Dr.heny Anggraeny Lenap - Fisiologi Sistem Reproduksi
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Transcript of Dr.heny Anggraeny Lenap - Fisiologi Sistem Reproduksi
DR. HENY ANGGRAENY LENAP
Fisiologi Sistem Reproduksi
Essential female reproductive System functions:
Alat-alat Reproduksi Wanita
Alat reproduksi pada wanita berupa:
- Sepasang ovarium- Oviduk/tuba
fallopii)- Uterus- Vagina- Organ kelamin
bagian luar
Alat-alat Reproduksi Wanita
Ovarium (indung telur):Merupakan kelenjar kelamin yang memproduksi ovum (sel telur) dan menyekresi hormon estrogen dan progesteron
Alat-alat Reproduksi Wanita
Oviduk/tuba Fallopii
(saluran telur):Berfungsi menyalurkan sel telur ke uterus (rahim) dengan gerakan peristaltik dan dibantu oleh gerakan silia pada dindingnya.
Alat-alat Reproduksi Wanita
Uterus (rahim):Tempat berkembangnya embrio. Selama kehamilan volume uterus mampu mengembang hingga 500 kali
Alat-alat Reproduksi Wanita
Vagina:Tempat penis pada saat kopulasi dan sebagai jalan keluar bayi pada proses kelahiran
Alat-alat Reproduksi Wanita
Organ kelamin luar:- klitoris/klentit: struktur
yang sama dengan penis
- Vulva: terdiri atas labium mayor (bibir besar) dan labium minor (bibir kecil)
- Lubang saluran kencing
- Lubang vagina: bagian terluar vagina
- Fundus: bagian lipat paha
Physiological Stages
Neonatal period: birth---4 weeksChildhood: 4 weeks----12 yearsPuberty: 12 years---18 yearsSexual maturation: 18 year---50 yearPerimenopause: decline of ovarian
function (40 years)----1 year postmenopause
Postmenopause:
Oogenesis
Tahapan oogenesis (pembentukan sel kelamin)
Oogenesis
Oogenesis pada ovarium.
Siklus menstruasi
• Fase menstruasi
• Fase pra-ovulasi
• Fase ovulasi
• Fase pasca-ovulasi
Menstruation
Menstruation cyclic endometrium sheds and bleeds due
to cyclic ovulation Mense1. Endometrium is sloughed (progesterone
withdrawal)2. Nonclotting menstrual blood mainly
comes from artery (75%)3. Interval: 24-35 days (28 days). duration:
2-6 days. the first day of menstrual bleeding is consideredy by day 1
4. Shedding: 30-50 ml
Menstruation (Menstrual cycle):
The menarche is the age at the first menstrual bleeding. It often occurs between the 12th and the 14th year.
A normal bleeding corresponds to a loss of up to 50 ml of whole blood. The mixture of vaginal fluid and menstrual blood produces a pH close to that of normal blood. The average cycle length is 28 days.
Fertilisasi
Proses terjadinya fertilisasi di dalam oviduk pada organ reproduksi wanita.
Fertilization & implantation:
Fertilization & Implantation:1-Site: Fertilization occur at mid portion of fallopian tube,sperms
become more able of fertilization after their journey in female genital tract (sperm capacitation)
2-Method Sperm bind to zona pellucida followed by acrosomal reaction(i.e. breakdown of acrosome and release of enzymes as acrosin (trypsin like protease) which facilitate penetrationPolyspermy (penetration of ovum by more than one sperm is prevented by fusion of sperm with zona pellucida causing structural changes in it)
3-Zygote Formed from fusion of sperm&ovum
4-Blastocyst: Formed due to mitotic division of the zygote
5-Implantation Occurs about 6-7 days after fertilization(blstocyst reaches the uterus within 3 days,remains for another 3 days) during this period the endometrium is prepared by progesterone from CLThe outer layer (syncytiotrophoblast erodes the endometrium till the blastocyst become implanted (usually in dorsal wall of uterus)
Kehamilan (gestasi)
Tahapan pembelahan zigot hasil fertilisasi dalam perjalanan ke uterus untuk proses implantasi.
Kehamilan (gestasi) (2)
Proses pembentukan membran kehamilan pada embrio.
Amnion
Amnion
Korion
Sakus vitelinus
Kantung telurPembuluh darah
Awal korion
Massa sel dalam
Endometrium
Uterus
Blastosol
Trofoblas
Kehamilan (gestasi) (3)
Bagian plasenta, cairan amnion, dan tali pusar.
