Reproductive System

Pre-reading Material

Education and Proficiency Centre

Table of Contents
Overview ........................................................................................................................................................... 2
 Male Reproductive System .......................................................................................................................... 3
Male Reproductive Organs .............................................................................................................................. 3
Disease of the Male Reproductive System .................................................................................................. 5
 Female Reproductive System ...................................................................................................................... 6
Female Reproductive Organs .......................................................................................................................... 6
Diseases of the Female Reproductive System ............................................................................................. 7
 Pregnancy .................................................................................................................................................. 10
Pregnancy Hormones .................................................................................................................................... 10
High risk pregnancies..................................................................................................................................... 10
Postnatal Complications ................................................................................................................................ 11
 Common Procedures and Applicable Machines........................................................................................ 12
References:..................................................................................................................................................... 15

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 Overview
Human reproductive system, organ system by which humans reproduce and bear live offspring.
Provided all organs are present, normally constructed, and functioning properly, the essential features
of human reproduction are:
1. liberation of an ovum, or egg, at a specific time in the reproductive cycle,
2. internal fertilization of the ovum by spermatozoa, or sperm cells,
3. transport of the fertilized ovum to the uterus, or womb,
4. implantation of the blastocyst, the early embryo developed from the fertilized ovum, in the wall
of the uterus,
5. formation of a placenta and maintenance of the unborn child during the entire period
of gestation,
6. birth of the child and expulsion of the placenta,
7. suckling and care of the child, with an eventual return of the maternal organs to virtually their
original state.
These functions are divided between the primary reproductive organs and
the secondary (or accessory) reproductive organs. The primary reproductive organs are
called gonads. They include the ovaries and testes. These gonads are responsible for producing the
egg and sperm cells, known as gametes. They are also responsible for producing hormones that
function in the maturation of the reproductive system and the development of sexual characteristics.
The hormones also play important roles in regulating the normal physiology of the reproductive
system. All other organs, ducts, and glands in the reproductive system are considered secondary, or
accessory, reproductive organs. These structures transport and sustain the gametes and nurture the
developing offspring.

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 Male Reproductive System
The male reproductive system produces, sustains, and transports sperm; introduces the sperm into the
female vagina; and produces hormones. Figure 16-1 illustrates the organs of the male reproductive
system.

Male Reproductive Organs

The major endocrine glands include the pituitary, pineal, ovaries, testes, thyroid, hypothalamus and
adrenal glands, additionally other tissues such as the kidney and liver also display secondary adrenal
functions.

The Penis
The penis, the male organ of copulation, is partly inside and partly outside the body. The inner part,
attached to the bony margins of the pubic arch (that part of the pelvis directly in front and at the base
of the trunk), is called the root of the penis. The second, or outer, portion is free, pendulous, and
enveloped all over in skin; it is termed the body of the penis. The organ is composed chiefly of
cavernous or erectile tissue that becomes engorged with blood to produce considerable enlargement
and erection. The penis is traversed by a tube, the urethra, which serves as a passage both for urine and
for semen.

The Scrotum
The scrotum is a pouch of skin lying below the pubic symphysis and just in front of the upper parts
of the thighs. It contains the testes and lowest parts of the spermatic cord. A scrotal septum or
partition divides the pouch into two compartments and arises from a ridge, or raphe, visible on the
outside of the scrotum. The raphe turns forward onto the undersurface of the penis and is continued

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back onto the perineum (the area between the legs and as far back as the anus). This arrangement
indicates the bilateral origin of the scrotum from two genital swellings that lie one on each side of the
base of the phallus, the precursor of the penis or clitoris in the embryo. The swellings are also
referred to as the labioscrotal swellings, because in females they remain separate to form the labia
majora and in males they unite to form the scrotum.

