Reproductive System

Anatomy of the male and female reproductive system

Physiology of the male and female reproductive system
Hormonal control of the male and female reproductive system
Phases of the Menstrual Cycle.
Effect of diseases/aging/injury/disorder on the reproductive
system.
Unit 6.10 Sistem reproduktif

a) mengenal pasti struktur dan fungsi sistem

reproduktif lelaki dan wanita.
b) memerihalkan fasa yang terlibat dalam kitaran
haid.
Anatomy of the female reproductive system
Anatomy of the male reproductive system
What is the physiology of the reproductive system?

▪In sexually mature males, millions of

gametes (spermatozoa) are continually
produced by the testes.

▪In females, fertility is cyclical and yields a

single gamete (oocyte) approximately once
per month.
NORMAL RANGE
• Normal sperm densities range from 15 million to greater than 200
million sperm per milliliter of semen. You are considered to have
a low sperm count if you have fewer than 15 million sperm per
milliliter or less than 39 million sperm total per ejaculate. Sperm
can live inside a woman's body for less than 5 days.

• At birth, the normal female ovary contains about 1-2

million/oocytes (eggs). Females are not capable of making new eggs,
and in fact, there is a continuous decline in the total number of eggs
each month. By the time a girl enters puberty, only about 25% of her
lifetime total egg pool remains, around 300,000. A released egg lives for
less than 24 hours. The highest pregnancy rates have been reported
when the egg and sperm join together within 4 to 6 hours of ovulation.
Physiology of the male reproductive system

Regulation of the mature hypothalamic-

pituitary-testicular axis and testicular
production of sex steroid hormones and
sperm during the fetal, neonatal,
pubertal, and adult phases of life.
THE HYPOTHALAMIC-PITUITARY-TESTICULAR AXIS 1
• This axis is controlled by a classic feedback loop.
• The major endocrine stimulators of human testes are luteinizing
hormone (LH) and follicle-stimulating hormone (FSH), which are
made by the pituitary and secreted into the systemic circulation.
• LH stimulates testicular synthesis of testosterone and its two major
active metabolites, estradiol and 5-alpha-dihydrotestosterone (DHT).
• LH is secreted in a pulsatile pattern with peaks approximately every
90 to 120 minutes [FSH has a subtler pattern of pulsatility.
• LH and FSH secretion are stimulated by the pulsatile release of
gonadotropin-releasing hormone (GnRH) from neurons in the
hypothalamus; GnRH reaches the gonadotroph cells of the anterior
pituitary via a portal vascular system.
THE HYPOTHALAMIC-PITUITARY-TESTICULAR AXIS 2
• The hypothalamic GnRH pulse generator — The medial basal region of the
hypothalamus (particularly the arcuate nucleus) contains neurons that
secrete gonadotropin-releasing hormone (GnRH) from axon terminals in the
median eminence into the hypothalamic-pituitary portal system.
• These neurons constitute the GnRH pulse generator and act as the
metronome of the axis.
• Because serum concentrations of GnRH in the portal system are normally low,
peripheral circulating GnRH concentrations are very low and not measurable
in humans.
• Several hormones, neuropeptides, neurotransmitters, and cytokines
modulate GnRH secretion.
THE HYPOTHALAMIC-PITUITARY-TESTICULAR AXIS 3
• Kisspeptin and its hypothalamic receptor, KISS1R (formerly
called GPR54), play a major role in stimulating GnRH
secretion, and it is likely that a synchronized interaction
between the secretion of kisspeptin and the co-expressed
neuropeptides, neurokinin B and dynorphin (from KNDy
neurons of the arcuate nucleus), regulate the pulsatility of
GnRH secretion.
• A number of neurotransmitters and hormones regulate
GnRH secretion, including gamma-aminobutyric acid (GABA),
glutamate, and leptin (stimulatory) and sex steroid
hormones, corticosteroids, and opioids (inhibitory).
Physiology of the female reproductive system 1
• The reproductive system in females is responsible for producing gametes (called eggs
or ova), certain sex hormones, and maintaining fertilized eggs as they develop into
mature fetuses and become ready for delivery.
• A female’s reproductive years are between menarche (the first menstrual cycle) and
menopause (cessation of menses for 12 consecutive months).
• During this period, cyclical expulsion of ova from the ovary occurs, with the potential
to become fertilized by male gametes (sperm).
• This cyclic expulsion of eggs is a normal part of the menstrual cycle.
• Female gametes derive from germ cells.
• In utero, oogonia rapidly divide until approximately 7 million germ cells form by the
7th month of gestation.
• The number of germ cells then rapidly declines; most oogonia perish while the
remaining cells, primary oocytes, begin the first meiotic division.
Physiology of the female reproductive system 2

