SUMMARY NOTES IN

EMBRYOLOGY
VOLUME ONE

COMPILED BY

Ogunmodede O.S.
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 SECTION A
INTRODUCTION

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What is General Embryology?
Human Embryology is one of the key subjects in Anatomy
and it deals with the study of the developmental events
associated with human development. General embryology
therefore, concentrates on those basic developmental
processes occurring prior to fertilization, during
fertilization and after fertilization –the gestation period.
The gestation period is otherwise the period from
fertilization to parturition. Clinically the period is classified
into three trimesters; each spanning a period of three
months i.e. First, Second and Third trimesters.
Also, the gestation period is subdivided into two
developmental periods i.e. embryonic period which last for
the first 8 weeks and the fetal period which spans from
the 9th week to the day of birth. Each of these periods has
its peculiarities.
NOTE (NB):
The embryonic period is considered as the period whereby
the developing embryo is more vulnerable to teratogens,
which are toxic substances that can cause abnormal
development otherwise referred to as congenital
anomalies or abnormalities.
The vulnerability to teratogens is hinged on the fact that
during the embryonic period, the basic body plan is laid
down following series of cellular migration, interactions,
and reorientations –a characteristic feature of the
embryonic embryo. In addition, this period is unique for
the development of primordial structures, from which
several body structures are derived (organogenesis).
On the contrary, the fetal period is less vulnerable to
teratogenic insults. However, it is marked with structural
differentiation and maturations.
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What are the associated control systems?
Usually the events associated with human development
are principally under endocrine and neural control
systems. The genetic make-up of the gametes also plays
an important role as regards the final reproductive
outcome.
The hypothalamus serves as the higher center control
station for the associated endocrine glands. It releases the
gonadotropic releasing hormone (GnRH) which in turn,
influences the pituitary gland to release these hormones –
Follicle Stimulating Hormone (FSH) and Luteinizing
Hormone (LH).
FSH is the hormone mainly responsible for follicular cell
proliferation with the LH playing a relatively minor role.
However, LH at its peak range triggers the events that lead
to the release of the ova (ovulation) from the ovary.
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It is important to note also that follicular cell proliferation
during oogenesis (development of the ova), is associated
with the release of another hormone by the proliferating
follicular cells now classified into two i.e. the theca externa
and theca interna cells. It is the theca interna cells that
release the hormone called oestrogen (estrogen), which
triggers proliferative changes in the uterine endometrium.
Other hormones associated with pregnancy include:
On the other hand, the remains of the proliferated
follicular cells after ovulation, becomes transformed into a
hormone secreting gland called the Corpus Luteum. It
secretes progesterone –a hormone that enhances the
endometrial changes induced by estrogen secretion.
Specifically, it controls the phase of the menstrual cycle
termed the luteal or secretary phase. It secretes estrogen
as well and reaches its peak by the 3rd to 4th week of
gestation.
NB
1. The corpus luteum continues to secret
progesterone if pregnancy occurs and as such,
maintains pregnancy up to the 20th week when the
placenta becomes fully developed and fully
functional. In this circumstance, the corpus luteum
is termed the corpus luteum of pregnancy.
Progesterone reaches its peak by the 6th week of
gestation
2. But if pregnancy does not occur, the corpus luteum
degenerates and progesterone secretion ceases. In
this circumstance, the corpus luteum is termed the
corpus luteum of menstruation.
3. Degenerated corpus luteums are transformed into
whitish scar-like structures called the corpus
albicans.
1. Inhibin -produced by the ovaries and inhibits FSH
production.
2. The Human chorionic gonadotropin (HCG) secreted
by the syncytiotrophoblast –a part of the
developing embryo called trophoblast. This
presence of this hormone in the blood or urine of a
pregnant woman forms the basis for pregnancy
test. HCG reaches its peak by the 9th week.
Functionally, HCG prevents immune attack on the
developing embryo from the mother. It also
maintains the endocrine functions of the corpus
luteum.
3. The Human chorionic somatomammotropin also
known as Placental Lactogen secreted by the
placenta. Its actions are similar to growth hormone
and it influences partial breast development;
decreases glucose level in mother and promotes the
release of fatty acids
4. Parathyroid hormone from the parathyroid gland. It
secretions increases to maintain higher Ca levels.
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 5. Aldosterone from the adrenal cortex. It secretion
increases to influence renal reabsorption of sodium
and the subsequent increase in fluid retention.
6. Prolactin, which is the hormone that influences
changes in the mammary gland; preparatory to
lactation after parturition. Note that the first milk
produced immediately after parturition, is called
colostrum and it is of immunological importance to
the newborn child.
7. Oxytocin, which is the hormone that induce uterine
contraction and triggering the series of changes
associated with labor and subsequently, parturition.
Sometimes it can be administered to induce labor
in pregnant women whose expected date of
delivery has been exceeded and are due for delivery
The autonomic nervous system also plays important roles
in the reproductive chain e.g. in males where by:
a. The physiological penile erection prior to copulation
is under the influence of the parasympathetic
nervous system, and
b. The physiological release of semen-containing
spermatozoon termed ejaculation is under the
influence of the sympathetic nervous system.
Another but most important control for reproduction, and
a strong determinant for the reproductive outcome, is the
genes (i.e. genetic make-up of the gametes).
It should be noted that usually, gametes have a haploid
number of chromosomes (23), with a genetic constitution
determined during meiotic division, at the stage termed
“crossing over” (genetic recombination). It is known also,
that no two daughter cells have same genetic constitution
and this forms one of basis for human variation.
After fertilization (between the male and female gametes),
the resultant cell called Zygote, has a diploid number of
chromosome (46) comprising 23 chromosomes from the
male and female gametes respectively. As such, the
zygote has a genetic constitution that is not exactly same
with those of any of the parents. This also contributes to
human variation.
In embryology, genetic anomalies (e.g. non-disjunction of
chromosome, deletions etc.), accounts for some of the
documented congenital anomalies. Some genetic
anomalies may arise due to mutations following exposure
to radiations or other related factors capable of inducing
inheritable gene mutation.
Furthermore, genes play significant roles in embryonic
induction and apoptosis.
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What are the developmental mechanisms?
A. Cellular Divisions
Both the mitotic and meiotic types of cell divisions are
involved in the reproductive chain of events. Specifically,
the meiotic division (meiosis) ensures the development of
haploid gametes, while the mitotic division (mitosis) is
associated with multiplication of diploid cells as seen with
primordial germ cell proliferation, cleavage and the series
of post-fertilization cells proliferation and differentiation.
B. Cellular Induction
The influence of one cell group (inducer) over a
neighboring cell group (induced) during embryogenesis is
known as induction. Embryonic induction is considered to
play an important role in human development and experts
believe that the first major induction phenomenon occurs
during the final stages of gastrulation. It is associated with
the release of inductive signals from one group of cells to
influence the development of another group of cells.
Scientists have identified three main ways in which signals
can be passed between cells i.e. by diffusible signal,
directly contact, or through gap junctions. In the first
mechanism, a diffusible signal is sent through the
extracellular space, and is received by a cell-surface
receptor, which further transmits the signals by way of
second messengers. In the second mechanism, cells
directly contact each other through transmembrane
proteins located on their surfaces; while in the third
mechanism, the cytoplasm of two cells is connected
through gap junctions, allowing the signal to pass directly
from one cell to another cell.
Various eye structures (lens, optic cup, and so on), internal
ear structures, as well as several tissues (for example,
vertebral cartilage) emerge from cells which were acted
upon by inducer tissues. In addition, limbs, kidney, nasal
structures, salivary glands, pancreas, teeth, feathers, and
hair are organs which require inductive stimuli. It is not
known whether a single common mechanism underlies
each of those inductions.
Many scientists believe that the inductive interaction
mediated by cell-cell contacts is dependent on the
developmental information that resides at the cell surface.
Perhaps the surface of the responding tissue recognizes
the signal molecules present on the surface of the inducing
tissue. In other instances, a secreted protein might move
among various cells or tissues and exert its effects on
competent cells.
C. Cellular Migration and Re-orientations
Cell migration is a broad term referring to the translation
of cells from one location to another. During development,
large groups of cells inside the blastocyst migrate to form
embryonic layers (endoderm, mesoderm and ectoderm).
These cells commit to differentiation programs and evolve