The Testicles
The two testes, or testicles, which usually complete their descent into the scrotum from their point of
origin on the back wall of the abdomen in the seventh month after conception, are suspended in the
scrotum by the spermatic cords. Each testis is 4 to 5 cm (about 1.5 to 2 inches) long and is enclosed
in a fibrous sac, the tunica albuginea. This sac is lined internally by the tunica vasculosa, containing
a network of blood vessels, and is covered by the tunica vaginalis, which is a continuation of the
membrane that lines the abdomen and pelvis. The tunica albuginea has extensions into each testis
that act as partial partitions to divide the testis into approximately 250 compartments, or lobules.

The prostate gland, seminal vesicles, and bulbourethral glands

These structures provide secretions to form the bulk of the seminal fluid of an ejaculate. The prostate
gland is in the lesser or true pelvis, centered behind the lower part of the pubic arch. It lies in front of
the rectum. The prostate is shaped roughly like an inverted pyramid; its base is directed upward and
is immediately continuous with the neck of the urinary bladder. The urethra traverses its substance.
The two ejaculatory ducts enter the prostate near the upper border of its posterior surface. The
prostate is of a firm consistency, surrounded by a capsule of fibrous tissue and smooth muscle. It
measures about 4 cm across, 3 cm in height, and 2 cm front to back (about 1.6 by 1.2 by 0.8 inch)

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and consists of glandular tissue contained in a muscular framework. It is imperfectly divided into
three lobes. Two lobes at the side form the main mass and are continuous behind the urethra. In front
of the urethra they are connected by an isthmus of fibromuscular tissue devoid of glands. The third,
or median, lobe is smaller and variable in size and may lack glandular tissue. There are three
clinically significant concentric zones of prostatic glandular tissue about the urethra. A group of
short glands that are closest to the urethra and discharge mucus into its channel are subject to simple
enlargement. Outside these is a ring of submucosal glands (glands from which the mucosal glands
develop), and farther out is a large outer zone of long branched glands, composing the bulk of the
glandular tissue.

Disease of the Male Reproductive System

1. Hypospadias – literally “below the fleshy spike.” A condition in which the external urinary
meatus (opening) opens anywhere below the tip of the penis rather than at the tip.

2. Hydrocele – a fluid filled sac partially surrounding the testis. Manifests itself as a swelling on
the side of the scrotum. May cause discomfort. Can be surgically corrected. And, who would
most likely be doing the surgery? A urologist!

3. Varicocele – dilated and twisted veins of the testis, sort of “hemorrhoids” of the scrotum!
Manifests itself as a swelling on the side of the scrotum which may look and feel like a “bag
of worms.” May be surgically corrected if causing discomfort. This condition may also cause
reduced sperm count and male sterility due to sluggish blood flow elevating testicular
temperature.

4. Cryptorchidism – literally “hidden testicle.” A condition of lack of descent of one or both

testes into the scrotum. If not corrected, usually by surgery, before puberty, can lead to
sterility and increased risk of testicular cancer.

5. Benign prostatic hypertrophy (BPH) – swelling of the prostate gland which surrounds the
base of the male bladder and urethra causing difficulty urinating, dribbling, and nocturia. The
bane of old men! BPH becomes more common as men age.

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 Female Reproductive System

The human female reproductive system is a series of organs primarily located inside the body and
around the pelvic region. It contains three
main parts: the vagina, which leads from the
vulva, the vaginal opening, to the uterus; the
uterus, which holds the developing fetus; and
the ovaries, which produce the female’s ova.
The breasts are also a reproductive organ
during parenting, but are usually not
classified as part of the female reproductive
system. The vagina meets the outside at the
vulva, which also includes the labia, clitoris,
and urethra. During intercourse, this area is
lubricated by mucus secreted by the
Bartholin’s glands. The vagina is attached to the uterus through the cervix, while the uterus is
attached to the ovaries via the Fallopian tubes. At certain intervals, approximately every 28 days, the
ovaries release an ovum that passes through the Fallopian tube into the uterus.

If the ova is fertilized by sperm, it attaches to the endometrium and the fetus develops. In months
when fertilization does not occur, the lining of the uterus, called the endometrium, and unfertilized
ova are shed each cycle through a process known as menstruation.

