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REPRODUCTIVE SYSTEM
10 marks

1. MENSTRUAL CYCLE
- Refers to cyclical changes that takes place in the women
- Preparatory step for fertilization and Pregnancy
Duration - 25 – 35 Days
Average – 28 Days
Changes include:
Ovarian Cycle
Uterine Cycle
Cervical Cycle
Vaginal Cycle
Ovarian Cycle
Follicular Phase
Ovulation
Luteal Phase
1. Follicular Phase
-Involves the development of a follicle
- One follicle matures each month
- During the lifetime of a female only 400 follicles mature
Stages of follicular development:
Primordial follicle → Primary Follicle → Secondary follicle → Tertiary follicle
(Involves addition of granulosa cells surrounding the oocyte & also formation
of theca cells)→Antral follicle(Having fluid filled space) → Matured
Graafian follicle
2. Ovulatory Phase
The process of expulsion of secondary oocyte from ovary into peritonial cavity
following rupture of mature graffian follicle
Timing:
14th day of sexual cycle
Events of Ovulation
- Rapid swelling of follicle
- Formation of stigma
- Release of proteolytic enzymes
- Dissolution of capsular wall
- Rupture of graffian follicle
3. Luteal Phase ( 15th - 28th Day)
Events :
- Formation of corpus hemorrhagicum (ruptured follicle filled with blood)
- Formation of corpus luteum (clotted blood replaced with yellow colored
lipid rich luteal cells)
- Formation of corpus albicans ( regression of corpus luteum)
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Uterine (Endometrial) Cycle

Menstrual (Bleeding) Phase
Proliferative phase
Secretory phase
1.Menstrual Phase
The lining of the uterus (endometrium) breaks down and is lost from the body. This is
called menstruation or a period
Duration - Days 1-5
Components:
- 30 – 50 ml blood (75% Arterial)
- Ovum - unfertilized
- Mucus
- Endometrial debris – damaged endometrial tissue, serous fluid, a large amount
of prostaglandins & fibrinolysin
Mechanism of menstruation
1. steroid production declines.
2. shrinking of endometrial tissue
3. reduction in blood flow to superficial layers – ischemic hypoxia & damage to
the epithelial and stroma cells & constriction of spiral arteries
4. Individual arteries re-open → tearing and rupturing the ischemic tissues.
5. Bleeding into the cavity
- About 50% of degenerating tissues is resorbed and 50% is lost as 'menstrual
bleeding'.
2. Proliferative Phase
- Days 6-13
- increase in estrogen causing the endometrium to thicken (from 1mm to 4 mm)
- angiogenesis
- stimulation of endometrial glands to grow
3. Secretory Phase
Days 15-28 :
increase in progesterone causes
- endometrial thickness
- increased vascularity
- secretion of endometrial glands
(in preparation for the developing embryo)
Cervical Cycle
1. Preovulatory Phase - Estrogen is predominant hormone
- Cervical mucus - Thin, Watery & Alkaline
2. Postovulatory Phase - Progesterone
- Cervical mucus - Thick & Tenacious
Vaginal Cycle
1. Preovulatory Phase - Estrogen predominance
Thick & Cornified Epithelium
2. Postovulatory Phase - Progesterone predominance
Thick & viscid secretion
Infiltrated with Leucocytes
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Hormonal Control of Sexual Cycle

Gonadotropins from Anterior pituitary
FSH - development of follicles (follicular phase)
LH - triggers ovulation
Ovarian Hormones
Estrogen – influences proliferative phase of endometrial cycle
Progesterone – influences secretory phase of endometrial cycle

Menstrual Disorders
Premenstrual Syndrome
Amenorrhoea - Absent
- Primary
- Secondary – Pregnancy
Menorrhagia – Excess bleeeding
Metorrhagia – intermenstrual bleeding
Oligomenorrhoea – decreased frequency
Dysmenorrhoea – painful menstruation
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2. CONTRACEPTION
- Refers to prevention of Conception
Methods of Contraception
Temporary Permanent
1. Barrier Methods 1. Vasectomy
2. Natural Methods 2. Tubectomy
3. Intrauterine Devices
4. Hormonal Contraception (Oral pills)
1. Barrier Methods
- Prevention of deposition of sperms in vagina
Mechanical Methods
Males - Nirodh (Condoms)
Females - Pouch (Female condom)
Diaphragm
Cervical Cap
Chemical Methods
Spermicides - Kill the Sperms
Jelly
Cream
Sponge
Combined (Mechanical & Chemical) - More Effective
2. Natural Methods
Rhythm Method – Following safe period
Coitus Interruptus
Complete abstinence
SafePeriod
Definition – the period of least fertility during menstrual cycle
Duration - 5-6 days after menstruation & 5-6 days before next cycle
Significance – rhythm method of contraception
3. Intrauterine Devices
Lippe’s Loop
Cu T 200
Multiload Cu T-250
Progestasert
Mechanism of Action
Increase tubal motility
Prevent implantation
Spermicidal activity
4.Hormonal /Oral Contraceptives
Sex Hormones - Oral Pills
Mechanism of Action
Negative feedback mechanism
Suppress FSH & LH secretion
Pills
Combined Pill - Progesterone & Oestrogen
21 Days - From the day bleeding stops
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Withdrawal bleeding occurs

