PAPER 1 - PART B

Embryology - Ovarian cycle

References
BD Chaurasia's Dream Human Embryology, 2nd Edition
Inderbir Singh’s Human Embryology. 11th edition

For first year BAMS students 2020-2021 batch

For internal circulation only

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Ovulation
The shedding of the ovum from the cortex of the ovary in to the
peritoneal cavity is called ovulation. It usually occurs 14 days after the
onset of menstruation. In a norml 28 days cycle. Prior to ovulation ,
LH and FSH increase . The layer of stroma and theca on this side of
the grafian follicle become very thin and an avascular area (stigma)
appears over the most convex point of the follicle. The stigma is nipple
shaped and is formed due to the rapid swelling of the follicle. The
theca externa releases proteolytic enzymes that dissolve the follicular
wall. The stihma ruptures and fluid along with secondary oocyte ooze
out in to the peritoneal cavity. The released ovum enters into the
fallopian tube through its fimbriated end. When one sperm penetrates
the secondary oocyte, meiosis II of secondary oocyte initiates.

Ovarian Cycle
Ovarian Cycle is the cyclical change taking place in the ovaries during
28 day reproductive cycle iin which ovulation occurs during the
middle of the cycle under the influence of anterior pituitary
gonadotrophic hormones [follicle stimulating hormone (FSH) and
luteinizing hormones (LH)]. It has three faces namely; pre-ovulatory,
ovulatory and postovulatory phases.

1. Preovulatory phase
In a 28-day reproductive cycle this extends from the 5 th to 14th day,
after menstruation. This phase lasts for 8–10 days and may vary from
10–25 days depending on the length of reproductive cycle. During this

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phase 10–15 primordial follicles start maturation process and the
process is known as folliculogenesis. FSH and LH control the growth
of follicles . Only one follicle matures fully while others undergo
degeneration.

The various types of follicles that are formed during folliculogenesis

are primordial, primary, secondary,vesicular, tertiary and Graafian
follicle.

The oogonia are surrounded by stromal cells. Some cells of the stroma
become flattened and surround a primary oocyte. These flattened cells
ultimately form the ovarian follicle and are, therefore, called follicular
cells.

primordial follicle

Each primary oocyte covered by single layer offlattened follicular cells

is known as primordial follicle. The primordial follicles are the basic
reproductive units at puberty

The division of primary oocyte is arrested until puberty by oocyte

maturation inhibition (OMI) factor produced by the follicular cells that
surround the oocyte.

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The oocyte resumes and completes its first meiotic division, when it
starts maturing after puberty, and is preparing for ovulation.

Several primordial follicles (10–50 numbers) start maturing in each

month, to be converted to primary follicles. Each primary follicle
consists of primary oocyte surrounded by a layer of cuboidal or low
columnar follicular cells

Primary follicle

The growing primary follicle forms a homogenous layer of

glycoprotein in between follicular cells and primary oocyte known as
zona pellucida.

The follicular cells undergo mitotic division and form several layers of
follicular cells surrounding the primary oocyte forminga multi-layered
stratum granulosum. The primary oocyte increases in size up to 40
microns. Its nucleus is large and vesicular. The follicular cells are now
called as granulosa cells. At this stage the follicl,e is called secondary
follicle.

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 Secondary follicle

Fluid-filled spaces appear between granulosa cells, and such follicle is

known as preantral follicle. The fluid is secreted by granulosa cells.

With the growth of the follicle, fluid-filled spaces between granulosa

cells coalesce and form a bigger cavity known as follicular antrum.
The cavity enlarges in size and pushes the primary oocyte with
surrounding granulose cells. This follicle is known as tertiary follicle

Tertiary follicle

The follicle increases due to the proliferation of granulose cells. The

tertiary follicles increases in size in response to FSH and LH and
forms the largest mature follicle and is known as Graafian follicle.

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Remaining follicles degenerate. A fully mature Graafian follicle is
about 3–5 mm in size. It reaches the periphery of the cortex and starts
projecting on to the surface of the ovary. The follicular antrum ( cavity
) is filled with fluid, pushing the primary oocyte with a layer of
covering cells to one side of the follicle. The layer of cells
immediately surrounding the oocyte and zona pellucida are called
corona radiate cells. The projection of granulosa cells covering the
primary oocyte projecting into the follicular antrum is called cumulus
oophorous. The area of attachment of primary oocyte and corona
radiata to the wall of follicle is called discus proligerous.

Graafian follicle.

As the follicle expands, the stromal cells surrounding the membrana

granulosa become condensed to form a covering called the theca
interna (theca = cover). Theca interna increases in thickness and
becomes more vascular. The cells of the theca interna later secrete a
hormone called estrogen. They are then called the cells of the thecal
gland. Outside the theca interna some fibrous tissue becomes
condensed to form another covering for the follicle called the theca

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externa. The ovarian follicle is now fully formed. The follicle
gradually increases in size and finally bursts and expels the ovum. This
process of shedding of the ovum is called ovulation.

Just before ovulation the primary oocyte of mature Graafian follicle

completes first meiotic division and forms secondary oocyte and first
polar body.

Ovulatory Phase
The diploid (46 chromosomes) primary oocyte in the mature Graafian
follicle completes its meiosis I, forming two cells of unequal size each
with haploid number of chromosomes (23). The smaller cell is called
first polar body. The larger cell is called secondary oocyte and at this
stage the meiosis. II begins but it is stopped in metaphase II. At this
stage the mature follicle ruptures and releases the secondary oocyte. At
ovulation the secondary oocyte is released from the surface of the
ovary into the pelvic cavity together with first polar body and corona
radiata cells. When sperm penetrates the secondary oocyte meiosis II
of secondary oocyte takes place

Postovulatory phase

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If fertilization takes place at the ampullary region of fallopian tube, the
fertilized ovum begins to develop into an embryo and If the ovum
(secondary oocyte) is not fertilized it dies in 12–24 hours and passes
through the uterus into the vagina and is discharged.

Formation of corpus luteum

After-shedding of the ovum the corpus luteum is formed by
enlargement and transformation of follicular cells. The wall of the
Graafian follicle collapses and becomes folded. At this stage, the
follicular cells are small and rounded. They now rapidly enlarge in size
and acquire a polyhedral shape. Their cytoplasm becomes filled with a
yellow pigment called lutein. They are now called luteal cells. The

presence of this yellow pigment gives the structure a yellow color and
that is why it is called the corpus luteum (= yellow body). The corpus
luteum secretes progesterone which is essential for maintenance of
pregnancy.

If the ovum is not fertilized, the corpus luteum persists for about 14
days. During this period it secretes progesterone. It remains relatively
small and is called the corpus luteum of menstruation.

Formation of corpus albicans

At the end of its functional life, it degenerates and forms a mass of

fibrous tissue called the corpus albicans (= white body)

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If the ovum is fertilized and pregnancy results,the corpus luteum
persists for 3–4 months. This is larger than the corpus luteum of
menstruation, and is called the corpus luteum of pregnancy.

After the 4th month, the corpus luteum is no longer needed, as the
placenta begins to secrete progesterone. Degeneration of the corpus
luteum in the early months of pregnancy is prevented by human
chorionic gonadotropin (HCG) secreted by the trophoblast cells of the
developing embryo.

Hormonal levels in the process of ovulation

 Increased secretion of LH and FSH

 Ovulation cause due to LH surge at mid cycle.
 Onset of LH occurs 34- 36 hours before ovulation.
 Peak of LH surge occurs 12-24 hours before ovulation
 Ovulatory peak of FSH occurs 2 days prior to ovulation