Female Reproductive Organs

Bartholin's glands: These glands are located beside the vaginal opening and produce a fluid (mucus)
secretion.

Clitoris: The two labia minora meet at the clitoris, a small, sensitive protrusion that is comparable to
the penis in males. The clitoris is covered by a fold of skin, called the prepuce, which is similar to the
foreskin at the end of the penis. Like the penis, the clitoris is very sensitive to stimulation and can
become erect.

Vagina: The vagina is a canal that joins the cervix (the lower part of uterus) to the outside of the
body. It also is known as the birth canal.

Uterus (womb): The uterus is a hollow, pear-shaped organ that is the home to a developing fetus.
The uterus is divided into two parts: the cervix, which is the lower part that opens into the vagina,

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and the main body of the uterus, called the corpus. The corpus can easily expand to hold a
developing baby. A channel through the cervix allows sperm to enter and menstrual blood to exit.

Ovaries: The ovaries are small, oval-shaped glands that are located on either side of the uterus. The
ovaries produce eggs and hormones.

Fallopian tubes: These are narrow tubes that are attached to the upper part of the uterus and serve as
tunnels for the ova (egg cells) to travel from the ovaries to the uterus. Conception, the fertilization of
an egg by a sperm, normally occurs in the fallopian tubes. The fertilized egg then moves to the
uterus, where it implants into the lining of the uterine wall.

Diseases of the Female Reproductive System

1. Endometriosis
Endometriosis is a problem affecting a woman’s uterus—the place where a baby grows when a
woman is pregnant. Endometriosis is when the kind of tissue that normally lines the uterus grows
somewhere else. It can grow on the ovaries, behind the uterus, on the bowels, or on the bladder.
Rarely, it grows in other parts of the body.

This “misplaced” tissue can cause pain, infertility, and very heavy periods. The pain is usually in
the abdomen, lower back, or pelvic areas. Some women have no symptoms at all, and having
trouble getting pregnant may be the first sign they have endometriosis.

2. Uterine Fibroids
Uterine fibroids are the most common noncancerous tumors in women of childbearing age.
Fibroids are made of muscle cells and other tissues that grow in and around the wall of the
uterus, or womb. The cause of fibroids is unknown. Risk factors include being African-American
or being overweight. The symptoms of fibroids include

- Heavy or painful periods or bleeding between periods.

- Feeling “full” in the lower abdomen.

- Urinating often.

- Pain during sex.

- Lower back pain.

- Reproductive problems, such as infertility, multiple miscarriages, or early labor.

But some women will have no symptoms. That is why it is important to see your health care provider
for routine exams.

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 3. Gynecologic Cancer
Gynecologic cancer is any cancer that starts in a woman’s reproductive organs. Gynecologic cancers
begin in different places within a woman’s pelvis, which is the area below the stomach and in
between the hip bones.

- Cervical cancer begins in the cervix, which is the lower, narrow end of the
uterus.

- Ovarian cancer begins in the ovaries, which are located on each side of the
uterus.

- Uterine cancer begins in the uterus, the pear-shaped organ in a woman’s pelvis
where the baby grows when a woman is pregnant.

- Vaginal cancer begins in the vagina, which is the hollow, tube-like channel
between the bottom of the uterus and the outside of the body.

- Vulvar cancer begins in the vulva, the outer part of the female genital organs.

4. HIV/AIDS
HIV is the human immunodeficiency virus. HIV affects specific cells of the immune system (called
CD4 cells). Over time, HIV can destroy so many of these cells that the body can’t fight off infection
anymore. The human body cannot get rid of HIV—that means once a person has HIV, he or she has
it for life. There is no cure at this time, but with proper medical care, the virus can be controlled. HIV
is the virus that can lead to acquired immune deficiency syndrome, or AIDS. AIDS is the late stage
of HIV infection, when a person’s immune system is severely damaged.

HIV in Women
Women who are infected with HIV typically get it by having sex with a man who is infected or by
sharing needles with an infected person. Women of minority races/ethnicities are especially affected,
and black or African American women are the most affected group.