into precursors that migrate to their final destinations
where they undergo terminal differentiation and produce
the different organs and limbs.
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A relatively simple example is the migration of muscle
precursors from somites to emerging limbs. In the
developing brain, neuronal precursors migrate out of the
neural tube and take up residence in the distinct layers
that will form the brain. These cells move within the layers
and send projections (axons and dendrites) through the
layers of developing cells to their final targets and then
form specific connections. These intercellular connections
(synapses) constitute highly specialized interfaces that
underlie complex processes such as learning and memory.
Finally, migration of cells from the neural crest is among
the best studied embryonic migrations. These cells arise
from the top of the neural tube and migrate to a plethora
of locations including bone, cartilage, PNS, and skin
(melanocytes).
D. Apoptosis
Apoptosis, otherwise called “controlled programmed cell
death” or “cell suicide”, is as much a part of embryonal
development as it is for cell proliferation and
differentiation. It is controlled by cell genes involved in
induction or prevention of programmed cell death (PCD).
During embryogenesis PCD implicates cell elimination,
necessary in fashioning of the body/ moulding of tissues.
PCD is often used synonymous with the designation
apoptosis, which indicates an endogenous cell suicide
program by which useless or crippled cells are eliminated.
Electron micrographs of embryos have revealed the
presence of numerous cells with the characteristic features
of apoptosis. Experiments, in which small tissue fragments
were explanted to other regions, have proven that focal
apoptosis is under control of genetic, hormonal and local
tissue factors. Morphological analysis has shown that most
of the ovarian follicles undergo development apoptosis,
resulting in follicle atresia. Only a small proportion escapes
PCD. Growth factors and estrogens have been identified
as follicle survival factors, androgens and gonadotropin
releasing hormones are potentiating apoptosis of the
follicle.
An exaggerated PCD or a defective apoptosis during
embryogenesis may cause developmental abnormalities.
Certain viruses can inhibit apoptosis, while metabolic
stress or damage of cell structures can induce apoptosis.
Therefore not only viral infections, also drugs and chemical
or physical injuries during embryogenesis may interfere
with the balanced PCD and thus induce malformations.
Drugs and therapy designs directed to modulate the
apoptotic process will offer new approaches to the
prevention of congenital malformations.
Examples: The development of the fingers and toes as well
as the atretic changes of the oocytes involves apoptosis.
E. Cellular Differentiation
During embryonic development there are some cellular
differentiation events in which mesenchymal cells become
epithelial cells and at other times epithelial cells
differentiate into mesenchymal cells. Following epithelial-
mesenchymal transition, cells can migrate away from an
epithelium and then associate with other similar cells in a
new location.
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During embryonic development, cells are restricted to
different layers due to differential affinities. One of the
ways this can occur is when cells share the same cell-to-
cell adhesion molecules. For instance, homotypic cell
adhesion can maintain boundaries between groups of cells
that have different adhesion molecules. Furthermore, cells
can sort based upon differences in adhesion between the
cells, so even two populations of cells with different levels
of the same adhesion molecule can sort out.
The molecules responsible for adhesion are called cell
adhesion molecules (CAMs) and several types of cell
adhesion molecules are known and one major class of
these molecules are cadherins. There are dozens of
different cadherins that are expressed on different cell
types. Cadherins bind to other cadherins in a like-to-like
manner: E-cadherin (found on many epithelial cells) binds
preferentially to other E-cadherin molecules. Mesenchymal
cells usually express other cadherin types such as N-
cadherin.
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What is an Embryonic Primordium (Primordia)?
An embryonic primordium is the earliest indication of an
organ or part of it, during embryonic development and
differentiation. It is otherwise an aggregation of cells in
the embryo indicating the first trace of an organ or
structure.
Examples of embryonic primordium include:
1. The connecting or body-stalk which gives rise to the
umbilical cord.
2. The notochord: most of which disappears but has
remnants that remains as the nucleus pulposus of
the intervertebral disc.
3. The Neural tube, which develops from the neural
plate. The brain and spinal cord develops from it.
4. The Somites, which develops from the paraxial
mesoderm. It remnants remains as most of the
intervertebral disc except the nucleus pulposus.
However, it has two components i.e. the sclerotome
from which bones, tendon and cartilage develop;
and Dermo-myotome from which the dermis of skin
and segmental muscles develop.
5. The intraembryonic coelom – a cavity formed within
the intraembryonic mesoderm. The pericardial,
pleural and peritoneal cavities develop from it.
6. The primitive gut tube which develops from the yolk
sac following its incorporation into the developing
embryo during embryonic folding. It is subdivided
into the foregut, midgut and Hindgut. The primitive
gut gives rise to structures of the gastrointestinal,
and respiratory systems, as well as some of the
structures of the urinary.
NB:
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Several buds or diverticular emerge from the
primitive gut tube and these include:
a. The Hepatic Bud from which most part of the
liver develops except the part that develops
from the primordium called the Septum
Transversum or the transverse septum.
b. The dorsal and ventral pancreatic buds which
fuses to form the pancreas.
c. The Lung Bud from which the lungs develops.
d. The Laryngo-Tracheal Diverticulum from which
the larynx, trachea, bronchi, and bronchioles
develops.
e. The Caecal Bud from which the caecum and
appendix develops.
f. The allantoic diverticulum (allantois), though
primarily a diverticulum of the yolk sac before
gut formation, is secondarily seen as the
diverticulum of the hindgut. It obliterates and
atrophies to become Urachus (median umbilical
ligament) in post natal life.
Note however, that a portion of the allantois is
incorporated into the body of the embryo to
form the Cloaca which is later partitioned into
two i.e. the dorsal and ventral portions. The
dorsal portion becomes the recto-anal canal
from which the rectum and anal canal develops,
while the ventral portion becomes the
Urogenital Sinus from which several urinary and
genital structures develop.
7. The limb buds from which the upper and lower
limbs develop.
8. The Septum Transversum derived from the
intraembryonic mesoderm. It contributes to the
development of the Liver and Diaphragm.
9. The neural crest from which several structures
develop. These include:
10. The Stomatodaeum or Stomodaeum from which
the mouth develop.
11. The Rathke’s pouch which forms the anterior lobe
of the pituitary gland or adenohypophysis. From the
anterior lobe arises the pars tuberalis and from the
posterior lobe arises the pars intermedia.
12. The proctodaeum from which the anus develop.
13. The Otic Placodes which invaginates to form the
otic vesicles from which structures needed for
hearing and maintenance of balance (equilibrium)
develop.
14. The Lens Placode from which eye lenses develop.
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15. The Nasal or olfactory placodes invaginates to form
the Nasal Pits from which the nasal cavities
develop.
16. The indifferent gonad from which the testis or ovary
develop.
17. The Phalus from which the penis or clitoris develop.
18. The Branchial or Pharyngeal apparatus which gives
rise to most structures of the Head and Neck.
19. The Heart tube from which structures of the heart
develop.
20. The pronephros, mesonephros and metanephrosis
transformed in phases to become the kidney.
21. The Sinovaginal bulb gives rise to a portion of the
vagina.
22. The Genital Ducts (mesonephric and
paramesonephric ducts) gives rise to the uterus,
fallopian tube, duct of the testis, ureter etc.
23. The Labioscrotal swelling which forms the Scrotum
in males and Labia majora in females.
24. The Ureteric Bud –an outgrowth of the mesonephric
duct. It gives rise to the ureter, renal pelvis, calyces
and the entire collecting system.
25. The Lingual Swellings, Tuberculum impar, and
copula, or hypobranchial eminence contributes to
the development of Tongue develop.
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What are Vestigial Structures?
Human development has been known to be associated
with the development of structures which are genetically
determined but apparently lost most or all of its ancestral
functions.
Vestigial status generally relies on the comparison with
homologous features in related species. The emergence of
“vestigiality” occurs by normal evolutionary process,
typically by loss of function of a feature that is no longer
subject to positive selection pressures when it loses its
value in a changing environment. More urgently the
feature may be selected when its function becomes
definitely harmful.
Vestigial features may take various forms -patterns of
behavior, anatomical structures, or biochemical processes.
Like most other physical features, however functional,
vestigial features in a given species may successively
appear, develop, and persist or disappear at various
stages within the life cycle of the organism, ranging from
early embryonic development to late adulthood.
Vestigial structures are often called vestigial organs,
although many of them are not actually organs. Experts
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say that such vestigial structures are typically degenerate,
atrophied, or rudimentary structures and tend to be much
more variable than homologous non-vestigial parts. They
