NURS N101F Human Anatomy and Physiology

L17 & 18 Reproductive System

By Ariel Chow (akmchow@ouhk.edu.hk)

Learning outcomes
By attending this lecture, you will be able to:
1. Explain the structures and functions of male and female reproductive organs.
2. Explain the process of sperm and ovum (egg) formation and development.
3. Explain the hormonal influences on male and female reproductive physiology.
4. Explain the physiology of pregnancy stages.
5. Describe the structures and functions of the breasts.
6. Describe methods for contraception.

Overview of the reproductive system

Sexual reproduction:
• Both male and female supply genetics material to create new offspring
• It ensures genetic diversity, which in turn promotes good health in a
population
Male:
• Produce sperms
• Deliver sperms to the female
• Sperms:
• Carry male’s half of the genetic material
• Produced in the testes (male reproductive gland)
Female:
• Produce egg cells (ova)
• Involve in conception, development and birth of offspring
• Ova:
• Carry female’s half of the genetic material
• Produced in the ovaries (female reproductive gland)

Male reproductive system

Male Genital organs
External genital organs
• Penis
• Scrotum
Internal genital organs
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 • Testes
• Epididymis
• Vas deferens
• Accessory glands
• Seminal vesicles
• Prostate gland
• Bulbourethral glands

Penis
Structure
• Root
• Attach to the bony pelvis
• Shaft
• With 3 parallel cylindrical structures
• Two corpora cavernosa (dorsolateral)
• One corpus spongiosum (ventral)
• with urethra
• Glans
• Enlarged distal portion of the corpus spongiosum
• Tip of the glans: external urethral orifice
• Foreskin
• Protective skin of the penis
Functions
• Urination
• The male copulatory organ
• Erection
• Enlargement and stiffening of the penis by blood filling of
corpora cavernosa, corpus spongiosum and glans
• Mediated by parasympathetic nervous system
• Facilitate ejaculation
• Propulsion of semen from the male ductal system
• Mediated by sympathetic nervous system

Scrotum
Structure
• A pouch of skin inferior to the base of the penis
• With right and left compartments
• With spermatic cord
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 • Nerves + blood vessels + lymphatic vessels + cremaster muscle + vas
deferens
Functions
• Holds the testes outside the body
• Maintain a lower temperature for sperm production (34℃)
• Exposure to cold condition
• Cremaster muscle contracts, bringing the testes closer to the body
• Exposure to warm condition
• Cremaster muscle relaxes, hanging the testes lower

Testes/Testicles
• The male gonad covered by tunica albuginea
• Components
• Spermatogonia
• Reproductive stem cells producing sperms
• seminiferous tubules
• Production of sperms from spermatogonia
• Interstitial cells
• Leydig cells producing androgen (mainly testosterone)
• Sertoli cells
• Nourish the maturing sperms and assist the maturation
process of sperms
Functions
1. Sperm production (spermatogenesis)
2. Androgen production and secretion

Sperms
Structure
• Head
• With a nucleus for DNA storage (23 chromosomes)
• No cytoplasm to store nutrients
• Anterior half is covered by acrosome
• Acrosome reaction (enzymatic reaction) to break down
the outer membrane of the ovum
• Midpiece
• With mitochondria for energy production (fructose and citrate
from semen)
• Tail
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 • With long flagella that provide a whip-like movement to propel
the sperm (sperm is motile)
• Produced by spermatogenesis in seminiferous tubules
• Chromosomes exit in pairs, one from each parent
• Sperms contain 23 chromosomes including 1 sex chromosome (X or Y)
• Spermatid differentiates into sperms through spermiogenesis with the help of
Sertoli cells
• Sperm leaving testes do not have the ability to move and carry out
acrosome reaction
• Maturation of sperms to gain the ability to move occur in epididymis
• Maturation of sperms to gain the ability of acrosome reaction only
after ejaculation when the sperm enter the female reproductive tract

Hormonal production and secretion

Secretion route:
• Hypothalamus secretes gonadotropins releasing hormone (GnRH)
• In response to GnRH, anterior pituitary secretes gonadotropins (Gn)
• Gn includes:
• Follicle-stimulating hormone (FSH)
• Essential for sperm production
• Acts on Sertoli cells, stimulating the production
of sperm survival factors
• Luteinizing hormone (LH)
• Binds to Leydig cells
• Stimulate androgen (mainly testosterone)
secretion
Inhibition route:
• FSH and LH inhibit GnRH secretion (Negative feedback)
• Secretion of inhibin by ovaries/testes