Pregnant Women
All pregnant women should know their HIV status. Pregnant women who are HIV-positive can work
with their health care providers to ensure their babies do not contract HIV during pregnancy,
delivery, or after delivery (through breast milk). It is possible for a mother to have HIV and not
spread it to her baby, especially if she knows about her HIV status early and works with her health
care provider to reduce the risk.

HIV and Breastfeeding

HIV can be spread through breast milk, so mothers in the US who have HIV should not breast-feed
their babies.

5. Interstitial Cystitis
Interstitial cystitis (IC) is a chronic bladder condition resulting in recurring discomfort or pain in the
bladder or surrounding pelvic region. People with IC usually have inflamed or irritated bladder walls

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that can cause scarring and stiffening of the bladder. IC can affect anyone; however, it is more
common in women than men. Some people have some or none of the following symptoms:

- Abdominal or pelvic mild discomfort.

- Frequent urination.

- A feeling of urgency to urinate.

- Feeling of abdominal or pelvic pressure.

- Tenderness.

- Intense pain in the bladder or pelvic region.

- Severe lower abdominal pain that intensifies as the urinary bladder fills or
empties.

6. Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome happens when a woman’s ovaries or adrenal glands produce more male
hormones than normal. One result is that cysts (fluid-filled sacs) develop on the ovaries. Women
who are obese are more likely to have PCOS. Women with PCOS are at increased risk of developing
diabetes and heart disease. Symptoms may include

- Infertility.

- Pelvic pain.

- Excess hair growth on the face, chest, stomach, thumbs, or toes.

- Baldness or thinning hair.

- Acne, oily skin, or dandruff.

- Patches of thickened dark brown or black skin.

7. Sexually Transmitted Diseases (STDs)

STDs are infections that you can get from having sex with someone who has the infection. The
causes of STDs are bacteria, parasites, and viruses. There are more than 20 types of STDs.
Most STDs affect both men and women, but in many cases the health problems they cause can be
more severe for women. If a pregnant woman has an STD, it can cause serious health problems for
the baby.

If you have an STD caused by bacteria or parasites, your health care provider can treat it with
antibiotics or other medicines. If you have an STD caused by a virus, there is no cure, but antiviral
medication can help control symptoms. Sometimes medicines can keep the disease under control.
Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of
catching or spreading STDs.

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 Pregnancy
Pregnancy occurs when a sperm fertilizes an egg after it’s released from the ovary during ovulation.
The fertilized egg then travels down into the uterus, where implantation occurs. A successful
implantation results in pregnancy.

On average, a full-term pregnancy lasts 40 weeks. There are many factors that can affect a
pregnancy. Women who receive an early pregnancy diagnosis and prenatal care are more likely to
experience a healthy pregnancy and give birth to a healthy baby.

Knowing what to expect during the full pregnancy term is important for monitoring both your health
and the health of the baby. If you’d like to prevent pregnancy, there are also effective forms of birth
control you should keep in mind.

Pregnancy Hormones

Human chorionic gonadotropin hormone (hCG).

This hormone is only made during pregnancy. It is made almost exclusively in the placenta. HCG
hormone levels found in the mother's blood and urine rise a lot during the first trimester. They may
play a part in the nausea and vomiting often linked to pregnancy.

Human placental lactogen (hPL).

This hormone is also known as human chorionic somatomammotropin. It is made by the placenta. It
gives nutrition to the fetus. It also stimulates milk glands in the breasts for breastfeeding.

Estrogen.

This group of hormones helps develop the female sexual traits. It is normally formed in the ovaries.
It is also made by the placenta during pregnancy to help maintain a healthy pregnancy.

Progesterone.

This hormone is made by the ovaries and by the placenta during pregnancy. It stimulates the
thickening of the uterine lining for implantation of a fertilized egg.

High risk pregnancies

A high-risk pregnancy is one that threatens the health or life of the mother or her fetus. It often
requires specialized care from specially trained providers.
Some pregnancies become high risk as they progress, while some women are at increased risk for
complications even before they get pregnant for a variety of reasons.
Early and regular prenatal care helps many women have healthy pregnancies and deliveries without
complications.