have also found out that though structures commonly
regarded as "vestigial", may have lost some or all of the
functional roles they had played in ancestral organisms,
such structures may retain lesser functions or may have
become adapted to new roles in extant populations.
It is on the basis of this that some experts have argued
that majority of the so called vestigial organs, especially in
man, has a definite use and is not, in any sense, atrophied.
Historically, a list of more than 80 organs were considered
vestigial amongst which were the thyroid, thymus, and
pituitary glands; olfactory bulb, middle ear, tonsils and
appendix. Today however, it is common knowledge that
all these organs have useful functions, and not
infrequently, essential. In the time the list was made,
nobody knew their function but as studies were developed
by physiologists, the list of human vestigial structures has
shrunken. For example:
1. The tonsils previously considered as "worthless" are
now know to protect you against infections.
2. The Appendix previously classified as "useless" is
now known as an important part of the reticulo-
enabthelial system of the body. Like the tonsils, the
appendix fights infection.
3. The Coccyx previously declared useless has been
found to be useful in the attachment of important
muscles (the levator and coccyges). These muscles
support the pelvic organs and ensure bowel
movements. Without them humans could cannot
walk or sit upright.
4. The Thymus once considered “worthless” is now
known as the primary central gland of the lymphatic
system. Without it, T cells that protect humans from
infection could not function properly, for they
develop within it.
5. The Pineal Gland is no longer considered as a
vestigial structure because it secretes critically
needed hormones, including, melatonin which
inhibits secretion of luteinizing hormone.
6. The Thyroid Gland also previously considered as a
useless organ is now known for sure, to secrete the
hormone, thyroxin, which goes directly into the
blood. This hormone is essential to normal body
growth in infancy and childhood. Without it, an
adult becomes sluggish. Either an oversupply or an
undersupply of thyroxin will result in over-activity
or under-activity of many body organs. Deficiency
of this organ at birth causes a hideous deformity
known as cretinism.
7. The Pituitary Gland once claimed to be vestigial, is
now known to ensure proper growth of the skeleton
and proper functioning of the thyroid, adrenal, and
reproductive glands. Improper functioning can lead
to Cushing's syndrome (gigantism).
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8. The Semilunar Fold of the Eye previously claimed
to be a vestige of the eye, is now known to be a
very necessary part of human eye as it is the
portion of the conjunctiva that cleanses and
lubricates the eyeball.
NB
It should be noted that during embryonic development,
some embryonic structures persist as modified structures
in adulthood. For example, the Urachus, which represents
the obliterated Allantois.
………………………………
Study Task
Look into your embryology textbooks and locate similar
structures in adults that are of embryonic importance.
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What are Structural Birth Defects (Congenital
Malformations)?
A congenital malformation which may be single or multiple
and have major or minor clinical significance, is defined as
an anatomical or structural abnormality that is present at
birth. It may be caused by genetic factors or
environmental insults or both during prenatal
development.
Experts have discovered that teratogenic agents usually
kill the embryo rather than cause congenital
malformations during the first two weeks of gestation.
Major malformations are more common in early embryos
than in new-borns and most severely affected embryos are
aborted spontaneously during the first six to eight weeks
of gestation.
NB
Teratogenic agents are more likely to cause major
congenital malformations between days 15 to 60 and the
study of abnormal development in an embryo as well as
the cause of congenital malformation or birth defect is
termed teratology.
A variety of causes of congenital malformations has been
documented and these include:
1) Genetic factors (chromosomal abnormalities as well
as single gene defects).
2) Environmental factors (drugs, toxins, infectious
etiologies, mechanical forces), and
3) Multifactorial etiologies including a combination of
environmental and genetic factors.
Simian crease or ear tags are considered as examples of
single minor malformations.
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1. Genetic factors:
Genetic factors are the most common causes of congenital
malformations and account for approximately one fourth
of all congenital malformations. Chromosomal
abnormalities including numerical and structural
abnormalities are a common cause of congenital
malformations.
Specific genetic syndromes are associated with the most
common of these chromosomal defects.
a. Trisomy 21 is referred to as Down syndrome and
has associated characteristic facial features,
congenital heart disease, growth retardation, and
mental retardation.
b. Monosomy of the X-chromosome is referred to as
Turner syndrome and is associated with webbing of
the neck, lymphedema of the hands and feet and
later in life short stature and infertility.
c. Trisomy 13 is associated with midline defects
including cleft lip and cleft palate, central nervous
system malformations, microphthalmia, and
congenital heart disease. Infants with this disorder
rarely live beyond the first year of life.
d. Trisomy 18 is associated with intrauterine growth
restriction, clenched hands, rocker bottom feet, and
congenital heart disease. Similar to trisomy 13,
infants with the syndrome also rarely live beyond
the first year of life.
2. Environmental Factors (i.e. Teratogenic Agents):
A teratogenic agent is a chemical, infectious agent,
physical condition, or deficiency that, on fetal exposure,
can alter fetal morphology or subsequent function.
Alternatively, a teratogen is any agent that can induce or
increase the incidence of a congenital malformation.
Experts have asserted that teratogenicity depends upon
the ability of the agent to cross the placenta. E.g. certain
medications such as heparin cannot cross the placenta due
to its high molecular weight and are therefore not
teratogenic.
NB:
According to experts, the following should be noted
a. The embryo is most susceptible to teratogenic
agents during periods of rapid differentiation and
as such considered as the most critical period.
b. The stage of development of the embryo
determines susceptibility to teratogens.
c. The nature of a congenital malformation produced
by an exposure depends on which organ is most
susceptible at the time of the teratogenic exposure.
d. A single event occurring during a single critical
sensitive period does not necessarily indicate that
malformations always result from it or that one can
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 determine the exact day on which a malformation
was produced.
e. Indeed, the recognition of human teratogens offers
the opportunity to prevent exposure at critical
periods of development and prevent certain types
of congenital malformations.
f. Drugs, food additives, and pesticides are tested to
determine their teratogenicity to minimize exposure
of pregnant women to teratogenic agents.
g. Less than 2% of congenital malformations are
caused by drugs or chemicals.
h. There are small numbers of drugs that have been
considered as teratogenic agents and these include
nicotine, alcohol, tetracycline, anticonvulsant
agents, anti-neoplastic or chemotherapeutic
agents, retinoic acid or vitamin A, tranquilizers e.g.
thalidomide -one of the most famous and notorious
teratogens.
i. Ionizing radiations can injure the developing
embryo due to cell death or chromosome injury.
The severity of damage to the embryo depends on
the dose absorbed and the stage of development at
which the exposure occurs.
j. Maternal medical conditions can also produce
teratogenic risks.
k. Infants of diabetic mothers have an increased
incidence of congenital heart disease, renal,
gastrointestinal, and central nervous system
malformations such as neural tube defects.
l. Tight glycemic control during the third to sixth week
post-conception is critical.
m. Infants of mothers with phenylketonuria who are
not well controlled and have high levels of
phenylalanine have a significant risk of mental
retardation, low birth weight, and congenital heart
disease.
n. Mechanical forces can also act as teratogens. The
uterus may restrict fetal movements and be
associated with congenital dislocation of the hip
and clubfoot.
o. Oligohydramnios can have similar results and
mechanically induce abnormalities of the fetal
limbs.
p. Infectious agents can also cause a variety of birth
defects and mental retardation when they cross the
placenta and enter the fetal blood stream. E.g.
congenital rubella or German measles associated
cataracts, cardiac malformation, and deafness.
q. The earlier in the pregnancy that the embryo is
exposed to maternal rubella, the greater the
likelihood that it will be affected.
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 This refers to the cavity formed during blastogenesis,
**************************************** within the proliferating blastomeres, following cleavage of
What cavities are associated with human the zygote. Its formation begins with the appearance of
development? spaces within the blastomeres which later coalesces into a
single cavity called the Blastocoel Antrum.
The major cavities formed during embryonic development
include: Further development leads to migration of cells from the
Hypoblast that lines the blastocoel cavity. These lining
1. The Follicular anthrum cells forms the Heuser’s Membrane otherwise known as
the Exoceolomic membrane. At this point, the blastocoel
2. The Blastocoel cavity cavity is refered to as the exoceolmic cavity.
With further development, the exoceolmic cavity become
3. The Lacuna networks the primitive yolk sac, much of which is incorporated into
the developing embryo during the embryonic event called
4. The Amniotic cavity Embryonic Folding.

