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Physiology of ReproductionPhysiology of Reproduction(II)(II)
Teng Yincheng M.D., Ph.D., Professor
Department Of Obstetrics & Gynecology
Renji Hospital Affiliated to SJTU School of Medicine
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Pregnancy occurs when a mature liberated ovum
is fertilized by a mature capacitated spermatozoon
Pregnancy is defined as the course of embryo and fetal growth and development in uterine
It begain at the fertilization and end the delivery of the fetal and it’s attachment
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The Sperm:The Sperm:• The spermatozoa leave
the testis carrying 23 chromosomes but not yet capable of fertilization.
• Their maturation is completed through their journey in the 6 meters of the epididymis and when mixed with the seminal plasma from the epididymis, seminal vesicle and prostate gland.
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After semen is ejaculated, the sperms reach the cervix by
their own motility within seconds leaving behind
the seminal plasma in the
vagina
The Sperm:The Sperm:
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At time of ovulation, the cervical mucous is in the most favourable condition for sperm
penetration and capacitation as:1. It becomes more copious, less viscous and
its macromolecules arrange in parallel chains providing channels for sperms passage.
2. Its contents from glucose and chloride are increased.
The Sperm:The Sperm:
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• The sperms ascent through the uterine cavity and Fallopian tubes to reach the site of fertilization in the ampulla by:
1. Its own motility, and by2. Uterine and tubal peristalsis which is
aggravated by the prostaglandins in the seminal plasma.
The Sperm:The Sperm:
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• The sperms reach the tube within 30-40 minutes
• But they are capable of fertilization after 2-6 hours. • This period is needed for sperm
capacitation.
The Sperm:The Sperm:
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• Is the process after which the sperm becomes able to penetrate the zona pellucida,that surrounding the ovum and fertilize it.
• The cervical and tubal secretions are mainly responsible for this capacitation.
Capacitation of spermsCapacitation of sperms
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• Capacitation is believed to be due to :1.Increase in the DNA concentration in
the nucleus,2.Increase permeability of the coat of
sperm head to allow more release of hyaluronidase.
Capacitation of spermsCapacitation of sperms
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The ovum:The ovum:The ovum leaves the ovary after
rupture of the Graafian follicle, carrying 23 chromosomes and surrounded by the zona pellucida and corona radiata.
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The ovum is picked up by the fimbrial end of the Fallopian
tubes and moved towards the ampulla by the :
1. Ciliary movement of the cells and 2. Rhythmic peristalsis of the tube.
The ovum:The ovum:
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Fertilization:Fertilization:• Millions of sperms
ejaculated in the vagina, but only hundreds of thousands reach the outer portion of the tubes.
• Only few succeed to penetrate the zona pellucida, and only one spermatozoon enters the ovum transversing the perivitelline space.
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Fertilization:Fertilization:• After penetration of the ovum by a
sperm, the zona pellucida resists penetration by another sperms due to alteration of its electrical potential.
• The pronucleus of both ovum and sperm unite together to form the zygote (46 chromosomes).
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ZygoteZygote
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Sex Determination:Sex Determination:* The * The mature ovummature ovum carries carries 22 autosomes22 autosomes and and
one X chromosomeone X chromosome, while the , while the mature mature spermsperm carries carries 22 autosomes22 autosomes and either an and either an X or Y chromosome. X or Y chromosome.
* If the fertilizing sperm is carrying * If the fertilizing sperm is carrying X X chromosome the baby will be achromosome the baby will be a female female (46 (46 XX),XX), if it is carrying if it is carrying Y Y chromosome the chromosome the baby will be a baby will be a male (46 XY).male (46 XY).
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Cleavage and blastocyst Cleavage and blastocyst formation:formation:
On its way to the uterine On its way to the uterine cavity, the fertilized ovum cavity, the fertilized ovum (zygote)(zygote) divides into divides into 2,4,8 2,4,8
then 16 cells then 16 cells (blastomeres(blastomeres). ).