Existing health conditions, such as high blood pressure, diabetes, or being HIV-positive

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Overweight and obesity. Obesity increases the risk for high blood pressure, preeclampsia, gestational
diabetes, stillbirth, neural tube defects, and cesarean delivery. NICHD researchers have found that
obesity can raise infants' risk of heart problems at birth by 15%.

Multiple births. The risk of complications is higher in women carrying more than one fetus (twins
and higher-order multiples). Common complications include preeclampsia, premature labor, and
preterm birth. More than one-half of all twins and as many as 93% of triplets are born at less than 37
weeks' gestation.

Young or old maternal age. Pregnancy in teens and women age 35 or older increases the risk for
preeclampsia and gestational high blood pressure.

Postnatal Complications

Excessive bleeding (Postpartum hemorrhage)

While bleeding after giving birth is normal — and most women bleed for 2 to 6 weeks — some
women can experience excessive bleeding after childbirth.

Normal postpartum bleeding typically begins immediately after giving birth, whether delivery
happens vaginally or via cesarean section. It’s normal immediately post-birth to bleed heavily and
pass lots of red blood and clots.

- Blood loss >500cc within 24 hrs of delivery (vaginal delivery)

- Blood loss >1000cc within 24 hrs of delivery (Cesarean delivery)
- A change in postpartum hemoglobin concentration
- Blood loss requiring transfusion

Infection and sepsis.

Some women experience infections (uterine, urinary, wound, upper respiratory, and mastitis) after
birth. When caught early, an infection can be resolved with antibiotics. However, if an infection
advances and is left untreated, it can lead to sepsis, abscesses, pulmonary embolism, septic shock and
more.

Stroke.
Approximately 50% of strokes occur postpartum. The highest risk periods appear to be the delivery
period and up to two weeks postpartum, but the risk can continue up to six weeks postpartum.

Cardiomyopathy and heart disease.

Some postpartum women are at risk for peripartum cardiomyopathy, a rare type of heart failure that
weakens the heart muscle and makes it harder for the heart to pump blood to the rest of the body.
Some risk factors include hypertension, obesity, diabetes, malnutrition, smoking and advanced
maternal age.

Pulmonary embolism.
This is a blockage in one of the pulmonary arteries in the lungs often caused by blood clots that
travel to the lungs from the legs. Some risk factors include obesity, C-section birth, prolonged labor,
hypertension, dehydration, and advanced maternal age.

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Depression and anxiety.
Perinatal mood and anxiety disorders (PMADs) affect up to 1 in 5 women during pregnancy and
after giving birth. While symptoms usually resolve within a week or two after delivery, sometimes
symptoms continue and worsen

Common Procedures and Applicable Machines

Cardiotocograph (CTG) or Fetal monitor

CTG is most commonly carried out externally. This means that the
equipment used to monitor the baby's heart is placed on the tummy
(abdomen) of the mother. An elastic belt is placed around the mother's
abdomen. It has two round plates about the size of a tennis ball which
make contact with the skin. One of these plates measures the baby's
heart rate. The other assesses the pressure on the tummy. In this way it
is able to show when each contraction happens and an estimate of how
strong it is.

Neonatal incubator

Infant incubators provide thermal support for the neonate. Most

incubators also incorporate means for controlling oxygen levels and
relative humidity of the air the infant breathes. Microprocessors
incorporated in most modern incubators assist in the accurate
control of temperature, humidity, and oxygen levels while enabling
such features as graphical data trending of the critical parameters
controlled by the incubator. An incubator PM program should take
into account the manufacturer's recommendations and should
include measurement of sound levels, operating temperatures of
humidifiers, and oxygen sensors. Servo-controlled oxygen and
humidity delivery systems typically require unique calibrations to
be performed during PM. In addition to calibration, humidifiers require periodic replacement of the
air-intake filter.