5. The Chorionic cavity .....................................

6. The intraembryonic coelom
.....................................
The Follicular antrum
This is the fluid filled cavity formed within the proliferating
follicular cells. Its formation begins with the appearance of
spaces within the granulosa cells (proliferating follicular
cells) which later coalesces into a single cavity called
Follicular Antrum.
The Lacuna Networks
This is formed within the trophoblast particularly in the
syncytiotrophoblast. Its formation coincides with
implantation.
During implantation, the syncytiotrophoblast invades into
the maternal endometrium, and in this sense it is more
invasive than any tumor tissue. As it comes into contact
with blood vessels it creates lacunae, or spaces which later
become filled with maternal blood. It is these lacunae that
fuse to form lacunar networks.

.....................................
The Blastocoel Cavity

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As maternal blood flows in and out of the networks, The Chorionic Cavity
exchange of nutrients and waste products occur with the
fetus, forming the basis of a primitive uteroplacental This cavity is formed within the extraembryonic
circulation. mesoderm.

First, an acellular epithelium proliferates between the

.....................................
The Amniotic Cavity
This is the cavity formed within the epiblast. The stages
involved in its development include:
a. The inner mass cell pulls away from the trophoblast
forming a hollow that is surrounded by cells
originating from the epiblast and called amnioblasts
exocoelomic membrane surrounding the exoceolmic
cavity, and the cytotrophoblast, forming the
extraembryonic mesoderm. This mesoderm surrounds the
exocoelomic and amniotic cavities. With further
development, the mesoderm increases in size and isolated
spaces appear within it. It is these spaces will rapidly fuse
to form a large cavity, the extraembryonic coelom or
chorionic cavity.

b. This cavity enlarges to form the amniotic cavity NB:

bounded by the amnioblasts and the rest of the
epiblast.
c. Further enlargement of this cavity occurs during
embryonic folding.
i. This fluid-filled cavity surrounds the conjoined
amnion and primary yolk sac except just dorsal to
the amnion where the extraembryonic mesoderm
remains connected to both the amnion and the
cytotrophoblast forming the connecting stalk

d. It is fluid filled (Amniotic fluid) and the volume of ii. The connecting stalk later becomes the major part
the fluid in a giving instance is of clinical of the umbilical cord.
importance. In one instance, an abnormally low
iii. The extraembryonic coelom splits the
volume might indicate abnormal development of
extraembryonic mesoderm into two parts i.e. the
the kidneys. The fluid constituents are of clinical
extraembryonic somatic mesoderm, which lines the
significance as well e.g. amniocentesis.
trophoblast and covers the amnion, and the
extraembryonic splanchnic (or visceral) mesoderm,
.................................... which covers the yolk sac.

17
iv. The extraembryonic somatic mesoderm and the
two layers of trophoblast form the chorion, or fetal
portion of the placenta.
v. The chorion forms the wall of the chorionic sac
within which the embryo and its amniotic and yolk
sacs are suspended by the connecting stalk.
vi. As the extraembryonic coelom forms, the primary
yolk sac decreases in size and a smaller, secondary,
yolk sac forms.
vii. By the end of Day 13 and beginning of Day 14, the
primitive yolk sac disintegrates into a collection of
exocoelomic cysts. The much smaller secondary
yolk sac is renamed the definitive yolk sac.
.....................................
The Ceolomic or Body Cavity
The Ceolomic or body cavity develops from the
intraembryonic coelom formed within the intraembryonic
mesoderm.
Its formation begins with the appearance of intercellular
clefts in the lateral mesoderm that gradually becomes the
intraembryonic coelom and subdivides the mesoderm into
two: the somatic and splanchnic mesodermal layers. The
splanchnic layer is continuous with the mesoderm of the
wall of the yolk sac.
Initially, the right and left sides of the intraembryonic
coelom are in open connection with the extraembryonic
coelom, but following embryonic folding, this connection
is lost with a resultant enlargement of the intraembryonic
coelom that now extends from the thoracic to the pelvic
region.
The intraembryonic coelom has walls of skin, connective
tissue, bone, muscles, and a serous membrane. The
muscular diaphragm divides the coelom into an upper
thoracic (chest) cavity that contains the heart and lungs
and a lower abdomino-pelvic cavity that contains the
intestines, liver, spleen, stomach, pancreas, kidneys, and
reproductive organs.
18
 SECTION B
DEVELOPMENTAL EVENTS

19
********************************************** 13. Organogenesis: Development of primordial
What are the developmental events? structures.