Kehamilan (gestasi) (4)
Embrio manusia pada usai kehamilan: (a) 4 minggu, (b) 5-6 minggu, (c) 8 minggu, dan (d) 16 minggu.
Laktasi
Kondisi payudara(a) sebelum kehamilan dan (b) setelah kehamilan.
Hormonal control of the Breasts:
1-Estrogen: Causes proliferation of the ducts,development of the nipples and increase fat deposition
2-Progesterone: Causes growth of the lobules & alveoli
3-Prolactin: Causes milk formation and secretionTogether with estrogen,progesteron,hCS produce full lobuloalveolar development of breasts during pregnancy
4-Oxytocin: Causes milk ejection (milk let down)Its secretion is stimulated by breast suckling and also affected by conditioned reflexes (mothers hearing their baby cry milk secretion)
5-Other hormones:
Insulin, glucocorticoids, growth hormone needed for breast response to other hormones. thyroid hormones are also necessary for milk secretion
Functions and regulation of prolactin hormone:
Functions of prolactin: Regulation of prolactin:
1-Causes milk secretion from breasts prepared 1st by estrogen & progesterone
1-Suckling reflexly stimulate prolactin (and Oxytocin) secretion
2-Shares other hormones in full breasts development during pregnancy
2-estrogen increase prolactin secretion during pregnancy but antagonizes its milk producing effect (so inhibit lactation during pregnancy)
3-causes amenorrheoa during lactation(as it inhibits GnRH secretion and antagonizes the action of FSH&LH on the ovaries)
3-PIH (prolactin inhibitoryhormone=dopamine) secreted from hypothalamus inhibit prolactin secretion, so L-dopa decrease prolactin secretion while serotonin increase prolactin secretionProlactin increase release of PIH so inhibit its own secretion(-ve feedback)
4-Sleep,exercise ,surgical & psychological stresses increase prolactin secretion
Suckling reflex for lactation
Central reproductive hormones
Hypothalamus-Pituitary-Ovary(H-P-O axis)
Central reproductive hormones
Neuroendocrine regulation1. Gonadotropin-releasing
hormone,GnRH1) chemical structure (pro)Glu-His-Trp-Ser-Tyr-Gly-Leu-Arg-Pro-
Gly-NH2
2) Synthesize and transport
nerve cells
hypothalamus
portal vein
pitutaryanterior lobe
Central reproductive hormones
Central reproductive hormones
3) Regulation of GnRH
Hypothalamus
GnRH
Pituitary
FSH, LH
Ovary
E,P
Central reproductive hormones
2. Gonadotropins1) Composition (glycoprotein) Follicle stimulating hormone,FSH Luteinizing hormone,LH2) Synthesize and transport
Gonadotroph (pulse)
Blood circulatio
n
ovary
Central reproductive hormones
3. Prolactin (PRL)Regulated by the prolactin inhibiting
factor (PIF)
The Ovarian cycle
Function of ovary1. Reproduction development and maturation of
follicle; ovulation2. Endocrine estrogens, progesterone, testosterone
The Ovarian cycle
Cyclic changes of ovary1. The development and maturation of follicle1) Primordial follicle: before meiosis2) Preantral follicle: zona pellucida, granulosa
cells (FSH receptor)3) Antral follicle: granulosa cells (LH receptor),
E↑ 4) Mature follicle: E↑,P↑Theca externa, theca interna, granulosa, follicular
antrum, mound, radiate coronal5) Follicular phase: day 1 to follicle mature (14
days)
The Ovarian cycle
The Ovarian cycle
2. Ovulation1) First meiosis completed → collagen
decomposed → oocyte ovulated2) Regulationa) LH/FSH peakE2↑(mature follicle) → GnRH ↑
(hypothalamus) → LH/FSH peak (positive feedback)
b) P cooperationLH ↑ → P ↑(follicle luteinized before
ovulation) →positive feedback
The Ovarian cycle
3. Corpus luteum1) follicle luteinized after ovulation:
luteal cells2) LH → VEGF → corpus hemorrhagicum3) Regression non fertilized → corpus albicans4) Luteal phase Ovulation to day 1
The Ovarian cycle
sex hormones secreted by ovary1. Composition Estrogen, progesterone, testosterone2. Chemical structure Steroid hormone3. SynthesisCholesterol→pregnenolone→androstenedi
one→testosterone→estradiolΔ5 or Δ4 pathway of estrogen production
The Ovarian cycle
4. Metabolism: liver5. Cyclic change of E and P in ovary1) Estrogena) E↑(day 7) → E peak (pre-ovulate) → E↓
→ E↑ (1 day after ovulate) →E peak (day 7-8) → E↓
b) theca interna cells (LH receptor) → testosterone
c) Granulosa (FSH receptor) → estrogen
The Ovarian cycle
2) ProgesteroneP↑ (after ovulation) → P peak (day 7-8) →
P↓
granulosa
progesterone
LH
The Ovarian cycle
H-P-O axis1. Positive feedbackSex hormones (E)↑ → GnRH or LH/FSH↑E peak (≥200pg/ml) → LH/FSH peak →
ovulation2. Negative feedbackSex hormones (E)↑ → GnRH or LH/FSH↓Follicular phase: E↑ → FSH↓Luteal phase: E↑P↑ → LH/FSH↓(formation) E↓P↓ → LH/FSH↑(regression)
Ovarian Cycle Phases
Fate of corpus luteum?
