Fertilization

Characteristics of sperm for fertilization

Capacitation the capacity to penetrate the ovum which involves the removal of the protective layer
of corona cells by the enzymes hyaluronidase, a protein layer that coats the head of the
spermatozoon

Acrosome reaction release of another trypsin like enzyme (acrosin) dissolving layers surrounding the ovum zona
pellucida

Zona Reaction formation of new barriers around the egg cell after it has been fertilized to prevent the entry
of the sperms
Fertilization  Once the sperm cell has entered, the ovum and the nucleus of 2 sex cells has fused ,
fertilization is achieved
 The second meiotic cell division of the ovum is completed after fertilization & it is
the secondary oocyte that is fertilized
 Fertilization is also known as conception, impregnation or fecundation

Zygote
Zygote  First cell of the human body formed from fertilization of sperm and ovum
 It contains 46 chromosomes: 44 are autosomes & the remaining are either XX
chromosome (female) or XY chromosome (male)
 The zygote journeys from the fallopian tube for a period of 3-4 days aided by
muscular contractions of fallopian tube
 Fertilization → Pronuclei (zygote) → undergo mitosis (cell division) → 2, 4, 8, 16 →
Morula (16 cell stage, apprxtly. On the 3rd day → blastocyst
 3 days – stay in the fallopian tube
 4 days –float in the uterine cavity
 Then implantation
 Upon reaching the uterine cavity, the remaining zona pellucida disintegrates & the
morula is transformed into blastocyst
 The zygote period is from fertilization to implantation

The 2 Layers of Blastocyst 1. outer layer/trophoderm (trophoblast)

2. . inner layer (endoblast/embryoblast)
1. outer layer/trophoderm gives rise to the placenta, fetal membranes, umbilical cord & amniotic fluid. “Feeding” layer;
(trophoblast) principal functions are to secure food for the embryo & secrete HCG to prolong life of the
corpus luteum.

2. inner layer develops into a fetus/baby. Gives rise to the three primary germ layers.
(endoblast/embryoblast)
ectoderm the 1st germ layer to develop that gives rise to the skin, hair nails, sense organs, nervous
system, mucous membrane of the mouth & the anus
Entoderm gives rise to the bladder, lining of the gastrointestinal tract, tonsils, thyroid gland and
respiratory system
Mesoderm gives rise to the kidney, musculoskeletal system, reproductive system and cardiovascular
system

Embryo
Embryo  The BLASTOCYST is a ball like structure composed of inner cell mass called
embryonic disc or blastocoele, occupying one of its poles & an outer layer of rapidly
developing cells called trophoblasts or trophoderm.
 Fluid fills the spaces found within the cells
 The trophoderm layer gives rise to placenta, fetal membranes, umbilical cord &
amniotic fluid. The important functions of the trophoblast are to:
 a. absorb nutrients from the endometrium
 b. secrete the hormone human chorionic gonadotrophin necessary to prolong the life
of corpus luteum


BLASTOCYST  is a ball like structure composed of inner cell mass called embryonic disc or
blastocoele, occupying one of its poles & an outer layer of rapidly developing cells
called trophoblasts or trophoderm.

blastocoele or embryonic disc gives rise to the three germ layers:

st
 DECIDUA: The Endometrium of Pregnancy
DECIDUA: The Endometrium of After implantation, the endometrium is referred to as decidua, the specialized
Pregnancy endometrium of pregnancy. It is composed of 3 layers:

endometrium of pregnancy 1. Decidua basalis

composed 3 layers: 2. Decidua capsularis
3. Decidua vera
1. Decidua basalis part that is directly under the embedded ovum . It will later form the maternal side of the
placenta.

2. Decidua capsularis portion that is pushed out by embedded and growing ovum
3. Decidua vera remaining portion which is not in immediate contact with ovum

4th month – d. capsularis lies in intimate contact with d. vera

Functions of Decidua
1. The most ideal site for implantation because of its rich blood supply that ensures maximum placental growth &
development

2. It provides easy access to the birth of the baby at the end of gestation as it is continuous with the birth canal

3. It may prevent infections coming from the vagina & cervix

4. It produces the following hormones: prolactin, relaxin, corticotropin releasing hormone (CRH), oxytocin &
endothelin-1

The Fetal Membranes

The Fetal Membranes • The membranes enclose the fetus & the amniotic fluid, they also protect the fetus
against ascending bacterial infection as long as it is intact.
• But once the integrity of the membranes are destroyed, the woman is prone to develop
infection

A.CHORION from the chorionic villi that envelops the embryo. The outermost membrane of the growing
zygote which serves as protective and nutritive covering. It provide support to the amniotic
membrane

B. AMNION
Most internal of the fetal membranes, contains cells that produce water (amniotic fluid)
surrounding the fetus in the utero. Also secrete phospholipid that plays an important role in
prostaglandin synthesis, a hormone that stimulates uterine contraction & can initiate labor

Amniotic fluid
1. Medium which the fetus & cord float inside the amniotic membrane

2. It is not static but is in a continuous turn over; 350-500 ml of it is produced and replaced each hour

3. Normal amniotic fluid volume ranges from 500-1200 ml, averaging at 1000 ml

4. It is composed of 99% water and 1% solid particles. It contains albumin, urea, uric acid, creatinine, lecithin,
sphingomyelin, bilirubin, minerals & suspended materials such as desquamated epithelial cells and vernix caseosa

5. It is clear & colorless to straw colored

 Green tinged or meconium stained in nonbreech presentation signifies fetal distress
  Golden colored signifies hemolytic disease such as Rh or ABO incompatibility
 Gray colored indicates infection
 Bloody AF at the time of rupture indicates vasa previa
 Brownish, coffee or tea colored indicates fetal death