Events associated with human development include: 14. Neurulation

1. Gametogenesis 15. Somitogenesis

2. Release of the Gametes 16. Embryonic folding

3. The female Reproductive Cycles 17. Development of the placenta.

4. Gamete transport

5. Gamete-in-transit modifications i.e. sp. cell **********************************************

activation Gametogenesis

6. Fertilization The phenomenon of human development begins with the

fusion of the males and female germ cells (the gametes).
7. Cleavage Prior to that however, the gametes must develop and the
series of events associated with Gamete development is
8. Morula and Blastocyst formation (Blastogenesis) termed Gametogenesis and occurs in the Gonads.

9. Differentiation of the cell masses of the Blastocyst In males, gamete development occurs in the Testis and it
(Embryogenesis) is called Spermatogenesis, while in the females, it occurs
in the ovary and called oogenesis.
10. Implantation
In both cases, a pluripotent cell called the Primordial germ
11. Development of Bilaminar germ cell Cell (PGC) is involved. This cell develops early by the 3rd
to 4th week of intrauterine life from the wall of the Yolk
12. Gastrulation: the development of Trilaminar germ Sac and migrates though the embryonic dorsal mesentery
cell by amoeboid movement, to the genital ridge from which
the indifferent gonad develops. The cell is easily

20
recognized because it contains lots of alkaline
phosphatase. It is also considered that the determination
of the PGC’s is one of the earliest events of
embryogenesis.
Under the influence of Testis Determining Factor (TDF),
the PGC’s in males transforms into spermatogonia while in
the absence of TDF as it is the case for females, PGC’s
transforms into Oogonia. Both spermatogonia and
Oogonia undergo multiplicative cell division (mitosis)
thereby ensuring a reservoir of cells for gamete
development.
NB:
• Differentiation of primordial germ cells in the male
begins at puberty.
• In the female, it begins in utero during the 3rd
month of development.
• At puberty as the testes descend into scrotum, the
sex chords develop a central lumen and
differentiate into the seminiferous tubules.
• Germ cells in the male at birth in the sex cords of
the testis are large, pale cells surrounded by
supporting cells.
• The supporting cells become sustentacular cells or
sertoli cells.
………………………………….
Spermatogenesis
Facts associated with spermatogenesis include:
a. Spermatogonia divide repeatedly, via mitotic
division to produce cells called Primary
spermatocytes, still with 46 chromosomes.
b. The Primary Spermatocytes undergo 1st meiotic
division to produce Secondary Spermatocytes.
c. The Secondary Spermatocytes undergo 2nd meiotic
division that produces Spermatids, which then
undergo mature into the Spermatozoa, or sperm
cells. These sperm cells have 23 chromosomes
each, half the number needed to initiate human
development.
d. Phases of gametogenesis include:
1. Multiplication Phase (Spermatocytogenesis)
2. Growth phase
3. Maturation phase
4. Spermiogenesis.
The events associated with spermatocytogenesis include:
i. Sperm mother cells present in germinal epithelium
of seminiferous tubules divide repeatedly by
mitosis to form large number of diploid rounded
sperm mother cells which are called as
spermatogonia.
21
 ii. Some of these sex cells move towards the lumen
of seminiferous tubules and enter the growth
phase. These cells are called primary
spermatocytes.
iii. The primary spermatocytes are diploid and
contain (44 + XY) chromosomes.
iv. Some of the sex cells produced by the division of
spermatogonia remain in their original condition
and continue to divide giving rise to primary
spermatocytes. Such cells are known as stem
cells.
The facts associated with the growth phase include:
i. The primary spermatocytes are diploid and
contain (44 + XY) chromosomes.
ii. During this phase the spermatocyte as well as its
nucleus enlarges in size.
iii. It gets ready to undergo maturation division.
The Facts associated with the Maturation Phase include:
i. Each diploid primary spermatocyte undergoes
meiosis I, which is a reduction division.
ii. Two daughter cells are formed each with 'n' number
of chromosomes.
iii. The daughter cells are called secondary
spermaotcytes.
iv. The secondary spermatocytes are haploid and
much smaller comparatively, containing (22+X) or
(22+Y) chromosomes.
v. The secondary spermaotcytes undergo the second
meiotic division. This results in the formation of four
daughter cells known as spermatids.
vi. The final stage of spermatogenesis, which sees the
maturation of spermatids into mature, motile
spermatozoa, is called Spermiogensis or
Spermiolysis.
The steps involved are:
1. Formation of an acrosome which covers half of
the nuclear surface. It contains enzymes to
assist in penetration of the egg and its
surrounding layers during penetration.
2. Condensation of the nucleus.
3. Formation of the neck, middle piece and tail.
4. Shedding of most of the cytoplasm referred to
as the Residue.
22
e. The time required for a spermatogonium to
develop into a mature spermatozoon is
approximately 74 days.
f. Fully developed spermatozoa enter the lumen of
seminiferous tubules.
g. Spermatozoa are pushed towards the epididymis
by contractile elements in the wall of the
seminiferous tubules.
h. The spermatozoa are initially only slightly motile,
but obtain full motility in the epididymis.
i. Clinical correlates include:
1. Abnormal Spermatozoa are seen frequently.
2. Up to 10% of all spermatozoa have observable
defects.
3. Structurally, the head and tail may be
abnormal; may be giants or dwarfs; or may be
joined.
4. Following non-disjunction of chromosomes,
some sperm cells may have 22 or 24
chromosomes instead of 23 and such has been
attributed to some genetic disorders. E.g.
Monosomy and Trisomy.
NB:
Sperm with morphologic abnormalities lack normal
motility and probably cannot fertilize oocyte.
…………………………..
Oogenesis
Unlike gametogenesis, Oogenesis is associated with
several unique features that include:
1. An early embryonic commencement (3rd month)
with the first meiotic division of the primary
oocytes.
2. Termination of the first meiotic division at the
prophase stage at birth.
3. Graduation atrophy/degeneration of oocytes during
child hood and adulthood.
4. Resumption of first meiotic division at puberty and
subsequent completion with the release of the first
polar body.
5. Commencement of the 2nd meiotic division after the
completion of the 1st but terminates also to resume
at fertilization. As such 2nd meiotic division is never
completed if fertilization does not occur.
6. At fertilization however, the 2nd meiotic division
resumes and then completed in the presence of the
23
 spermatozoon. It is believed that the spermatozoa
play an inductive role.
7. It is associated with the female reproductive cycles
(i.e. ovarian and menstrual cycles).
8. It ceases at the attainment of menopause.
Other facts associated with Oogenesis include:
a. By the third Month, Oogonia undergo a number of
mitotic divisions. By the end of the third month, they
are arranged in clusters surrounded by a layer of flat
epithelia cells called Follicular cells. The follicular cells
are believed to originate from the surface epithelium
of the ovary. The majority of the Oogonia continue to
divide by mitosis, but some of them arrest their cell
division in prophase of meiosis 1 and form Primary
Oocytes. During the next few months, Oogonia
increase rapidly in number.
b. It is observed that by the fifth month of prenatal
development, the total number of germ cells in the
ovary reaches its maximum, estimated at about 7
million. At this point cell deaths begin, and many
Oogonia as well as primary Oocytes become atretic.
c. By the seventh Month, majority of the Oogonia have
degenerated except for a few near the surface. All the
surviving primary Oocytes have entered prophase of
meiosis 1, and most of them are individually,
surrounded by a layer of flat epithelia cells.
d. At birth, the total number of primary oocytes is
estimated to vary from 700, 000 to 2 million.
e. During childhood, most of the oocytes become atretic;
only approximately 400,000 are present by the
beginning of puberty, and fewer than 500 will be
ovulated.
f. Some oocytes that reach maturity late in life have
been dormant in the diplotene stage of the first
meiotic division for 40years or more before ovulation.
g. The fact that the risk of having children with
chromosomal abnormalities increases with maternal
age (particularly in mothers who are 35 and older)
indicates that primary oocytes are vulnerable to
damage as they age.
h. As it is known, fetal oocytes are arrested in the first
prophase of meiosis shortly after chromosome
crossing over. At this time, the nuclear membrane is
still visible and is called germinal vesicle. Some
oocytes remain at this "dictyate" stage until the
beginning of the menstrual cycle. With each cycle, a
cohort of these follicles begins to develop and resume
meiosis. One dominant follicle complete maturation
and release an egg.
i. At ovulation, the oocyte completes the first meiotic
division and extrudes the first polar body and proceeds
24
 to metaphase of the second meiotic division, where it
again arrests pending arrival of the sperm.
j. It is only after activation by the process of sperm-egg
fusion, that meiosis II is completed with extrusion of
the second polar body and formation of a female
pronucleus.
k. Like spermatogenesis, abnormal oocytes can be
encountered e.g.
1. An ovarian follicle may contain two or three clearly
distinguishable primary oocytes but they usually
degenerate before reaching maturity.
2. One primary oocyte may contain two or even three
nuclei but usually die before reaching maturity.
3. Similarly, as described for the sperm cells, non-
disjunction of chromosomes may occur and some
ova may have 22 or 24 chromosomes instead of
23; and such has been attributed to some genetic
disorders. E.g. Monosomy and Trisomy.
NB
i. Recall that oogenesis is associated with follicular
proliferation under the influence of FSH.
ii. Proliferating follicular cells are also termed granulosa
cells.
iii. Terms describing follicular stages during oogenesis
include:
a. Primordial Follicle
b. Primary Follicle
c. Secondary follicle
d. Tertiary or Grafian Follicle
NB:
 Primordial follicles appear in the ovaries during
the third month of development.
 Primary follicles consist of primary oocyte
surrounded by the Zona Pellucida (a
glycoprotein coat) and a layer of follicular cells.
 Primary follicle becomes the secondary follicle
with rapid follicular cell proliferation and the
development of the follicular anthrum. It is
otherwise called the antral follicle
 The mature, vesicular or graafian follicle is
characterized by an enlarged antrum with
defined granulosa cells in contact with the zona
pellucida (called corona radiate) and those that
bulge into the antrum called the cumulus
oophorus.
25
……………………………………………. b. Site of Fertilization
Study Task c. Early development of the Zygote

