberty, different stages of spermatogenic
cells are seen: (from periphery to lumen):
 Spermatogonium à primary spermatocyte à secondary
spermatocyte à spermatid.
Sertoli cells (sustentacular cells / nurse
cells):
· They are large irregular columnar cells
extending from the basement membrane to the
lumen.
· Supporting cells that provide protection &
nourishment for spermatogenic cells till the
spermatozoa are released from them.
 Functions of sertoli cells:
· Convert androgens into estrogens via the enzyme
aromatase present in sertoli cells.
· Secrete androgen binding protein (ABP) & EstrogenBP
(EBP).
· Secrete inhibin & activin– which inhibit & stimulate
the release of FSH from ant. Pituitary respectively.
· Secrete Mullerian regression factor (MRF) or
Mullerian inhibiting substance (MIS) in fetal testes. MRF is
responsible for regression of Mullerian duct during sex
differentiation in fetus.
Blood-Testis Barrier
· It is a mechanical barrier that separates
seminiferous tubules of testes from blood & other
testicular tissues.
· It is formed by tight junctions btwn the
adjacent sertoli cells near the basal membrane of
s.tubule.
· The testosterone must be bound to androgen-
binding protein (ABP) to cross the barrier.
·
 Functions:
Prevents the entry of large molecules (such as
proteins & cytotoxic substances, galactose)
Allows the passage of water, urea, nutritive
substances & hormones for spermatogenesis.
· Damage of the barrier: by trauma or viral
infection like mumps. The sperms enter the blood à
activation of immune system à autoantibodies
against sperms à destruction of germ cells à sterility.
Androgens (male sex hormones):
· They are C19 steroid hormones.
· They include potent hormones like
testosterone (T) & 5α-dihydrotestosterone
(DHT) and
Less potent 17-ketosteroids (17-KS) such as DHEA.
· In males: synthesis of testosterone:
95% à by the testes
5% à by the adrenal cortex.
·
 In females: testosterone is synthesized by Ovaries & adrenal cortex.
· Plasma testosterone conc. in males is 15 times higher than in
females.
· 98% of testosterone circulating in blood = bound to plasma
proteins (albumin and sex hormone-binding globulin, SHBG).
· The testes secrete also small quantities of DHT and estradiol
(E2).
· Larger quantities of DHT (via 5-α-reductase) & estradiol are
synthesized from testosterone (via aromatase) by their respective
target cells.
· DHT and testosterone bind to the same intracellular receptor.
· Estradiol influences many functions in the male, e.g., epiphyseal
cartilage & ejaculate formation.
 Actions of Testosterone
1. Responsible for the pubertal growth of male accessory
sex organs & for the appearance & maintenance of male
secondary sexual characteristics
2. Increases body hair, decreases scalp hair- Male pattern
baldness
3. Laryngeal hypertrophy associated with a low pitched
voice
4. Increased thickness of skin and subcutaneous tissues
 Actions of Testosterone
5. Increased rate of secretion of sebaceous glands
predisposing to acne
6. Increased deposition of protein in muscle leading to
muscular hypertrophy
7. Responsible for Libido
8. Promotes spermatogenesis along with FSH
9. Increase basal metabolic rate
 Actions of Testosterone
10. Stimulation of erythropoiesis

11. Promotes protein synthesis & decreases protein

breakdown-favors growth
12. Causes moderate retention of sodium, potassium
calcium water
13. Cause adolescent growth spurt

Although causes linear bone growth it causes epiphyseal

fusion with long bones thus terminates their growth
SPERMATOGENESIS
1. Phase of mitotic division of spermatogonia:
 spermatogonia divides mitotically 7 times to form
128 spermatogonia
2. Phase of formation of primary spermatocye by
maturation :
 128 spermatogonia undergoes maturation to form
128 primary spermatocytes.
They are large cells with diploid no of chromosomes
Sertoli cells:
 secrete androgen binding factors(ABP),inhibin
and MIS
They do not synthesize androgens but promotes
spermatogenesis
 ABP helps to maintain stable supply of androgens
 inhibin inhibits FSH
 MIS causes regression of mullerian ducts
Seminal fluid with fructose help in maturation of
sperms
Vitamin E,C and several mem of B complex are
required for normal spermatogenesis
Vasectomy
Age
Contraception
Aims of contraception:
Refers to prevention of pregnancy.
Main aim ,is family planning
Important to prevent STDs
Contraceptives are also recommended on medical
grounds to control the stress of pregnancy,labour &
lactation in women suffering from heart diseases.
 Methods of contraception

Can be broadly grouped as

Spacing methods
Terminal methods.
Both types of measures are available for use by
females as well as males,therefore,these can be
described as
Contraceptive methods in females
“ “ “ in males.
 Contraceptive methods in females.

