ANATOMY, EMBRYOLOGY REPRODUCTIVE PHYSIOLOGY OYA AKCIN, M.D.

Department of Histology & Embryology

Female Reproductive System Organs Ovaries Genital Ducts -Vagina -Uterus -Uterine Tubes Extra Genitalia Mamary Glands

Default pathway
GONAD on hold

OVARY

OR

GONAD on hold

OVARY

Sex-determining Factor
Driven pathways
TESTIS

UROGENITAL SINUS & TUBERCLE MULLERIAN DUCT

TESTIS
INTERSTITIAL CELLS

Testosterone Mullerian-inhibiting Factor

SERTOLI CELL

TUBULUS RECTUS SEMINIFEROUS TUBULE

WOLFFIAN DUCT

Development Of Genital Tract by Embryologic Age Weeks Genital Development

Urorectal Septum Formation of cloacal folds, genital tubercle

4-6

Genital ridges

Week 6

6-7

End of indifferent phase of genital development Development of primitive sex cords Formation of paramesonephric ducts Labioscrotal swellings
Week 8

8 12 20

Distal paramesonephric ducts begin to fuse Formation of sinuvaginal bulbs Development of clitoris and vaginal vestibule Canalization of vaginal plate

HYPOTHALAMUS

(Gonodotropin-relasing Hormone(GnRH))
regulates & times changes in circulating hormone levels for

Menarche

Ovulation
Menstruation

Gestation
Parturition Lactation Suckling Menopause

FEMALE HORMONAL CONTROL

UTERINE TUBE

REGONS

Fimbria Infundibulum Ampulla (Usual site of fertilization) Isthmus Intramural

STRUCTURES

Ciliated & secretory columnar epithelial cells Muscularis Serosa

FUNCTIONS

Catches oocyte Guides sperm & egg together for fertilization Timed transport of developing zygote to uterus Nutrition of gametes & zygote

UTERUS

The never pregnant (nulliparous) uterus is a 7-8 cm long to 4-5 cm wide, muscular pear-shaped organ lying in the pelvic cavity on the superior surface of the bladder. The uterus weighs under 50 grams divided into the broad-ended fundus, body and thin isthmus ends in the uterine cervix

Histologically, the uterus is composed of three layers. The Serosa (Perimetrium) The Muscularis(Myometrium)
Inner Musculer Layer; Longitudinally orriented; St. Subvasculare A thick Middle Layer of Circular and Oblique; numerous blood vessels; St. Vasculare An outer thin; longitudinal muscle; beneath the perimetrium; St. Supravasculare. A simple columnar epithelium (ciliated cells and secretory cells) Stroma The mucosa is invaginated to form many simple tubular uterine glands.

The Mucosa (Endometrium)

The endometrium can be divided into two zones: the basalis and the functionalis

CERVIKS

Fibromuscular organ receiving sperm and serving as birth canal Cervix attaches to vagina at nearly 90o angle Simple Columnar epithelium

Simple columnar epithelium

Stratified squamous epithelium

Transformation zone

MUCOUS PLUG: becomes less viscous at mid-cyle to allow entry of sperm, but still can resist microbial entry

Mucous cervical glands

Stratified squamous epithelium has progressed to cover a gland causing a retention cyst(naboth)

CERVIX

UTERUS

PERIMETRIUM
MYOMETRIUM

Grips the opening to hold in baby. Ripens & relaxes (fromrelaxin) at term

VAGINA U Tube

Transformation zone

ENDOMETRIUM

Stratified squamous epithelium replaces simple columnar a metaplasia. The instability raises the cervical cancer risk. Hence, monitor any progression of change with Pap smears.

VAGINA
STRUCTURES
Stratified squamous epithelium Fibroelastic wall A thin Muscularis Adventitia No glands

FUNCTIONS
By glycogen, specifies luminal microbial flora permits penile movement Receives semen & starts capacitation (boosting) Exit of baby

VULVA & VESTIBULE

STRUCTURES
Skin or Stratified squamous epithelium Adipose and erectile tissues

Sensory receptors
Mucous vestibular glands

FUNCTIONS
Protective folds

Exit of baby
Micturition

STRUCTURES
Covering epithelium

OVARY

Follicles to mature & release the oocytes and to make hormones Stroma of special connective-tissue cells that can become

glandular theca cells

Glandular structures - corpora lutea Degenerating structures as part of the cycle of activity Central blood vessels

FUNCTONS
Releases one or two oocytes periodically For genital & breast development Determines wombs endometrial state for receipt of the fertilized oocyte Maintains secretory state of the endometrium (decidua after implantation) Starts secretory processes in the breast Feedback to hypothalamus for overall timing

OVARY
SURFACE EPITHELIUM; Simple cuboidal & squamous STROMA; somewhat denser under the epithelium

STROMAL CELLS ; fibroblastic with potential to: 1 secrete steroids 2 produce thick collagen - fibrosis 3 become decidual cells (ectopic pregnancy) 4 become Leydig cells (near hilus)