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• This This cleavagecleavage starts starts within within 24 hours of 24 hours of fertilizationfertilization and occurs and occurs nearly nearly every 12 hoursevery 12 hours repeatedly repeatedly
• The resultant The resultant 16 cells 16 cells massmass is called is called morulamorula which reaches the which reaches the uterine cavity after uterine cavity after about about 4 days4 days from from fertilization. fertilization.
Cleavage and blastocyst Cleavage and blastocyst formation:formation:
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• A cavity appears within the morula converting it into a cystic structure called blastocyst.
• The cells become arranged into an :1. Inner mass (embryoblast) which will form
all the tissues of the embryo, and an 2. Outer layer called trophoblast which
invade the uterine wall.
Cleavage and blastocyst formation:Cleavage and blastocyst formation:
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The blastocyst remains free in the uterine cavity for 3-4 days, during which it is nourished by
the secretion of the endometrium (uterine milk).
Cleavage and blastocyst Cleavage and blastocyst formation:formation:
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Implantation Implantation (nidation) :(nidation) :
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The necessary conditions of imbed
Disapearing of
the pellucid zone Syntrophoblast
formed from the blast Synchronizing development of blast
and the endometriun P Secretory enough
The stage of egg imbedThe stage of egg imbed
Apposition
Adhesion
Penetration
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The deciduaThe decidua::• It is the thickened
vascular endometrium of the pregnant uterus.
• The glands become enlarged, tortuous and filled with secretion.
• The stromal cells become large with small nuclei and clear cytoplasm, these are called decidual cells.
The decidua, like The decidua, like secretory secretory
endometrium, endometrium, consists of three consists of three
layers:layers:1.1. The superficial The superficial
compact layer,compact layer,2.2. The intermediate The intermediate
spongy layer,spongy layer,3.3. The thin basal The thin basal
layer.layer.
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The trophoblast of the blastocyst invades the
decidua to be implanted in:
-The posterior surface of the upper uterine segment in about 2/3 of cases,
-The anterior surface of the upper uterine segment in about 1/3 of cases.
The deciduaThe decidua
After implantation the decidua becomes
differentiated into: 1. Decidua basalis; under
the site of implantation.2. Decidua capsularis;
covering the ovum.3. Decidua parietalis or
vera; lining the rest of the uterine cavity.
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The deciduaThe decidua
As the conceptus enlarges and fills the uterine cavity the decidua capsularis fuses with the decidua parietalis
This occurs nearly at the end of 12 weeks
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The decidua has the following functions:
1.It is the site of implantation. 2.It resists more invasion of the trophoblast. 3.It nourishes the early implanted ovum by
its glycogen and lipid contents.4.It shares in the formation of the placenta.
The deciduaThe decidua
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Chorion:Chorion:After implantation, the trophoblast differentiates After implantation, the trophoblast differentiates
into 2 layers:into 2 layers: a. An outer one called syncytium
(syncytiotrophoblast) which is multinucleated cells without cell boundaries,
b. An inner one called Langhan’s layer (Cytotrophoblast) with simple cytoplasm.
• A third layer of mesoderm appears inner to the cytotrophoblast.
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• The trophoblast and the lining mesoderm together form the chorion.
• Mesodermal tissue ( connecting stalk) connects the inner cell mass to the chorion and will form the umbilical cord later on.
Chorion:Chorion:
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• Spaces (lacunae) appear in the syncytium, increase in size and fuse together to form the " chorio-decidual space" or " intervillus space".
• Erosion of the decidual blood vessels by the trophoblast allows blood to circulate in this space.
Chorion:Chorion:
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• The outer syncytium and inner Langhan’s cells form buds surrounding the developing ovum called primary villi.
• When the mesoderm invades the center of the primary villi they are called secondary villi.
• When blood vessels (branches from the umbilical vessels) develop inside the mesodermal core, they are called tertiary villi.
Chorion:Chorion:
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Primary villous Secondary villousSecondary villous
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Transverse section of tertiary villous
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• At first, the chorionic villi surround the developing ovum.