• Spacing methods increase the gap between two

pregnancies. these include:
• Rhythm method
• Barrier method
• Chemical method and
• Intrauterine contraceptive devices.
 Rhythm method

Calender method or safe period method or natural

method.
This method depends on the time of ovulation.
In a women having regular menstrual cycle,
ovulation -14th.
After ovulation,ovum remains viable for 48-72h
After ejaculation sperms remain alive for 24-48h.
Thus pregnancy occurs only if coitus is performed
during this period.
This is period of high fertility & is called as
dangerous period.
Therefore,to avoid pregnancy intercourse should be
avoided in the dangerous period.
Rest of the cycle ,5 to 6 days after bleeding phase of
M.cycle &
5-6 days before the next cycle is the safe period .
This method is successful only if M.cycles re regular
and
Women knows the exact time of ovulation
 Barrier methods

Prevent the meeting of ovum and sperms after

coitus.
1. mechanical barriers.
Used as contraceptive are:
Diaphragm ,cervical caps
Adv:these devices are inexpensive &usually do not
require any medical consultation
Dis adv:failures are quite common.
B. Diaphragm
Used as a barrier
Used along with spermicide jelly.
 Chemical barriers

Refer to spemicidal agents,which can destroy the

sperms when applied in female genital tract .
Spermicidal agents are available in various forms
such as:
Foam tablets,creams,jellies &vaginal sponge.
• C. Vaginal sponge: impregnated with a spermicide
jelly
• Kills the sperms inside the female genital tract.
• D. Intra uterine contraceptive devices(IUCD)
• Lippes Loop, copper T, inserted inside the uterus,
where these prevent implantation of the zygote.
The devices are usually made up of insert matreials
like plastic, polythene and metal
Lippes loop
It is a serpentine or S shaped device made upof
plastic to which is attached to a fine nylon tail.
Lippes loop is available in different sizes.
 Copper -T

Is the most commonly used IUCD in india

Made up of copper and its shape resembles the letter
T
It is also attached with a nylon thread.
Moa:
Prevents implantation &growth of fertilized ovum by
provoking aseptic inflammation &thus makg
endometrium unsuitable for implantation.
 Chemical methods

Oral contraceptives:
Are most widely used contraceptive measure by
women
These are recommended in women of younger age
group upto 35yrs.
MOA:
 Types of pills

1.Combined/classical pills
2.sequential pill
3.minipill
4..post-coital(morning after pill)
2.Combined pills-or classical pill
both estrogen & progesteron
Are available under 2 brand names
MALA-N
MALA-D.
Dosage:
The pill is given for 21 consecutive days beginnning
on the 5th day of M.cycle
 Mechanism of action

Prevent ovulation .
Prevent implantation of ovum.
Restrict the entry of sperm by altering the character
of cervical mucus.
 Sequential pill

High dose of Estrogen along with moderate dose of

progesterone
Only estrogen is given starting from 5th day of cycle
to 15th day & then followed by both E+P foe next 5
days.
Nwadays it is not used becz of high incidence of
endometrial carcinoma.
Mini pill
It involves low doses of progestreon
Pill should be taken daily thr whole of the M.cycle.
MOA:
Prevents fertility without inhibiting ovulation.
Acts on cervical mucus,endometrium,decrease the
motility of fallopian tubes.
 Post coital or morning after pill

It is recommended 72 hr of unprotected intercourse.

Double dose of combined pill should be taken
immediately followed by another double dose after
12 h.
It is advocated as emergency method for eg:
Unprotected intercourse,rape or contraceptive
failure.
Progesterone antagonists,
Is helpful in producing abortion following the
conception.
 Terminal methods

Means permanent sterilization.

Tubectomy :
Fallopian tubes are cut & ligated
Preventing entry of ovum into the uterus.
Permanent methods.
Laproscopic cuulusion:
Fallop.tubes r occluded using silicon rubber bands.
Much quicker,and simple
 Contraceptive methods in males

Spacing methods used in males are

Natural method
Barrier methods
Chemical methods.
 Natural /coitus interruptus

Coitus interruptus.
Male withdraws from the act before ejaculation.
Abstinence
Avoiding sexual intercourse.
 Barrier methods

Mechanical devices.
Condom:popular contraceptive agent.
It is known by its trade name nirodh.
Prevent STD like AIDS,syphilis,gonorrhea etc.
Condom prevents deposition of semen into vagina
thus doesnot allow the sperms and ovum to meet.
Chemical methods
Few drugs which inhibit spermatogenesis
1.Male pill-glossypol
2.testosterone
Administration of testosterone in high doses
decreases the sperm count.
 Surgical methods

Vasectomy:
Vas deferenses are cut & ligated
Thus Preventing ejaculation of sperms.
No scalpel vas occlusion
Newer tech
Which is safe,convienient,acceptable to males
An elastomer in injected into vas deferns,it get
hardened in situ within 20 min & plug the
vas(occlude it)