Comparatively, there are obvious differences between 3. The Uterus:

Spermatogenesis and Oogenesis. Of course there are a. Involved in the menstrual Cycle
similarities. Can you spot out these differences and b. Involved in embryo Implantation
similarities? c. Involved in embryo/fetus development

Note that the best way to establish comparative NB:

differences is to establish the feature for comparison e.g.
the gonad involved, the pattern of meiotic division, the
existing gender independence, duration of occurrence,
eventual outcome etc.
For the similarities, features like number of chromosome,
gamete abnormalities etc. should be considered.
Take note of the following of about the roles the different
part of the female reproductive system plays:
Recall that the female reproductive organs
undergoes regular cyclic changes (structural and
function) from puberty (menarche between 9 – 14
years of age) to menopause (climacteric; between
45 and 55 years of age)
4. The Vagina:
a. It is the corpulatory organ.
b. Serves as the route for child birth (parturition).

1. The Ovaries:
a. For the development of the female gametes.
This is associated with follicular development,
development of corpus luteum, degeneration of
corpus luteum to corpus albicans, and atretic
changes (atresia).

b. Secretion of oestrogen and progesterone

(endocrine function)

2. The Uterine Tubes:

a. Gamete Transport

26
PICTORIAL SUMMARY 1

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 *******************************************
Release of the Gametes

In females, the female gametes are released cyclically under the influence of
Hormones FSH and LH as stated earlier. The event is termed ovulation and the
following sub-events are associated with it:

1. Development of a cystic swelling or bulge on the surface of the ovary after

the ovarian follicle under the influence of FSH and LH undergoes a sudden
growth spurt.

2. Appearance of a small avascular spot, the stigma, on the cystic swelling.

3. Detachment of some cells of the cumulus oophorus from the interior of the
distended follicle prior to ovulation, the secondary oocyte and some cells of
the.

4. Surge of LH, which triggers ovulation proper beginning with the rupture of the
stigma thereby expelling the secondary oocyte with the follicular fluid.

NB:
The expulsion of the oocyte is due to intrafollicular pressure and possibly, the
contraction of smooth muscle
in the theca externa owing to stimulation with prostaglandins.

5. Enzymatic digestion of the follicular wall seems to be one of the principal

mechanisms leading to ovulation.

6. The expelled oocyte is surrounded by the Zona Pellucida and one or more
layers of the follicular cells specifically termed the corona radiata.

………………………………………………….
In males, gametes release occurs during copulation as stated earlier also. It is under
the influence of the nervous system.

First, the parasympathetic nervous system induces penile erection prior to copulation.

Secondly, the sympathetic nervous system takes charge of the series of events leading
to the ‘forceful’ release of semen-containing sperm cells into the female vagina. This,
as stated earlier, is called ejaculation and powerful muscle contractions are involved.

Note that Semen is the product of secretory contributions from the bulbourethral
glands, the prostate, and the seminal vesicles.

42
*******************************************
The female Reproductive Cycles

A. The Ovarian Cycle

This term refers to the series of events leading to the release of a mature ovum from
the ovary per month – per month. It is cyclic event occurring in the ovary of normal
females who have attained the age of puberty but not menopause, and are not
pregnant. The hormones FSH and LH, influence the cyclic changes that take place in
the ovaries.

During each cycle, FSH promotes growth of several primordial follicles into primary
follicles; however only one primary follicle usually develops into mature follicle and
ruptures through the surface of the ovary, expelling its oocyte. Some experts have
asserted that about to 11 follicles degenerate each month.

The events associated with the ovarian cycle are:

1. Development of follicles

2. Ovulation; and

3. Corpus Luteum formation

NB:

Recall that each of these events have been described earlier.

………………………………………………………

B. The Menstrual Cycle.

The menstrual cycle refers to the period during which the oocyte matures, is ovulated,
and enters the uterine tube. Involved in the menstrual cycle include the brain,
pituitary gland, uterus and cervix, ovaries, fallopian tubes, and vagina.

Recall that the hormones produced by the ovarian follicles and corpus luteum
(estrogen and progesterone) produce cyclic changes in the endometrium. These
monthly changes in the internal layer of the uterus (endometrium), constitute the
endometrial cycle, commonly referred to as the menstrual cycle or period because
menstruation (flow of blood from uterus) is the obvious event.

The average menstrual cycle is 28 days, with day 1 of the cycle designated as the day
on which menstrual flow begins.

43
Menstrual cycles vary in length by several days in normal women. The variations result
from the alterations in the durations in the duration of the proliferative phase of the
menstrual cycle.

Phases of the Menstrual Cycle

The phases of menstruation are

1. The Menstrual phase.

 First day of menstruation is the beginning of the menstrual phase.

 The functional layer of the uterine wall is sloughed off and discarded with the
menstrual flow –menses (monthly bleeding). It lasts for 4 –5 days.

 The Blood discarded through the vagina is combined with small pieces of
endometrial tissue. After menstruation, the eroded endometrium is thin

2. The Proliferative (follicular or estrogenic) phase

 It lasts for about 9 days.

