Reproductive Biology

Reproductive physical maturity and the capacity for human reproduction begin during
puberty, a period of rapid growth and change experienced by both males and females.
Puberty is not an isolated event, but a process which takes place over several years.
During puberty, the hypothalamus (a gland located at the base of the brain which
regulates temperature, sleep, emotions, sexual function and behavior) produces
hormones (chemicals that originate in a gland or organ and travel through the blood to
another organ, stimulating it by chemical action to increase functional activity and
secretions).
These hormones stimulate the gonads, the reproductive glands (the testes in males and
the ovaries in females) to produce testosterone (males) and estrogen and progesterone
(females).
Male puberty generally occurs between the ages of 13-15 and is characterized by the
secretion of the male hormone testosterone, which stimulates spermatogenesis (sperm
production), and the development of secondary sexual characteristics (increased height
and weight, broadening shoulders, growth of the testes and penis, pubic and facial hair
growth, voice deepening, and muscle development).
Female puberty generally occurs between the ages of 9-13, and results in ovulation and
menstruation, which involve cyclic hormonal changes in estrogen and progesterone.
Secondary sexual characteristics (growth of pubic and underarm hair, breast enlargement,
vaginal and uterine growth, widening hips, increased height, weight and fat distribution)
also occur as part of the female pubertal process.

Female Reproductive
System

Understanding female
reproductive anatomy
includes the study of
the
external
and
internal
structures;
and the hormonal
cycle.

Structures

The external genitalia, also called the vulva, includes the mons pubis (a fatty mound
which covers the pubic bone), the labia majora (outer lips of the vagina), the labia
minora (the inner lips of the vagina), the vaginal opening, the urethral opening
(opening of the urethra, a tube which carries urine from the bladder outside of the body),
the clitoris (a small structure with sensitive nerve endings located within the labia
minora, the sole purpose of which is for sexual arousal and pleasure), and the perineum
(the space between the anus (the rectal opening), and the vaginal opening).
Urinary Track Infections: The close proximity of the urethra and the rectum makes
women susceptible to urinary tract infections (UTIs) because bacteria from the anus can
enter the urethra. Health education about reproductive anatomy includes instructing
women to avoid contamination of the urethra by wiping from front to back following
urination.

The internal reproductive anatomy includes the uterus, two ovaries, two fallopian
tubes, the urethra, the pubic bone, and the rectum. The uterus contains an inner lining
called the endometrium (which builds ups and sheds monthly in response to hormonal
stimulation). The lower portion of the uterus is called the cervix, which contains a small
opening called the os. Menstrual blood flows through the os into the vagina during
menstruation. Semen travels through the os into the uterus and the fallopian tubes
following ejaculation during sexual intercourse. The cervical os dilates (opens) during
childbirth.

Reproductive Healthcare
1. The cervix, the lower portion of the uterus, can be visualized during a gynecological
examination by inserting a speculum into the vagina. The Pap smear, developed in the
1940's by Dr. George Papaniclaou, is a simple and cost-effective screening test that
involves the collection of a sample of cells from the cervix, which are examined
microscopically. The Pap smear screens for infections and/or cell changes which, can
detect indications of cervical cancer. In the developed world, Pap smear screening has
been instrumental in reducing morbidity and mortality associated with cervical cancer.
Cervical screening technologies have expanded to include liquid cytology, although the
traditional Pap smear is still used.
2. Despite the availability of Pap smear screening in the developed world, studies of its
use reveal racial, economic and ethnic disparities. In the developing world, programs for
screening and treating cervical cancer are rare.
The ovaries, two small almond-shaped structures located on each side of the uterus, are
the female gonads (reproductive glands). Female babies are born with over 400,000 ova
(the gametes, also referred to as egg cells or oocytes), which are stored in the ovaries.
The female body does not produce any additional ova. The ovaries produce estrogen and
progesterone. The ovaries are close to, but not actually connected to the fallopian tubes,
thin tube-like structures that are the site of fertilization, the fusion of the male and
female gametes.

The Menstrual/Hormonal Cycle

The hormonal cycle facilitates maturation and rupture of the ovarian follicle resulting in
the release of an ovum (the female reproductive or germ cell). Each month a series of
changes take place which prepares the uterus for pregnancy. This cycle (menstrual cycle)
is described below:
The first day of menstruation (referred to as Day 1) occurs when levels of estrogen
and progesterone are low. In response to these low levels, the hypothalamus secretes
gonadotrophin releasing hormone (GnRH) which triggers the anterior pituitary
gland to release two hormones: follicle stimulating hormone (FSH), and
luteinizing hormone (LH).
FSH stimulates the development of many follicles within the ovary. One dominant
follicle takes over. As it continues to grow, it produces increasing amounts of
estrogen, which stimulates the release of LH, and inhibits FSH, which suppresses
further follicular development.
When LH levels are highest (LH surge), the ovarian follicle ruptures and releases
one ovum, which is swept into the fallopian tube by hair-like projections called
cilia that line the fimbriae (the fringe-like end of the fallopian tube that is closest to
the ovary). This process is called ovulation. Increasing estrogen levels causes the
cervical mucous (vaginal secretions) to become clear and profuse and the os to

dilate. These two actions may facilitate the transport of semen (containing sperm)
from the vagina, through the uterus, and into the fallopian tube.
Following ovulation, the ruptured follicle is transformed into the corpus luteum, a
glandular mass that continues to produce estrogen and high levels of progesterone.
The progesterone causes the endometrium to thicken, preparing it for implantation of
a fertilized egg. If fertilization takes place during ovulation, hormonal levels remain
high, essential for the maintenance of the pregnancy.
If fertilization does not occur, the corpus luteum shrinks and levels of both estrogen
and progesterone decrease. The withdrawal of estrogen and progesterone cause the
blood vessels of the endometrial (uterine) lining to break resulting in vaginal
bleeding (menstruation). The average menstrual cycle is 28-35 days, and menstrual
flow usually continues for three to seven days, although there are variations among
women.
Following menstruation, estrogen and progesterone levels are low, triggering the
hypothalamus to once again release GnRH, starting the entire cycle again. If
fertilization does take place, menstruation will not reoccur for the duration of the
pregnancy

