FEMALE REPRODUCTIVE SYSTEM

1. FEMALE REPRODUCTIVE SYSTEM • Internal sex organs : • ovary : gametogenesis and hormone production • oviduct : oocyte transport • uterus : embryo development • vagina : • External genital structures : vulva

2. External Genital Structures (I) • Mons pubis • Labia majora • Labia minora • Clitoris: • numerous sensory ending • erectile structures : • corpora cavernosa • glan clitoris

3. External Genital Structures (II) • Vestibule : • mucous glands : • lesser vestibular glands (Skene's gland) • greater vestibular glands (Bartholin's gland) • Opening of vigina • Esternal urethral orifice • Mammary glands

4. Mature Stage • Menarche : • the initiation of the menstrual cycle • Menstrual cycle : • about 28 - 30 days each cycle • from menarche to menopause (45 - 55 years) • Menopause : climacterium • ovaries cease reproductive function

5. Ovary (I) • Functions : • gametogenesis (oogenesis) • steroidgenesis : • estrogen • progestogen • Surface supporting structures : • superior pole : suspensory ligament • inferior pole : ovarian ligament (gubernaculum)

6. Ovary (II) • Internal consists : • medulla : loose connective tissue • cortex : ovarian follicles, cellular connective tissue • Geminal epithelium : surface mesothelium (mesovarium) • Tunica albuginea : dense connective tissue • Rete ovarii : irregular blind ducts • Ovarian follicles : 600,000 - 800,000 at birth

7. Follicle Development • Primordial follicle : • 30um, single layer of squamous follicular cells • Primary follicle : • one layer or more cuboidal follicular cells (granulosa cells) • oocyte : 50-80 um, zona pellucida appear • Secondary follicle : • 0.2 -10 mm, oocyte : 125 um • antrum appear

8. Primary Follicle • Zona pellucida • Granulosa cell • Theca folliculi : stromal cell • theca interna : • steroid-producing cells : synthesis androgen (precursors of estrogen) • LH receptor (stimulate by LH) • theca externa : • connective tissue, smooth muscle • Maturation of oocytes cooure in the primary follicle

9. Secondary Follicle • Hormone (factor) require : • follicle-stimulating hormone (FSH) • epidermal growth factor (EGF) • insulinb-like growth factor I (IGF-I) • calcium ions (Ca+2) • Liquor folliculi : • antrum • Cumulus oophorus • corona radiata

10. Graafian Follicle • Graafian follicle : 10 mm or more • LH stimulate : • theca internal cell secrete androgen • FSH stimulate : • granulosa cells product estrogen • Ovulation : • with corona radiata

11. Fertilization • Spermatozoon : • final step capacitation • acrosome reation • male pronucleus • Prevent polyspermy : • fast block : depolarization • cortical reation : Ca+2 release, cortical granules release • zona reaction : proteases degrade oolemma receptors • Form perivitelline barrier : zona pellucida surface proteins cross-linking

12. Corpus Luteum • Corpus luteum (luteal gland) : • consists : • granulosa lutein cells • theca lutein cells • Hormones : • estrogen • progesterone

13. Corpus Luteum of Pregnacy • Corpus Luteum of Pregnacy : implantation • paracrines : • estrogens • IGF-I and IGF-II • endocrines : • human chorionic gonadotropin (hCG) • liteinizing hormone • prolactin • insulin

14. Corpus Luteum of Menstruation • Corpus luteum of menstruation : • not implantation • active only 14 days • Corpus albicans : hyaline material accumulates • Atresia : follicular astresia • Interstitial cells (luteal cells) : • Ovarian hilar cells :

15. Blood Supply and Nerve Innervation • Arteries : • ovarian arteries : • ovarian branches of the uterine arteries : • helicine arteries : • pampiniform plexus • Nerve innervation : • sympathetic and parasympathetic nerve • midcycle pain (mittelschmerz)

16. Oviduct • Segments : • infundibulum, ampulla, isthmus, uterine (intramural) part • Consists : no submucosa • serosa (peritoneum) : mesothelium • muscularis : inner circular and outer longitudinal layer • mucosa : folding, simple columnar epithelium • cilliated cells : stimulated by estrogen • peg cells : stimulated by progesterone

17. Uterus • Anatomically divides : • body : fundus • cervix : • internal os • external os • portio vaginalis • Uterine wall consists: • perimetrium • myometrium • endometrium

18. Uterine Wall (I) • Endometrium : • stratum functionale (functional layer): • endometrial stroma, • uterine glands • stratum basale (basal layer): • artery : • radial arteries, small straight arteries, spiral artery • lacunae

19. Uterine Wall (II) • Myometrium : • thickest layer • three smooth muscle layer • middle muscle layer : • stratum vasculare • circular or spiral • inner and outer layer smooth muscle : • longitudinal : • Perimetrium :

20. Cervix • Cervical mucosa : • little change in thickness during menstrual cycle • no sloughed during menstruation • mucus secretion vary during the menstrul cycle • under the control of ovarian hormones • Nabothian cysts : blockage of the openings • Partio vaginalis : • stratified squamous epithelim

21. Menstrual Cycle • Proliferative phase : • under influence of estrogen • epithelium and stromal cells rapid proliferation • spiral arteries replenish • Secretory phase : • under influence of progesterone • Menstrual phase : • Anovulatory cycle : • Gravid cycle :

22. Implantation • Morula : • Blastomeres : • Blastocyst : • inner cell mass : form embryo • outer cell mass : form placenta • syncytiotrophoblast (synthesize hCG), cytotrophoblast • endometrium decidualization : • decida basalis, decida capsularis, decida parietalis

23. Placenta (I) • Chorion : • primary chorionic villi • secondary villi • tertiary villi • trophoblastic shell • cell types : • fibroblasts • Hofbauer cells : (macrophages)

24. Placenta (II) • Decidua basalis : • Placental barrier : • syncytiotrophoblast • discontinuous inner cytotrophoblast layer • basal lamina of trophoblasts • connective tissue of the villus • basal lamina of endothelium • endothelium of the fetal placental capillary

25. Placenta (III) • Endocrine functions : fetoplacental unit • human chorionic hormone (hCG) • human chorionic somatomammotropin (hCS) • insulin-like growth factors I and II (IGF-I, IGF-II) • endothelial growth factor (EGF) • relaxin • other growth factors : fibroblast growth factor, colony-stimulating factor (CSF-1), platelet-derived growth factor, interleukins (IL-1, IL-3), tumor necrosis factor

26. Placenta (IV) • Circulation exchange : • fetal circulation : • umbilical arteries : • capillary networks in villi : • umbilical vein : • maternal circulation : • spiral endometrial arteries : • intervillous spaces : • endometrial veins :

27. Vagina and External Genitalia • Vagina : few general sensory nerve endings • inner mucosa layer : no glands • intermediate muscular layer : inner circular and outer longitudinal • outer adventitial layer • External Genitalia : vulva • mons pubis, labia minora, labia majora, clitoris, vestibule • Glands : • lesser vestibular glands (Skene’s glands) • greater vestibular glands (bartholin’s glands)

28. Mammary Glands • Mammary papilla (nipple) : • Mammary ridges (milk lines) : • Inactive gland : • Active gland : • merocrine secretion : milk protein • apocrine secretion : fatty and lipid • colostrum : low lipid content, more antibodies • Hormone control :