Sequential Pill - 15 days Oestrogen + Combination
Mini pill - Low dose estrogen
Postcoital pill – within 72 hours after sexual intercourse
Complications of oral contraceptives
Thromboembolic phenomenon
Increase in weight
Jaundice
Avoid in Diabetics
Fibroid Uterus
Permanent Contraceptive Methods
Vasectomy
Tubectomy
Medical Termination of Pregnancy (MTP) or Abortion
Dilatation & curettage (D&C)
Vacuum aspiration
Administration of prostaglandins
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5 MARKS
1. SERTOLI CELLS
Sertoli cells are the supportive cells found in the seminiferous tubules of testis.
Functions:
1. Play a role in the maturation of sperms
2. Provide nutrition to the developing spermatozoa
3. Play a part in the mechanism of blood testis barrier
4. Phagocytize damaged germ cells.
5. Takes part in aromatization of testosterone into estrogen
6. Secretes the following substances:
- MIS (Mullerian Inhibiting substance)
- Inhibins
- Androgen binding protein
7. Influence Leydig cell secretion through activins & inhibins
2. SPERMATOGENESIS
Definition: The development and maturation of spermatozoa (male gametes) is called
spermatogenesis.
Stages:
I.Spermatocytogenesis: Development of spermatogonia into spermatids
1. Spermatogonium A: Primitive germ cells which are diploid (44+XY) and
divide by mitosis to spermatogonium B cells
2.Spermatogonium B: These are also Primitive germ cells which are
diploid (44+XY) and divide by mitosis. These cells
give rise to primary spermatocyte
3. Primary spermatocyte: Diploid cells which divide by meiosis to form
secondary spermatocyte.
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4. Secondary spermatocyte: These are haploid cells (22+X or Y). They

undergo second meiotic division to form spermatids
5. Spermatids: Haploid cells which transform into motile spermatozoa.
II.Spermiogenesis: Transformation of spermatids into tailed, motile spermatozoa
(sperms)
Spermatozoa: Matured male gamates, haploid and posses a head, middle
piece and a tail. About 512 spermatozoa develop from a single
spermatogonium

Spermatocytogenesis

Spermiogenesis
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Regulation of Spermatogenesis:
A.Hormones:
1. Testosterone: Secreted from Leydig cells of testis. Acts on seminiferous
tubules and stimulates the proliferation of spermatogonia into
primary spermatocyte
2. FSH: Stimulates proliferation as well as maturation of spermatozoa. Trophic to
Sertoli cells which play an important role in maturation.
3.LH: Stimulates the Leydig cells to produce testosterone which is required for
Spermatogenesis
4. Other hormones which are required for spermatogenesis: Thyroxine, Growth
hormone & Insulin
B.General factors:
1. Temperature: Speramatogenesis requires 2 to 3oc less than the core temperature
of the body
2. Irradiation: Exposure to harmful radiation causes degeneration of seminiferous
tubules and leads to sterility
3. Toxins: Bacterial and viral toxins may cause selective destruction of
seminiferous ubules. E.g. Mumps
4. Vitamins: Vitamins A, C & E are required for spermatogenesis

3. TESTOSTERONE.
Secreted from Leydig cells of testis. About 4-9 mg is secreted per day.
Mechanism of Action:
It combines with cytoplasmic receptor and reaches DNA. It acts on DNA and
stimulates mRNA and protein synthesis
Functions:
1. In Fetus:
a) Sex differentiation: Stimulates the development of Wolffian duct into
male accessory sex organs. Development of male external genitalia
requires dihydrotestosterone which is derived from testosterone
b) Descent of testes: Along with MIS, testosterone stimulates the descent of
testes from abdominal cavity into scrotum through inguinal canal
2.During Puberty:
a) On accessory sex organs: Stimulates the development and growth of the
male accessory organs like vas deference, seminal vesicles,
prostate, scrotum & penis
b) On distribution of body hair: General body hair increases. Moustache &
beard appear.Pubic hair appear & attains male pattern
c) On voice: Becomes deeper and low pitched due to growth of vocal cords &
larynx
d) On skin: Thick with more sebaceous secretion. Acne appears on face
e) Mental behavior: More aggressive
3. Spermatogenesis: Stimulates the proliferation of spermatogonia into primary
spermatocyte in seminiferous tubules.