Mechanism of Action for Contraception/Pregnancy

1. Most hormonal methods of birth control, including emergency contraception, work by
preventing or postponing ovulation, and by thickening the cervical mucous.
2. The absence of a menstrual period in a sexually active woman may indicate that
pregnancy has occurred. It is a presumptive, although not definitive, sign of pregnancy.

Menopause
Menopause, the end of menstruation, occurs between the ages of 45 and 55 (with the
average age of 51.3). An entirely normal developmental and physiological process, it can
be accompanied by symptoms including hot flashes, fatigue, moodiness, insomnia,
decreased libido and sexual response, changes in memory, weight gain, and vaginal
dryness. Until cessation of ovarian function is confirmed through a blood test, and/or one
year of no menses, women may continue to ovulate and therefore require contraception to
prevent unintended pregnancy.

Fertilization
During coitus (sexual intercourse) between a male and a female, semen is released into
the vagina and transported through the uterus into the fallopian tube. Although many
factors contribute to whether or not a single act of intercourse will result in pregnancy,
most important is whether or not a sperm cell will meet an ovum in the fallopian tube
(fertilization). Fertilization can only occur if intercourse takes place before the time of
ovulation that usually occurs mid-cycle, or about 14 days before the woman's next
menstrual period. At the time of ovulation, the ovum is released from the ovary and
transported in the fallopian tube where it remains for about 24-48 hours. Pregnancy is
most likely to occur if fresh semen is present when ovulation occurs.

Sperm cells remain

viable within the
female reproductive
tract for about 72
hours. Only a single
sperm cell is needed
to
fertilize
the
ovum, even though
the
average
ejaculation contains
approximately 300
million sperm.
During fertilization, the sperm enters the cell membrane of the ovum so the nuclei of the
sperm and egg cells combine to form a zygote. The zygote will remain in the fallopian
tube for approximately three days before it travels to the uterus where it will remain for
approximately four to five days before implantation into the uterine lining.

Ectopic Pregnancy
An ectopic pregnancy is when a fertilized egg becomes implanted outside the uterus,
most often in the fallopian tubes. Ectopic pregnancies are often the result of fallopian
tube scarring caused by untreated sexually transmitted infections, which impedes the
transport of the zygote from the fallopian tubes to the uterus. If left undiagnosed or
untreated, the zygote grows in the fallopian tube, and may result in fallopian rupture.
Without medical or surgical intervention, ectopic pregnancy usually results in infertility,
severe infection, or death. Ectopic pregnancy can be difficult to diagnose, as it shares
many symptoms with uterine pregnancy. However, Some symptoms of ectopic pregnancy
include pain in the vagina, abdomen, or lower back, vaginal bleeding or spotting,
dizziness, fainting, and low blood pressure.

PID

Pelvic inflammatory disease (PID) is the most common preventable cause of infertility
The more often a woman gets PID, the greater her risk of becoming infertile.
Most cases of PID develop from sexually transmitted diseases (STDs), usually gonorrhea
or chlamydia. These two different kinds of bacteria can be passed by a man to a woman
during sex. First, they infect the cervix, the part of the uterus that extends into the vagina.
From there, they can move through the opening of the cervix into the uterus. Then they
can enter the fallopian tubes, which carry an egg that has been released by the ovary into
the uterus. The bacteria can work their way up the tubes to the ovary. (See illustration.)

PID is insidious: Not all women with PID have symptoms. This is particularly true for
infection with chlamydia. Those who do get symptoms may experience:

pain in the pelvis and lower abdomen

vaginal discharge with an unpleasant odor
fever and chills
nausea and vomiting
pain during sexual intercourse

If you have symptoms that might indicate PID, its important to see a doctor right away.
If the doctor diagnoses PID, you should begin treatment immediately.
PID is treated with antibiotics. Most cases clear up after 10 to 14 days. Finish the entire
course of antibiotics, even after your symptoms go away, as the infection can still be
present after the symptoms disappear. Stopping treatment early may leave you with an

ongoing infection. You may not have symptoms, but the continuing infection can damage
your tissues.
If your infection is more severe, you may need to be hospitalized and given antibiotics
intravenously. You can relieve pain and discomfort with pain medication, hot baths and
heating pads. If the infection causes an abscess, or collection of pus, you may need
surgery.
PID can cause infertility by producing scarring that damages or blocks the fallopian
tubes. If an egg released by the ovary cant pass through the fallopian tubes, it cant get to
the uterus to be fertilized.
How can you prevent future attacks of PID and the infertility that it can potentially cause?
If you are in a relationship with one uninfected partner, you are unlikely to be reinfected.
If its not clear whether your sexual partner or partners are free of these infections, always
use a condom during sexual intercourse to prevent another episode of PID. And make
sure your sexual partners have been treated for STDs.
If you and your partner want to have kids and you are having trouble getting pregnant,
see your gynecologist. You may need to have special testing to see if your tubes have
been scarred by PID. If they have, there are surgical procedures that may help. Finally, in
vitro fertilization can be an answer for infertility due to scarring from PI.

http://www.columbia.edu/itc/hs/pubhealth/modules/reproductiveHealth/anatomy.html