Inadequate maintenance can result in incubators that are hazardous to the infant. Incubators are used
for many years, during which time they are subjected to appreciable shock and vibration because
most are mounted on casters and are moved about for cleaning and storage. In the past, mechanical
stress has damaged temperature control mechanisms, which, in turn, have overheated infants, causing
brain damage or death. Old incubators that have been relegated to storage can be placed back into
service during a high census period. These semiretired incubators might lack necessary safety
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features and manufacturer-recommended upgrades or modifications and can pose serious risks to
neonates. For example, on some older models, a missing heat shield can permit an infant to crawl
over a hot air vent and thus suffer severe burns. Lack of maintenance results in the use of incubators
with high ambient-noise levels originating from defective or misaligned air-circulating fans, which
can cause hearing loss. Defective door latches can enable an infant to crawl out of an incubator and
fall to the floor. Older incubators used mercury-based temperature sensors, which often broke, thus
exposing the infant to hazardous mercury vapors. It was not uncommon to observe a pool of mercury
from broken thermometers and mercury switches on the floor of the heating compartment directly
beneath the infant mattress.

Fetal Doppler
A Doppler fetal monitor is a hand-held ultrasound
transducer used to detect the fetal heartbeat for prenatal
care. It uses the Doppler effect to provide an audible
simulation of the heartbeat. Some models also display the
heart rate in beats per minute (BPM).

Ultrasound Machine

Obstetric and gynecologic studies can be performed with a basic portable ultrasound system to
evaluate and visualize the fetus, uterus, ovaries and surrounding tissues. Pelvic ultrasound is
performed routinely during pregnancy examinations to determine causes of infertility, pelvic pain or
abnormal vaginal bleeding.

Women with uncomplicated pregnancies are

generally referred for an ultrasound during
pregnancy for routine assessment of
gestational age, fetal size and growth using a
real-time ultrasound scanner. High-risk or
complicated pregnancies will require higher-
end portable ultrasound units with Color
Doppler, detailed resolution and more
imaging enhancement features. Many defects
and complications of the fetal anatomy can be identified using ultrasound during the pregnancy.

For gynecological sonography, an abdominal sonogram is performed with a full bladder. If the pelvic
ultrasound shows any pathology, or does not provide a clear image of the organs, a transvaginal
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ultrasound is performed to better visualize the uterus and ovaries. In general, ultrasound can detect
inflammation, free fluid, cysts, and tumors in the pelvic region.

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Boundless. (n.d.). Boundless Anatomy and Physiology. Lumen.

https://courses.lumenlearning.com/boundless-ap/chapter/overview-of-the-reproductive-
system/.

Centers for Disease Control and Prevention. (2018, April 27). Common Reproductive Health
Concerns for Women. Centers for Disease Control and Prevention.
https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html.

DeFrancesco, V. (2004). Neonatal Incubator. Neonatal Incubator - an overview | Science Direct

Topics. https://www.sciencedirect.com/topics/nursing-and-health-professions/neonatal-
incubator.

Encyclopedia Britannica, inc. (n.d.). The uterus. Encyclopedia Britannica.

https://www.britannica.com/science/human-reproductive-system/The-uterus.

Harding, M. (2016, August 31). Cardiotocography. Patient.info.

https://patient.info/pregnancy/cardiotocography.

Hormones During Pregnancy. Johns Hopkins Medicine. (n.d.).

https://www.hopkinsmedicine.org/health/conditions-and-diseases/staying-healthy-during-
pregnancy/hormones-during-pregnancy.

Johnson, T. C. (2020, December 4). Female Reproductive System: Organs, Function, and More.
WebMD. https://www.webmd.com/sex-relationships/guide/your-guide-female-reproductive-
system.

Kumar, P., & Magon, N. (2012, October). Hormones in pregnancy. Nigerian medical journal: journal
of the Nigeria Medical Association. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3640235/.

Zimmermann, K. A. (2018, March 22). Reproductive System: Facts, Functions & Diseases.
LiveScience. https://www.livescience.com/26741-reproductive-system.html.

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