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Androgen mainly testosterone
• Develops male primary sexual characteristics
• Stimulates the growth and differentiation of foetal internal and
external reproductive organs
• Secretion level sharply increases during puberty
• Develops male secondary sexual characteristics, such as:
• Growth of penis and testes
• Growth of genital and axillary hairs
• Presence of mature sperms in semen
• Lengthen of bones and increase in muscle mass
• Voice deepens

Accessory glands
Contribute to semen production:
1. Seminal vesicles (~65-75% semen production)
• Paired glands posterior to the urinary bladder
• Secrete alkaline vesicular fluid with fructose, vitamin C, semenogelin,
etc.
• For neutralization of acidic environment, sperm nourishment and
semen coagulation
2. Prostate gland (~25-30% semen production)
• Circles the proximal urethra distal to the neck of the bladder
• Secretes fluid with citric acid, zinc, prostate-specific antigen (PSA), etc.
• PSA cleaves semenogelin and liquefy semen
• Zinc stabilize the DNA content
• For sperm nourishment and stabilization and liquefy semen
3. Bulbourethral glands (<1% semen production)
• Pea-sized glands, one on each side of the membranous urethra
• Secrete mainly alkaline mucus
• Neutralizes any remaining urine (acidic) in the urethra
• Provides lubrication of the urethra for smooth flow of semen
• Provides lubrication to facilitate vaginal penetration

Semen
• Sperms (with epididymis secretion) + accessory glands secretions
• Milky, slightly alkaline fluid serves as a liquid transport and nutrient medium
for sperm
• After ejaculation, semen coagulates into gel
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 • ensure most of the semen stay close to the cervix of female
reproductive tract
• The final stage of the sperm to mature and gain to ability to fertilize an
egg
• 20 mins after ejaculation, semen liquefies and freeing sperm

Ductal system carrying sperms

• Route of sperm movement through the ductal system
• Testes
• Epididymis
• Vas deferens
• Urethra

1. Testes
• Production of immature sperms
2. Epididymis
• Narrow tubular structure, with ~6 m in length
• Coiled on the posterior aspect of testis, with cilia that sweep sperms
• Sperms gains the ability to swim, remain in epididymis until
ejaculation
• Functions
• for sperm maturation and temporary storage until ejaculation
3. Vas deferens
• A muscular tube, ~3 mm in diameter, ~45 cm in length
• Joined by seminal vesicle, forming the ejaculatory duct, and then
penetrates the prostate
• Functions to receive sperms from the epididymis
4. Urethra
• The terminal male duct, carries urine / semen to outside
• Originated from the internal urethral orifice in the urinary bladder
• Ends at the external urethral orifice on the tip of the penis
• Three parts
• Prostatic urethra
• Received the ejaculatory duct
• Membranous urethra:
• Embedded in the skeletal muscles of the external
urethral sphincter
• Spongy urethra
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 • Embedded in the spongy tissue of the penis

Female reproductive system

Female Genital organs
External genital organ (Vulva)
• Mons pubis
• Clitoris
• Labia majora
• Labia minora
Internal genital organs
• Vagina
• Uterus
• Uterine tubes
• Ovaries

External female genital organ (Vulva)

• Mons pubis
• Fatty mound of tissue covering the pubic bone
• Labia majora
• A soft and rounded folds of skin
• Homologues of the male scrotum
• Labia minora
• Folds of moist mucosa immediately medial and deep to the labia
majora
• With the opening of the vagina
• As flaps-like structure to keep microbes out and moisture in
and allow for penile insertion
• Vestibular glands at the opening of the vagina
• Homologues of the male bulbourethral glands
• Secrete mucus during sexual arousal, facilitate penile
insertion
• With external urethral orifice
• immediately posterior to the clitoris
• Clitoris
• Homologues of the male penis
• A collection of highly sensitive erectile tissue
• anterior of labia minora

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Internal female genital organs
• Organs includes
• Vagina
• Uterus
• Uterine tubes
• Ovaries
• General functions
• Production of ovum
• Production and secretion of hormones
• Site where sperm fertilizes ovum
• Site for embryo and foetal development
• Deliver the foetus

Vagina
Structure
• Muscular tube (~8-10 cm) located between the bladder and the rectum
• Three layers
• Outer loose fibrous layer
• Middle smooth muscle layer
• Inner mucosa layer
• Release glycogen, allowing vaginal bacteria convert into lactic
acid
Functions
• Accepts penis during intercourse and holds sperms after ejaculation
• As a passageway of menstrual flow and foetal birth
• Acidic: protection against microbes infection