• These cells arrest in prophase I and remain dormant as such until menarche.
• A primordial follicle made up of granulosa and theca cells surrounds each oocyte.
• When primordial follicles mature, the granulosa cells proliferate to form concentric layers
around the oocyte.
• The oocyte itself undergoes a drastic volume increase.
• With the onset of menarche, finite groups of oocytes periodically resume meiosis and continue
to develop.
• At the time of fertilization, oocytes are arrested in metaphase II.
• The oocyte becomes an ovum as it expels its second polar body, and meiosis resumes when
the egg undergoes activation by a sperm cell (a male gamete).
• Menarche is a female’s first menstrual cycle, marked by her first episode of menstrual
bleeding.
• Menarche occurs during puberty, preceded by breast growth, axillary and pubic hair growth,
and a growth spurt.
Physiology of the female reproductive system 3
• At the initiation of each menstrual cycle, a number of primordial follicles in the
female’s ovaries continue development.
• One becomes the dominant follicle and continues to grow while the other follicles
become atretic and cease to develop.
• The dominant follicle develops into a Graafian follicle, at which point meiosis I has
completed, and the ovum is no longer in prophase I arrest.
• At ovulation, the Graafian follicle expels the ovum from its surrounding tissue,
henceforth called the corpus luteum.
• If no fertilization takes place, the expulsion of the egg occurs from the uterus
along with the secretory endometrial lining under the influence of declining levels
of progesterone; this presents as menstrual bleeding.
• If fertilization does occur, the fertilized egg implants in the endometrial wall and
the endometrial lining is maintained by progesterone secreted (initially) by the
corpus luteum until the placenta takes over.
Hormonal control of the male and female reproductive system
What is the normal menstrual cycle? 1

• The normal menstrual cycle divides into the follicular and luteal phases, with
ovulation occurring between phases.
• The follicular phase begins with menstrual bleeding and ends right before the
LH (luteinizing hormone) surge.
• The luteal phase begins with the LH surge and ends with the onset of menses.
• A typical cycle lasts approximately 28 days; the luteal phase lasts 14 days, while
the follicular phase is more variable in its time course.
What is the normal menstrual cycle? 2
• Low serum levels of estradiol and progesterone mark the beginning of the
follicular phase.
• The lack of inhibitory feedback allows for an increase in pulsatile GnRH
(gonadotropin-releasing hormone) levels, leading to elevations in FSH
(follicular stimulating hormone) and LH.
• This rise in FSH levels stimulates follicular maturation, resulting in a select
number of follicles' continued growth.
• The growth of these follicles results in increasing FSH and estradiol levels.
• By the end of the follicular phase, the dominant follicle has emerged and
increased to a size of approximately 20-25mm.
• The increase in estradiol induces thickening of the endometrium to
accommodate the potential implantation of a fertilized egg.
What is the normal menstrual cycle? 3
• When estradiol levels reach a critical level, the negative feedback effect of
estradiol on LH becomes a positive feedback effect, resulting in a massive
surge in LH concentration (and a smaller surge in FSH levels.)
• Approximately 36 hours following the LH surge, the oocyte is released from
the dominant follicle and travels into the uterus via the fallopian tube.
• The corpus luteum (the remaining follicular tissue following oocyte
expulsion) releases progesterone, inhibiting the release of LH and FSH and
stimulating the formation of the secretory endometrium.
• In the absence of fertilization, declining LH levels contribute to a decline in
progesterone and estradiol levels.
• In the presence of fertilization, the oocyte implants into the endometrium
and releases chorionic gonadotropin, which maintains the corpus luteum
and, thus, progesterone production.
The four phases of the menstrual cycle are
menstruation, the follicular phase, ovulation and the
luteal phase.

The menstrual cycle is regulated by the complex

interaction of hormones: luteinizing hormone,
follicle-stimulating hormone, and the female sex
hormones i.e estrogen and progesterone.

The menstrual cycle is governed by an interaction

between reproductive hormones (LH, FSH, oestradiol
and progesterone) that result in growth of a follicle
(follicles are fluid-filled sacs in the ovaries that contain
eggs), ovulation (release of the egg from the ovary
into the fallopian tubes), formation of the corpus.
 How many days old should sperm be for IVF?
2 days prior to the IVF procedure but not more than 6 days. This will help
to obtain optimal sperm quality for the IVF procedure.

Safety and Risks of IVF

IVF is generally safe, but as with any medical procedure, there are risks. Your
provider should explain all the possible side effects and risks of each
procedure before you begin:-
▪ Cramping, Discomfort, or Infection
▪ Multiples
▪ Birth Defects
Effect of aging on the reproductive system.
 • MENOPAUSE: Most women experience menopause between the ages
of 45 and 55 years as a natural part of biological ageing. Menopause
is caused by the loss of ovarian follicular function and a decline in
circulating blood oestrogen levels. The menopausal transition can be
gradual, usually beginning with changes in the menstrual cycle

▪ ANDROPAUSE: The decrease in testosterone is an important factor in

men suspected of having andropause. However, as men age, not only
does the body start making less testosterone, but also the levels of
another hormone called sex hormone binding globulin (SHBG), which
pulls usable testosterone from the blood, begins to increase
•TQ