• After the 12th week, the villi opposite the decidua capsularis atrophy leaving the chorion laeve which forms the outer layer of the foetal membrane and is attached to the margin of the placenta.
Chorion:Chorion:
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• The villi opposite the decidua basalis grow and branch to form the chorion frondosum and together with the decidua basalis will form the placenta.
• Some of these villi attach to the decidua basalis ( the basal plate) called the "anchoring villi", other hang freely in the intervillus spaces called "absorbing villi"
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Amnion:Amnion:After implantation, 2 cavities appear in the inner cell mass; the amniotic
cavity and yolk sac and in between these 2 cavities the
mesoderm develops.
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Development of embryo and fetus
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3 weeks 4 weeks 6 weeks 8 weeks
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Attachment of the fetalAttachment of the fetal
1.Placenta
2.Fetal membranes
3.Umbilical cord
4.Amniotic fluid
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1.PlacentaIt’s an exchange organ between maternal and fetal Amniotic membrane
chorion frondosum
Basal decidua
Round
Weight:450-650g
Diameter:16-20cm
Thickness:1-3cm
thick in center and thin
in margin
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The functions of placenta
Gas exchangeSuply of nutritionDepletion of fetal product of metabolisnDefense functionHormone synthesisHuman chorionic gonadotropin(HCG)
Human placental lactogen(HPL)
Pregnancy specific -glycoprotein(PS 1G)
Human chorionic thyrotropin(HCT)
Estrogen, P, Oxytocinase, heat stable alkaline
phosphatase(HSAP)
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2.Fetal membrane Chorion
Amnion
3.Umbilical cord Length:30-70cm average:50cm
Consist of 2 artery and 1 vein
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4.Amniotic fluid
Source: early from serum dialysis
late from fetal urine
Absorse: by fetal membrane, fetal
swallowing(500ml/day)
Amniotic exchange: between maternal
and fetal 400ml/h
Status of amniotic fluid
pH:7.20
Density:1.007-1.025
Contained: water(98-99%)
inorganic substance
organic substance(1-2%)
Volume of amniotic fluid
8 weeks:5-10ml
10 weeks:30ml
20 weeks:400ml
38 weeks:1000ml
The function of amniotic fluid Protect maternal and fetal
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Maternal changes during pregnancy
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Isthmus: be dialated and become soft from 1cm
pre-pregnancy a portion of the uterus
after 12 gestational weeks
Cervix: be soft and coloration or stain
secrete amount of mucus avoiding the
uterus cavity suffer from infection
Changes of ovary
Stop ovulation
Corpus luteum formation and maintains for
10 weeks
And the function of corpus luteum is
substituted by the placenta
Corpus luteum atretic gradually after 3-4
months gestation.
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2.Changes of the circulationHeart border: become enlargement
Heart rate: increased 10-15 beat per min at the
late pregnancy Heart volume: increased 10% at the late
pregnancy
Cardiac output
Very important for fetal growth and development
Incrased begain 10 weeks and upto the peak at 32 weeks
80ml/bp and keeps the level to the term pregancyChanges of blood system
Volume: increased (30-45% ) begain 6- 8 weeks
and up to the peak at 32-34 weeks
increased about 1500ml including
plasma 1000ml and red cell 500ml
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Changes of blood component
Red cell: reticulocyte increased
red cell decreased 3.6×1012(4.2×1012)
Hb decreased 110g/L(130g/L)
WBC: neutrophilic granulocyte increased
lymphocyte mild increased
no change in orther blood cells Coagulation
Hypercoagulability
Factor increasedⅱⅴⅶ ⅷ Ⅸ ⅹESR increased significantly upto 100mm/h
Plasma protein
albumin decreased
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THANKS FOR YOUR ATTENTION
Teng YinchengTeng Yincheng
M.D., Ph.D., ProfessorM.D., Ph.D., Professor
Dep. of Obstet. & Gynecol.Dep. of Obstet. & Gynecol.
Renji Hospital Affiliated to SJTU School of MedicineRenji Hospital Affiliated to SJTU School of Medicine