Uterus
• A hollow, thick-walled organ in the midline of the pelvis, anterior to the
rectum, posterosuperior to the bladder
Structure
• Body
• The broad superior part of uterus
• Cervix
• The narrow inferior end of uterus
• The central canal of cervix opens into the superior end of the vagina
through cervical os (small opening)
• Plugged with mucus to prevent entry of vaginal bacteria into
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 uterus
• Endometrial cavity
• Hollow interior cavity of uterus
• Connects below to the cervical canal and above to the oviducts
• Endometrium
• Lining of the uterus
• For implantation if pregnant
• Shed monthly by menstruation
• Myometrium
• 3 layers of smooth muscle
• Muscular contractions
• Intensive for childbirth
• Mild to expel menstrual flow
Functions
• Site for implantation and foetus growth
• If no implantation occur, endometrium shed and become menstrual
flow

Uterine tubes
• Fallopian tubes/ Oviducts
• begins from the superior, lateral edges of the uterus and ends very close to
the ovaries
Structures
• Four parts
1. Isthmus
2. Ampulla
3. Infundibulum
4. Fimbriae
• Capture the ovum as soon as it is released
• With smooth muscle layer, lined with ciliated and nonciliated cells
1. Rhythmic contractions of smooth muscle and the beating of cilia move
the ovum along the tube towards the uterus
2. Nonciliated cells secrete fluid to nourish and moisten ovum/sperm
Functions
• Fertilization occurs in the ampulla of the uterine tube
• Facilitate ovum (fertilized or not) movement
• Nourish and moisten ovum and sperms

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Ovaries
Structure
• Medulla
• With connective tissues, blood vessels and nerves
• Cortex
• Contains follicles
Functions
• Production of hormones
• oestrogen (follicular cells and corpus luteum)
• Progesterone (corpus luteum)
• Androgen
• Production and maturation of ovum

Female reproductive cycle (~28 days)

• Reproductive years: between puberty and menopause
• Marked from the 1st day of menstruation
• Ovarian cycle
• Preovulatory (follicular) phase
• Ovulation (usually on day 14)
• Postovulatory (luteal) phase
• Uterine cycle
• Menstrual phase
• Proliferative phase
• Secretory phase
• With the release of an ovum from the ovary (ovulation) and growth of
endometrium of the uterus for implantation

Hormonal influence on reproductive cycle

Secretion route:
• Hypothalamus secretes gonadotropins releasing hormone (GnRH)
• In response to GnRH, anterior pituitary secretes gonadotropins (Gn)
• Gn includes:
• Follicle-stimulating hormone (FSH)
• Stimulate follicular development
• Luteinizing hormone (LH)
• Stimulate development of secondary oocyte and
ovulation
Sites of secretion:
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 • Follicular cells secretes oestrogen
• Corpus luteum secretes oestrogen and progesterone
• Ovaries secretes androgen
Control of secretion:
• Oestrogen + progesterone à inhibit GnRH, LH and FSH
• Large amount of oestrogen à stimulate GnRH and LH secretion

Roles of hormones
Oestrogen
• Stimulate the growth of follicles
• Stimulate endometrium thickening (proliferation)
• Primary sexual characteristics of female
• Maturation and maintenance of uterus, uterine tubes and vagina
• Secondary sexual characteristics of female
• Breast development at puberty and maturation during pregnancy
• Female fat deposition
• Maintenance of health of various organs
• Bone, cardiovascular system, immune system, mental health, etc.
Progesterone
• Supports pregnancy
• Maintains endometrium and promotes endometrial glands growth
Androgen
• Small amount secretion from ovaries and adrenal glands
• Female sex drive
• Growth of body hair

Ovum
• Process of mature female gametes production: oogenesis
• Site of oogenesis: ovaries
• Mostly (90-95%), only one ovum developed in each reproductive cycles
• Follicle
• Follicular cells
• Protect and nourish the oocyte
• Produce oestrogen
• Developing oocyte
• Developed into ovum
• Structure of an ovum
• Formed after ovulation
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 • Ovum surrounded by
• Zona pellucida (jelly coat)
• Corona radiata (follicular cells)

Ovarian cycle
Preovulatory phrase (~Day 1 to 14)
Day 1:
• Anterior pituitary secretes significant amounts of FSH and LH
Day 2 to 11:
• FSH and LH stimulate follicular development (primary follicle to mature
follicle) and oocyte development (primary oocyte to secondary oocyte)
• Follicular cells secrete more oestrogen
• Positive feedback mechanism: more follicular cells secrete more oestrogen
and stimulate the further proliferation of follicular cells
Day 11 to 14 (36 hours before ovulation):
• oestrogen level is so high that stimulate LH secretionà LH surge