 It coincides with the growth of the ovarian follicles.

 It is controlled by estrogen secreted by the follicular cells.

 During this phase, there is a two-three-fold increase in the thickness and water
content of the endometrium.

 Early in the phase the surface epithelium of the endometrium reforms and
covers it.

 The endometrial glands increase j number and length and the spiral arteries
elongate.

3. The Luteal (secretory or progestational) phase

 It last for about 13 days

 It coincides with the formation of, functioning, and growth of the corpus
luteum.

 The progesterone produced by the corpus luteum stimulates the the glandular
epithelium of the endometrium to secrete a glycogen-rich material.

44
  The glands become wide, tortuous, and saccular, and the endometrium thickest
because of the influence of progesterone and estrogen from the corpus luteum
and because of increased fluid in the connective tissue.

 As the spiral artery grows into the superficial compact layer of the
endometrium, they become increasingly coiled. The venous network become
complex and large lacunae (venous spaces) develop. Direct arterio-venous
anastomoses are prominent features of this stage.

4. The Ischemic phase (if pregnancy does not occur)

 Occur if oocyte is not fertilized.

 Vascular changes occur, leading to ischemia due to the constriction of the

spiral arteries due to decreased seretion of hormones by the corpus luteum
and this gives the endometrium a pale appearance.

 Due to reduced hormone secretion also, there is stoppage of glandular

secretion, a loss of interstitial fluid and a marked shrinking of the
endometrium.

 Towards the end of the ischemic phase, the spiral arteries become
constricted for longer periods leading to venous stasis and patchy ischemic
necrosis of in the superficial tissues.

 This is followed by rupture of damaged vessel walls and blood seeps into
the surrounding connective tissue.

 Small pools of blood form and break through the endometrial surface,
resulting in bleeding into the uterine lumen from the vagina.

 As small pieces of the endometrium detach and pass into the uterine cavity,
the torn ends of the arteries bleed into the uterine cavity resulting in a loss
of about 20 – 80 ml of blood.

 Eventually, over 3 to 5 days, the entire compact layer and most of the
spongy layer of the endometrium are discarded in the menses.

5. The Pregnancy phase

 Occur if oocyte is fertilized.

 Menstrual cycles ceases and the endometrium passes into the pregnancy phase
until the end of the gestation period.

 However, ovarian and menstrual cycles resume after a variable period (usually
6 – 10 weeks if the woman is not breastfeeding her baby).

45
*******************************************
Gamete transport

*******************************************
Gamete-in-transit modifications i.e. sp. cell activation

*******************************************
Fertilization

This is the series of events leading to the fusion of the male and female gametes. It
also refers to the process in which the spermatozoon penetrates into the ovum to form
fertilized ovum. It occurs in the ampulla of oviduct. The events include:

1. Sperm Capacitation

2. Sperm-Zona Pellucida Binding

3. The Acrosome Reaction

4. Penetration of the Zona Pellucida

5. Sperm-Oocyte Binding

6. Oocyte Activation and the Cortical Reaction

7. The Zona Reaction

……………………………………………
What actually happens during fertilization?

a. Sperm penetrates the Corona Radiata

b. Sperm attaches to Zona Pellucida (Sperm Zona Pellucida Binding)
c. Acrosome of sperm releases trypsin like enzyme (Acrosome Reaction)
d. Sperm penetrates the Zona Pellucida
e. Sperm binds with Oocyte (Sperm-Oocyte Binding)
f. Egg membrane depolarizes (Na diffuses in, Ca out) (Oocyte activation).
g. Cortical granules released (Cortical Reaction)
h. Zona hardens (Zona Reaction)
i. Prevents multiple fertilizations
j. Secondary Oocyte divides (completion of second meiotic division)
k. Polar body formed (release of the second polar body)
l. Formation of the male and female pronucleus.
m. Fusion of the male and female gamete pronucleus (Egg and sperm nucleus fuse)

46
NB:

The acrosome reaction provides the sperm with an enzymatic drill to get through the
zona pellucida.

The same zona pellucida protein that serves as a sperm receptor also stimulates a
series of events that lead to many areas of fusion between the plasma membrane and
outer acrosomal membrane.

Membrane fusion (actually an exocytosis) and vesiculation, expose the acrosomal

contents, leading to leakage of acrosomal enzymes from the sperm's head.

Sperm that lose their acrosomes before encountering the oocyte are unable to bind to
the zona pellucida and thereby unable to fertilize.

Following fusion of the fertilizing sperm with the oocyte, the sperm head is
incorporated into the egg cytoplasm. The nuclear envelope of the sperm disperses,
and the chromatin rapidly loosens from its tightly packed state in a process called
decondensation. In vertebrates, other sperm components, including mitochondria, are
degraded rather than incorporated into the embryo.

Chromatin from both the sperm and egg are soon encapsulated in a nuclear
membrane, forming pronuclei.

…………………………………………………….

What is the outcome of fertilization?

1. Resumption and completion of the second meiotic division and release of the
second polar body.
2. Development of the Zygote
3. Restoration of the diploid number of chromosome
4. Determination of sex
5. Induction of Cleavage
6. A factor of human variation

NB:
……………………………………………………
Infertility

The inability in individuals to achieve fertilization is termed Infertility.

Women with repeated miscarriages are also classified as Infertility.

Infertility in Females
In order for a woman to become pregnant:

47
i. Egg must be released from one of her ovaries (ovulation)
ii. Egg must go through the fallopian tube toward the uterus
iii. Sperm must join with the egg in the fallopian tube (fertilization).
iv. Fertilized egg must attach to the uterine wall (implantation)

Therefore, infertility can result from problems that interfere with any of these steps
listed above.

The risk factors of infertility include age, stress, poor diet, smoking, alcohol, sexually
transmitted disease, overweight, underweight, caffeine intake, and too much exercise.

Factors influencing infertility in females include:

1. Severe endometriosis
2. Pelvic Inflammatory Disease (PID)
3. Ovulation disorders
4. Elevated prolactin
5. Polycystic ovary syndrome (PCOS)
6. Early menopause
7. Benign uterine fibroids
8. Pelvic adhesions

…………………………………….
Physical Obstructions
• Endometriosis
• Pelvic Inflammatory Disease
• Uterine Fibroids
• Pelvic Adhesions
• Ovarian Failure

……………………………………..
Endometriosis
• Occurs when the uterine tissue implants and grows outside of the uterus,
affecting the function of the ovaries, uterus and fallopian tubes.
• Scar tissue can block the fallopian tubes and prevent the egg from entering the
uterus.
• There is a 25-35% rate of infertility in moderate to severe cases of
Endometriosis

……………………………………..
Pelvic Inflammatory Disease

• Pelvic inflammatory disease (PID) is a spectrum of infections of the female

genital tract that includes endometritis, salpingitis, tuboovarian abscess, and
peritonitis.

48
 • Endometritis (Inflammation of the endometrium). , salpingitis (Inflammation of
the uterine tube). , tuboovarian abscess (A large abscess involving a uterine
tube and an adherent ovary, resulting from extension of purulent inflammation
of the tube.), and peritonitis (Inflammation of the peritoneum .)

• Infection of the uterus (womb), fallopian tubes (tubes that carry eggs from the
ovaries to the uterus) and other reproductive organs. It is a common and
serious complication of some sexually transmitted diseases (STDs), especially
chlamydia and gonorrhea. PID can damage the fallopian tubes and tissues in
and near the uterus and ovaries. Untreated PID can lead to serious
consequences including infertility, ectopic pregnancy (a pregnancy in the
fallopian tube or elsewhere outside of the womb), abscess formation, and
chronic pelvic pain.