MEDULLA ; with convoluted vessels entering at the hilus

OVARY

CORTEX
Primordial FOLLICLES Primary, secondary, tertiary

Atretic
Theca interna GLANDULAR STRUCTURES Granulosa lining

Corpora lutea
Atretic follicles REMNANTS Corpora albicantes
(Corpus albicans X 2,3,)

IVF-ICSI (Intra Cytoplasmic Sperm Enjection)

Embryo Development
OPU ET

Day 1

Day 2
COH IN VITRO CULTURE

Day 3 Day 4 Day 6 Day 5

Transfer

Early Cell Lineages in the Human Embryo

Delamination precedes gastrulation separating ICM into epiblast & hypoblast Gastrulation occurs in epiblast (future embryo). Gastrulation involves several types of movements and shape changes The hypoblast will form the yolk sac The epiblast will form embryo plus the amnion Migration of cells of the epiblast through primitive streak leads to formation of mesoderm and endoderm Ectoderm is left behind Thus gastrulation results in the formation of the three primary embryonic germ layers: ectoderm, mesoderm and endoderm

Day 1

Day 2

Day 3

Day 4

Day 5

Totipotent

Pluripotent

Embryonic Stem Cells

Trophectoderm

ICM

Evans ve Kaufman, 1981 (Mouse ES)

Thompson , 1998 (Human ES)

CARNEGE STAGES OF HUMAN DEVELOPMENT

CARNEGIE STAGE FOR I. WEEK

Stage Days (approx) Size (mm) Images

Events Fertilized Oocyte

0,1- 0,15

CharecteristicFeature: Unicellularity

Clevage continues

begining

and

2-3

0,1-0,2

Charecteristic Feature: More than 1 cell but no blastocystic cavity.

4-5

0,1-0,2

Free Blastocyst (Formulation of cavity)

Blastocyst

CARNEGIE STAGE FOR I-II. WEEK

Stage Days Size (mm) (approx) Images

Events

5-6

0,1- 0,2

Attaching blastocyst Implantation

7 -12 0,1-0,2 Week 2

13-15

0,2

extraembryonic mesoderm, primitive streak

ALL THREE GERM LAYERS ARE DERIVED FROM EPIBLAST

Ectoderm:

Outer epithelia and nervous system. Endoderm: Epithelial linings of the respiratory and digestive tracts; including the glandular cells of the liver and pancreas. Mesoderm: Smooth muscular coats, connective tissue, skeleton, striated muscle, reproductive and excretory organs, the vessels supplying these organs, and bloods cells and the bone marrow. OVERHEAD LIST OF STRUCTURES FORMED SUMMARIZE :

Ectoderm
central nervous system peripheral nervous system sensory epithelium of ear, nose and eye epidermis glands subcutaneous mammary pituitary teeth enamel

Mesoderm
supporting tissues cartilage bone muscle connective tissue blood and lymph cells walls of heart, blood and lymph vessels kidneys, gonads and associated ducts suprarenal gland cortex spleen

Endoderm
epithelial lining of gut respiratory tract urinary bladder and urethra tympanic cavity and auditory tube parenchyma of thyroid parathyroid glands liver stroma of tonsils and thymus

CARNEGIE STAGE FOR III. WEEK

Stage Days Size (mm) (approx) Images

Events

15 17 Week 3

0,4

Gastrulation, Notochordal process Primitive Pit, Notochordal Canal Somite Number 1-3 Neural folds,cardiac primordium

17 -19

1,0-1,5

19-21

1,5-2,5

CARNEGIE STAGE FOR IV. WEEK

Stage Days Size (mm) (approx) Images

Events

10

22-23 Week 4

2- 3,5

Somite Number 4-12 neural fold fuses

11

23-26

2,5-4,5

12

26-30

3-5

Somite Number 13-20 Rostral neuropore closes Somite Number 21-29 caudal neuropore closes

CARNEGIE STAGE FOR V. WEEK

Stage Days Size (mm) (approx) Images

Events

13

28-32 Week 5

4-6

14

31-35

5-7

Somite Number 30 leg buds, lens placode, pharyngeal arches Lens pit, optic cup Lens vesicle, nasal pit, hand plate

15

35-38

7-9

CARNEGIE STAGE FOR VI.-VII. WEEK

Stage Days Size (mm) (approx) Images

Events

16

37-42 Week 6

8-11

17

42-44

11-14

Nasal pits moved ventrally, auricular hillocks foot plate Finger rays

18

44-48 Week 7

13-17

Ossification commences
Straightening of trunk

19

48-51

16-18

CARNEGIE STAGE FOR VIII. WEEK

Stage Days Size (mm) (approx) Images

Events

20

5 1- 53 Week 8

18-22

Upper limbs longer and bent at elbow

Hands and feets turned inward

21

53-54

22-24

22

54-56

23-28

Eyelids, ears

external

23

56-60

27-31

Rounded head, body and limbs

End of Week 8 Systems

Nervous CNS, PNS, Sensory Cardiovascular Heart, Blood Vessels Skeletal Axial, limbs, muscle, connective tissue Digestive Gastrointestinal tract and associated organs Urogenital Kidney, gonad Respiratory Upper respiratory tract, lungs