Ovulation (~ Day 14)

Day 14:
• When LH secretion reaches the highest level
• Rupture of the mature follicle and ovarian wall
• Release the secondary oocyte surrounded by corona radiata
• The ruptured follicle converts into corpus luteum
• With the rupture of follicle, oestrogen level sharply decrease

Postovulatory phrase (~Day 15 to 28)

Day 15 to 28:
• Corpus luteum secretes both oestrogen and progesterone
• Inhibit GnRH à inhibit FSH an LH production
• Prevent development of other follicles
• Promote endometrium growth and prepare for pregnancy
• If no fertilization occurs (after ~10 days)
• Corpus luteum turn to corpus albicans
• oestrogen and progesterone levels fall
• No inhibition of GnRH à FSH and LH levels increase
• Back to day 1
Result:
• Production and release of ovum
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 • Production of hormone-secreting corpus luteum

Uterine cycle
Menstrual phase (Menstruation)
Day 1 to 5:
• Reduction of oestrogen and progesterone level (due to corpus luteum
degeneration)
• Constriction of the endometrial blood vessels and death of the endometrium
• Menstrual bleeding (a mixture of blood and dead tissue)

Proliferative phase
Day 6 to 14:
• Proliferation (thickening) of endometrium under the influence of rising
oestrogen secreted from the follicle
• Proliferation of blood vessels
• Thinning of cervical mucus, facilitate sperm passage

Secretory phase
Day 15 to 28:
• Corpus luteum secretes oestrogen and progesterone
• Endometrial glands grow into wide and convoluted tubes, secreting glycogen-
rich fluid
• In preparation for the implantation of the fertilized egg
• If there is no pregnancy, menstruation starts, and the next cycle begins

Menopause
• Normal, age-related cessation of ovulation and hence menstruation
• Occurs at ~50 years of age
• Follicles no longer responsive to FSH and LH stimulation
• No follicles growth, oestrogen level falls
“symptoms”:
• Hot flashes, sweating, depression, fatigue
• Decline of sexual drive
• Vaginal dryness and atrophy
• Increase the risk of developing osteoporosis and cardiovascular diseases

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Pregnancy
Union of an ovum and a sperm
Timing:
• Survival period of an oocyte: ~24 hours after ovulation
• Survival period of a sperm: ~5 days in the female reproductive tract
Sperms movement (whip like movement of their tails):
• Most of them deposited into the deepest portion of the vagina adjacent to
cervix
• Less than ~1% can pass through the cervical os into the uterus
Ovum movement (immotile, by the action of the uterine tube only):
• The fimbriae bind to the corona radiata of the ovum
• Sweep the ovum into the uterine tube
• Propel the ovum within the uterine tube by cilia

Fertilization
Site of fertilization: usually ampulla
• Sperms completed the maturation process once they enter the female
reproductive tract and move towards the uterine tubes
• Sperm burrows through the corona radiata
• Sperm penetrates the zona pellucida (a glycoprotein capsule protects the
ovum) by acrosome reaction
• Head of a sperm with acrosome, contains digestive enzymes to digest
the zona pellucida
• when the proteins in the head of a single sperm bind to the receptors on the
oocyte
• Completion of meiosis by the secondary oocyte
• Trigger fusion of the sperm and ovum cell membranes
• forming barrier that prevent the entry of other sperms (only one
sperm can fertilized an egg)
• Nuclei of the sperm and ovum fuse together to form a zygote

Implantation
• Zygote divides and differentiates into blastocyst
• the outer layer with trophoblasts
• the inner cell mass
• a hollow cavity
• Blastocyst is swept into the endometrial cavity
• Trophoblast cells adhere and invade into the the endometrium and burrowed
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 the blastocyst into the endometrium (implantation)
• Trophoblast cells continue to grow, together with the endometrium layer,
forming the placenta
• Secrete human chorionic gonadotropin (hCG) à stimulates the corpus
luteum to continue the secretion of oestrogen and progesterone
• Placenta is a highly vascular tissue to support foetus growth

Embryonic period
Inner cell mass divides and differentiates into
• Yolk sac
• Initial site of blood cell production
• Disappeared after embryonic organs formation ( ~ week 9)
• Embryonic cells
• All the tissue and organs of the embryo
• Amnion
• Amniotic membrane: A semitransparent membrane completely
surrounds the fetus
• With an amniotic cavity filled with amniotic fluid
• Provides room for movement and growth and cushions the foetus