4. On growth: Stimulates skeletal growth. But finally it causes fusion of

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epiphyseal plates and arrest growth

5. On muscle mass: Testosterone is a protein anabolic hormone. It increases
protein synthesis.This increases the muscle mass and muscle power in
males.
6. On erythropoiesis: Stimulates the production of erytropoietin there by
increases RBC count. Hence males have higher RBC count than females

4. PLACENTA
Nutritive Function
-Transport of Glucose, Amino acids , Fatty acids & Vitamins from maternal blood
to foetal blood
- Storage of Glycogen, Lipids, Fructose
Respiratory Function
-Diffusion of O2 from maternal blood to foetal blood
-Diffusion of CO2 from foetal blood to maternal blood
Double Bohr effect
- Increased affinity of Foetal Hb (Hb F) shifts the ODC of foetal blood to left
- Increased Level of CO2 shifts the ODC of maternal blood to right
(Both the effects increase the O2 content of foetal blood)
Excretory function: Transport of metabolic waste products like urea, uric acid,
creatinine from foetal blood to maternal blood
Endocrine function
Placental Hormones
-Human Chorionic Gonadotrophin (HCG)
- Human Placental Lactogen (HPL, HCS - Human Chorionic
Somatomammotrophin)
-Human Chorionic Thyrotrophin (HCT)
-Oestrogen , Progesterone
-Relaxin
Human Chorionic Gonadotrophin (HCG)
Growth of Corpus Luteum
Presence in Serum & Urine - Diagnostic of Pregnancy
Growth of Testis / Ovarian Follicles in Fetus
Human Placental Lactogen
- Maternal Growth Hormone of Pregnancy
- Growth of Breast glands
- Retention of Nitrogen, Calcium , Sodium
- Makes Glucose & Fats available to the Fetus
Oestrogen
- Growth of ducts of Breast glands
- Increases the sensitivity of uterus to Oxytocin
Progesterone
- Growth of alveoli of Breast glands
- Maintenance of Pregnancy
-
Relaxin - Relaxes Pelvic joints & Pubic symphysis
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Softens and dilates the uterine cervix Facilitates delivery

6. INDICATORS OF OVULATION
1. Basal Body Temperature- A rise of 0.50C after ovulation
2. Billings Method -
Cervical Mucus :
Before ovulation- Elastic, Stretchable upto 10 cms (Spinnbarkeit effect)
After ovulation – Thick and can not be stretched
3. Fern Test
Before Ovulation –cervical mucus produce a fern pattern when dried on a glass
slide
After Ovulation – Fern pattern disappears
4. Biopsy of the endometrium – checking for the secretory phase
5. Endoscopy
6. Blood Gonadotrophins Level
7. Ultrasound Abdomen
7. NEUROENDOCRINE REFLEXES
Partiturition/Ferguson Reflex
Uterine contraction
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Milk let down or suckling reflex

Suckling of breast by the baby
↓
Stimulation of mechanoreceptors on nipple & areola
↓
Afferents (somatic nerve)

spinal cord
↓
Hypothalamus

Anterior pituitary Posterior pituitary

(Lactotrops) (Paraventricular nucleus)
↓ ↓
Prolactin Oxytocin

8. FETO_PLACENTAL UNIT
- Fetus & Placenta function as a unit in synthesising estrogen & progesterone
- Helps to maintain the level of steroids which inturn maintain the pregnancy
Maternal blood Placenta Foetal Adrenal
Progesterone Progesterone Cortisol, Corticosterone

Acetate

Pregnenolone DHEAS

16 – OH DHEAS 16 – OH DHEAS

Estrogen Estrogen

9. HCG
-Secreted by syncytiotrophoblast of placenta
-Reaches its maximum level at 60th -70th day of pregnancy
Functions:
- Growth of corpus luteum
- Secretion of progesterone & estrogen from Corpus Luteum
- Growth of testes & testosterone secretion in male foetus
- Androgen production from fetal adrenal cortex
- Formation of primordial follicle in fetal ovary
- Growth of breast
- High level in urine – diagnosis of pregnancy