………………………………………………….
Uterine Fibroids and Pelvic Adhesions

• Fibroids are benign tumors in the wall of the uterus

• May cause infertility by blocking the fallopian tubes
• Pelvic adhesions are bands of scar tissue that bind organs after pelvic infection,
appendicitis, or abdominal or pelvic surgery
• This scar tissue formation may impair fertility.

……………………………………
Ovarian failure

• Ovarian failure can be a consequence of medical treatments, or the complete

failure of the ovaries to develop or contain eggs in the first place (Turner's
syndrome).

• Ovarian failure can also occur as a result of treatments such as chemotherapy

and pelvic radiotherapy for cancers in other body areas. These therapies
destroy eggs in the ovary.

………………………………………
Hormonal Obstructions

• Ovulation disorders
• Elevated prolactin
• Polycystic ovary syndrome
• Early menopause

………………………………
Ovulation disorders

A delicate balance of sex hormones (oestrogen, progesterone, luteinizing hormone,

follicle stimulating hormone) is needed for the timely growth and release of the egg
from the ovary (ovulation).

49
Hormone imbalances can cause ovulation disorders in women and are the most
common cause of infertility in women.

Disruption in the part of the brain that regulates ovulation can cause low levels of
luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Even slight irregularities in the hormone system can affect ovulation.

…………………………..
Elevated prolactin

• Also called hyperprolactinemia

• Can cause irregular or no ovulation
• Irregular periods
• May cause galactorrehea, milk production when not pregnant

……………………………………………..
Polycystic ovary syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a health problem that can affect a woman’s
menstrual cycle, fertility, hormones, insulin production, heart, blood vessels, and
appearance. Women with PCOS have these characteristics:

 High levels of male hormones, also called androgens

 An irregular or no menstrual cycle

 May or may not have many small cysts in their ovaries. Cysts are fluid-filled
sacs.

 PCOS is the most common hormonal reproductive problem in women of

childbearing age. An estimated five to ten percent of them have PCOS.

 In women with PCOS, the ovary doesn't make all of the hormones it needs for
any of the eggs to fully mature. They may start to grow and accumulate fluid.
But no one egg becomes large enough. Instead, some may remain as cysts.
Since no egg matures or is released, ovulation does not occur and the hormone
progesterone is not made. Without progesterone, a woman’s menstrual cycle
is irregular or absent. Also, the cysts produce male hormones, which continue
to prevent ovulation.

………………………….
Early menopause

• Absence of menstruation

• Early depletion of ovarian follicles before age 35

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 • Although the cause is unknown, certain conditions are associated with early
menopause, including immune system diseases, radiation or chemotherapy
treatment, and smoking

…………………………
Other Causes

• Medications

• Thyroid problems

• Cancer and treatment

• Other medical conditions

– conditions associated with delayed puberty or amenorrhea, sickle cell
disease, HIV/AIDS, kidney disease and diabetes

Temporary infertility may occur with the use of certain medications. In most cases,
fertility is restored when the medication is stopped.

Disorders of the thyroid gland, either too much thyroid hormone (hyperthyroidism) or
too little (hypothyroidism), can interrupt the menstrual cycle and cause infertility.

Certain cancers — particularly female reproductive cancers — often severely impair

female fertility. Both radiation and chemotherapy may affect a woman's ability to
reproduce. Chemotherapy may impair reproductive function and fertility in men and
women.

Medical conditions associated with delayed puberty or amenorrhea, such as Cushing's

disease, sickle cell disease, HIV/AIDS, kidney disease and diabetes, can affect a
woman's fertility.

Excessive caffeine consumption reduces fertility in the female.

…………………………………
Development Problems

• Hard Eggs

• Teratogens

If the egg is too 'hard', then the embryo cannot hatch out of the zona pellucida and it
dies.

To fix this problem, scientists can make a tiny hole in the egg to give it a head start.

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Recall fertilization is associated with sperm–egg interaction, which begins after sperm
capacitation. A sperm first penetrates the cumulus oophorus (a), consisting of cumulus
cells (somatic cells from the ovarian follicle) embedded in an extracellular matrix
(ECM). The sperm then contacts the zona pellucida (b), where the acrosome reaction
is triggered by ZP3. Acrosome-reacted sperm penetrate the zona pellucida, enter the
perivitelline space, then adhere to (c) and fuse with (d) the plasma membrane of the
egg. The egg has extruded the first polar body (PB1) and progressed to metaphase
II. In most mammals, sperm–egg fusion triggers the completion of meiosis. This model
is based on in vitro studies of gamete interactions and is consistent with in vivo
fertilization, which occurs in the oviduct.

…………………
Teratogens

• Damage from external sources, including viral infections, x-rays and other
radation, and poor nutrition

• Depending on the stage of development at which the exposure to the teratogen

takes place, a variation of developmental malformations may occur.

• Stunting of the fingers and toes due to damage from external sources
(teratogens) including viral infections such as rubella, x-rays and other
radiation, and poor nutrition by week 8.

• In Week 3 we see the formation of the heart, the beginning development of

the brain and spinal cord, and the beginning of the gastrointestinal tract.

• Teratogens introduced during this period may cause severe problems such as
the absence of one or more limbs or a heart that is outside of the chest cavity
at birth.

………………………..
Infertility in Males

Factors influencing infertility in males include:

 Infection
 Hernia
 Vas Deferens
 Androgen Deficiency
 Testicular mass
 Varicocele

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******************************************
Cleavage

This is the series of mitotic division induced in the zygote immediately after
fertilization. The following facts are associated with it:

1. Occurs after fertilization

2. It is the first step in embryonic development

3. It is associated with the division of fertilized egg into a large number of smaller
cells (blastomeres).
Blastomeres are daughter cells of cleavage.

4. It Leads to development of a hollow blastocyst

5. At 12 -16 cell – stage, the zygote becomes the morula. It is described as a

mulberry-shaped solid cell mass

6. As cleavage goes on, the mass of the embryo does not increase.

7. At 8 –cell stage, compaction occurs. It is associated with the cell polarization,

change in shape of the embryo, flattening of the blastomeres against each
other and formation of tight junctions.

8. Development of the blastocyst with a blastocoel cavity and two masses of cells
called the inner mass cells (embryoblast) and the outer mass cells
(Trophoblast). This is associated with cell adhesion which is critical in cell
differentiation and the changes in form (morphogenesis) of the blastocyst.
Without cell adhesion, the cells die.

9.

*******************************************
Implantation

This is the process by which the blastocyst settles into endometrium. It begins by
the 6th day and completed by the 7th day after fertilization. By the 10th day, the
blastocyst becomes completely imbedded into the endometrium with the point of
implantation sealed up completely by the development of new epithelia lining.

Other facts associated with it include:

1. Proliferation of the Trophoblast into two layers i.e. the Syncytiotrophoblast

(outer layer) and Cytotrophoblast (inner layer).

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 2. Hatching of the blastocyst with the shedding or disappearance of the zona
pellucida by the 5th day. Note that one functions of the zona pellucida is to
prevent premature implantation.

3. Invasion of the endometrium by the syncytiotrophoblast.

NB:
Implantation may be accompanied by slight bleeding via the vagina and this is called
implantation bleeding. However, it is no longer an implantation bleeding if it is
accompanied by cramping, backache or increased bleeding.

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