Placenta and umbilical cord

• Placenta
• Contains both maternal and foetal tissue
• Well-established by about 5 weeks of gestation
• Blood travels between the placenta and the foetus via the umbilical cord
(with 2 arteries and 1 vein)
• Umbilical artery: carries oxygen-deficient blood from the foetus to the
placenta
• Umbilical vein: carries oxygen-rich blood from the placenta to the
foetus
• Keep maternal and foetal blood from mixing but allowing substances
exchange among mother and foetus
• Enables the transfer of oxygen and nutrients from the mother to the
foetus
• Enables the transfer of wastes from the foetus to the mother
• Enables the transfer of antibodies from maternal blood to foetal blood
(IgG)

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Placenta as endocrine organ
• An endocrine organ secreting hormones such as:
• Human chorionic gonadotropin (hCG): maintains corpus luteum,
stimulates the synthesis of oestrogen and progesterone
• When fully developed, the placenta replaces corpus luteum and
secretes oestrogen and progesterone
• Human chorionic thyrotropin: stimulates thyroid hormone synthesis
• Relaxin: increases joint laxity, especially in pubic symphysis

Pregnancy stages: Trimesters

First trimester (1st three months):
• Complex development occurs
• Folate is essential for nervous system development
• Vulnerable to viruses, alcohol, drugs etc..
Second trimester:
• A period of rapid growth and maturation
Third trimester (the last three months):
• Organs’ maturation completes

Parturition
• Process of giving birth (~38-42 weeks of gestation)
Three stages:
• Cervical dilation: to diameter ~10cm
• Permits the passage of the foetus
• Expulsion of the foetus
• with the regular and strong contraction of the myometrium plus
maternal pushing
• Expulsion of the placenta
• placenta separates from the endometrium and expelled through the
vagina
Initiation:
• Uterus becomes more sensitive to oxytocin due to the accumulation of
oxytocin receptors
Oxytocin-induced positive feedback loop occurs:
1. Oxytocin stimulates uterine contraction
2. Head of the foetus is pushed against the cervix
3. Signal is sent to the hypothalamus for more oxytocin production
4. More uterine contraction and further production of oxytocin
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 5. Uterine contraction until delivery of baby

Breasts
• With a central pigmented circular area: areola
• Within the areola is a central projection: nipple
• Composed of fat and fibrous tissue and rich in lymphatic network
• Composed of mammary glands
• A modified sweat gland that produce milk
• Small and inactive in non-pregnant female but enlarge during
pregnancy (oestrogen)
• Connect to the nipple by lactiferous ducts and milk is stored in
lactiferous sinuses
Lactation
• Secretion of milk to nourish infant
• Colostrum (immediate after birth)
• Milk-like secretion rich in antibodies, proteins, carbohydrates and low
in difficult-to-digest fat
• Mature milk (3-4 days after birth)
• Contain lactalbumin à easy to digest protein
• Rich in cholesterol and omega-3-fatty acids à support neurological
development
• Contain antibodies à boost up the infant’s immune system
• Changes the composition to meet the needs of the infant as it grows
• With watery foremilk and creamy hindmilk

Regulation of milk production

By hormones:
• oestrogen and progesterone: stimulate fibrous tissue and fat growth after
puberty à prepare the breast for lactation
• Prolactin: produced by the anterior pituitary gland, stimulates mammary
gland to produce milk. [prolactin can suppress GnRH production]
• Oxytocin: produced by the hypothalamus (stored in posterior pituitary gland),
stimulates contraction of cells around the glands and ducts à stimulates milk
ejection.
By stimulation:
• Mental: seeing the baby
• Physical: baby suckling
• Stimulate the secretion of prolactin and oxytocin à increase milk production
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 and secretion à enhance suckling à more milk production
• (positive feedback mechanism)

Contraception
Prevent conception/ implantation of the fertilized egg
• Coitus interruptus and rhythm method (unreliable!)
• Spermicidal drugs: introduce to the vagina to kill sperms
• Male condoms: also for reducing sexually transmissible diseases (STD)
• Vasectomy: cutting out a section of vas deferens, tying off the ends.
• Cervical cap: blocks the sperms from entering the cervical canal

Prevent conception/ implantation of the fertilized egg

• Tubal ligation: a portion of each uterine tube is removed
• “the pill”: oral tablets with a mixture of oestrogen and progesterone
• Morning-after pills: oral tablets with HIGH concentration of oestrogen and
progesterone
• Intrauterine devices (IUD): insert into the endometrial cavity to prevent the
implantation of the fertilized egg

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