6. Ph: 7.0 to 7.25; reaction is neutral to alkaline (litmus test: blue gray to deep blue – nitrazine)

7. Specific gravity: 1.005 to 1.025

8. Production & removal is achieved through the following mechanisms:

a. The mother contributes to the AF by transudation from maternal circulation. Maternal serum composes most of the
fluid in early pregnancy
b. The fetus contributes to AF by:
=active secretion from the epithelium of the
amniotic membrane
=transudation from fetal circulation
=fetal urination as primary source of AF in late
Pregnancy
c. Removal or uptake of AF is by:
=absorption through the amnion to the maternal circulation
=fetal swallowing is the chief mechanism which controls the volume of fluid

9. Deviations from Normal:

A. Oligohydramnios – scanty amniotic fluid less than 500 ml.
Causes:
a. fetal renal anomalies resulting to anuria
b. premature rupture of membranes
c. exposure to angiotensin converting enzyme inhibitors
B. Polyhydramnios – excessive amniotic fluid more than 2000 ml.
Causes:
a. Fetal abnormalities like anencephaly and esophageal atresia
b. Multiple Pregnancy
c. Diabetes Mellitus

Placenta
Placenta 1. Formed at 3rd month
2. A fleshy disklike organ which measures 20 cm in diameter and 2 cm thickness late in
pregnancy.
3. Formed by union of chorionic villi and decidua basalis
4. At term, it weighs 500 gms. Appxtly. 1/3 of baby’s weight
5. Fetal side is smooth & glistening & covered by amnion
6. Maternal side is red & fleshlike divided into number of segments or cotyledons

Placenta(Functions) Functions
1. Transfer of gases ( acts as fetal lung)
2. Transport of nutrients (source of nutrition)
3. excretion of wastes (acts as kidneys)
4. Transfer of heat (acts as skin)
5. Hormone production (acts as endocrine organ through production of various
proteins & hormones)
6. Provider of antibodies (passive natural immunity, IgG)
7. Protective barrier – filters microorganisms
-large particles such as bacteria can’t pass through
-nutrients, drugs, antibodies & viruses CAN pass through
 - alcohol makes the brain of the baby small (mental retardation)
smoking may interfere with blood flow thus small baby with complication
6 months of life (3rd trimester) – span when mother still gives protection to the baby
through transfer of immunoglobulin IgG (passive immunity)

Mechanisms by Which 1. Diffusion

Nutrients Cross the Placenta
1. Diffusion
2. Facilitated diffusion
2. Facilitated diffusion
3. Active transport
4. Pinocytosis
When there is a greater concentration of a substance on one side of a semipermeable
membrane than on the other, substances of correct molecular weight cross the membrane from
the area of higher concentration to the area of lower concentration. Oxygen, carbon dioxide,
sodium, and chloride cross the placenta by this method
To ensure that a fetus receives sufficient concentrations of necessary nutrients, some
substances cross the placenta guided by a carrier so move more rapidly or easily than would
occur if only simple diffusion were operating. Glucose is an example of a substance that
crosses by this process.

3. Active transport This process requires the action of an enzyme to facilitate transport. Essential amino acids
and water-soluble vitamins cross the placenta by this process. The process ensures that a
fetus will have adequate amino acid concentrations for fetal growth.
4. Pinocytosis This is absorption by the cellular membrane of microdroplets of plasma and dissolved
substances.
Gamma globulin, lipoproteins, and phospholipids all have molecular structures too large
for diffusion so cross in this manner. Unfortunately, viruses that then infect the fetus can also
cross in this manner.

Umbilical cord
1. connects the placenta with the umbilicus of the fetus

2. made up of 2 arteries and 1 vein (AVA)

3. 50-55 cm (20 in.) in L & 2 cm diameter

a. Short cord may lead to:
- intrapartum hemorrhage due to premature separation of the placenta
-delayed descent of fetus during labor
-inversion of the uterus
b. long cord may lead to:
- cord presentation and cord prolapse
- coiling of cord around the neck
- True knots of the cord

4. encased in a mass of gelatinous tissue called “Wharton’s jelly”. No nerve endings

-it may prolapsed; if outside the vagina – revealed; if inside the vagina-concealed

Knots of the Cord:

true knots fetus passes through a loop of cord

false knots wharton’s jelly containing a loop of umbilical vessels
Loops of the cord cord coil around the fetal body & neck. When the cord coil is around the neck, also called
 nuchal cord
Fetal circulation
Differences between adult & fetal 1. Presence of certain structures in the fetus
circulation: a. umbilical arteries (2) –carry unoxygenated blood from fetus to the placenta
Later (Filled with clotted blood & converted to fibrous cords)

b. umbilical vein (1) – carry oxygenated blood from the placenta to the fetus
Later ( becomes round ligament of the liver)

c. ductus venosus – connects umbilical vein & inferior vena cava

d. ductus arteriosus –connects pulmonary artery & aorta
Later (d.v. & d.a. shrivel up & converted to fibrous cords or ligaments in 2-3
months
e. foramen ovale – opening between the right atrium & the left atrium

2. Right sided pressure is greater than the left sided pressure because of deflated lungs
Placenta → O2 blood to umbilical vein → part to liver & most to ductus venosus → inferior
vena cava → right auricle → foramen ovale → left auricle → left ventricle → head arms,
others → superior vena cava → right auricle → right ventricle → pulmonary artery→ part
goes to lung
↓
Most to ductus arteriosus → aorta → trunk & lower extremities → umbilical arteries →
placenta

------------------------------------------------------PADAYON!!! ------------------------------------------------------