1-If fertilization of the released ovum takes place it prepares the endometrium for the implantation of the fertilized ovum (continue to secret estrogen & progesterone)
2-if no fertilization occur it degeneratesWhich leads to loss of hormonal support to the uterine
lining disintigration & sloughing (menstrual blood flow)
*Then the cycle restarted by the follicular phase again to rebuild the endometrium (under effect of estrogen)
The endometral cycle
Proliferative phase1. E↑(mitogen)→ stroma thickens and
glands become elongated → proliferative endometrium
2. Duration: 2 weeks3. Thickness: 0.5mm → 5mm
The endometral cycle
Secretory phase1. P↑(differentiation) → secretory
endometrium2. Featuresstroma becomes loose and edematousblood vessels entering the endometrium
become thickened and twistedglands become tortuous and contain
secretory material within the lumina3. Duration: 2 weeks4. Thickness: 5-6mm
Change of Other genital organs
Cervixendocervical glands (E↑)→
mucus(thin,clear, watery) → maximal (ovulation)
endocervical glands (P↑)→ mucus(thick, opaque, tenacious)
VaginaVaginal mucosa (E↑)→ thickening and
secretory changesVaginal mucosa (P↑) → secrete↓
Functional Comparison Between Male & Female reproductive systems
1-Male 2-FemaleA-Pair of
gonads=Testes
B-Produce gametes (sperms) +sex
hormones (testosterone)
A-Pair ofgonads=Ovaries
B-Produce gametes)ova +(Sex hormones
(estrogen-progesterone)
Hormones roles in Female reproductive physiology:
1-In non pregnant state: 2-In pregnant state:
Controlled by: hypothalamic (GnRH) –
pituitary(FSH&LH)-ovarian(estrogen,proges
terone ) axis
Controlled by:Placental hormones
Cyclic changes in Cervix, vagina & breasts:
1-Cervix 2-Vagina 3-Breasts
Estrogen: make mucusthinner, more alkaline If spread on slide dries
in fern like manner
Progesterone : make mucus thick, more
cellular, If spread on slide doesn’t fern
Estrogen: cornification of vaginal epithelium
Progesterone: thick mucus secretion,
proliferation of vaginal epithelium and
leucocytes infiltration
Estrogen:Proliferation of breasts ducts
Progesterone:growth of breast lobules &
alveoli
Functions of estrogen and Progesterone:
Estrogen Progesterone1-Facilitate growth of follicles 1-Causes secretory phase of menstrual cycle
2-growth of female external genitalia,breasts duct system
2-Stimulate developmentof breast lobules & alveoli
3-Produce female 2ry sex characters,body configuration,fat distribution & increase libido
3-Essentia for maitenance of pregnancy
4-Produce proliferative phase ofMenstrual cycle,++uterine blood flow,musculature and make it more sensitive to oxytocin
4-Decrease sensitivity of uterus to oxytocin
5-produce cyclic changes in cervix & vagina 5-Produce cyclic changes in cervix & vagina
6-Control FSH&LH secretion & causes the LH surge at midcycle
6-Inhibit LH secretion during pregnancy (producing amenorrhea)
7-Has metabolic anabolic effects, cause epiphyseal closure of bones (also ++bone density), decrease serum cholesterol level,++angiotensinogen secretion from liver,increase HDL,--LDL(Cardioprotective)Produce salt & water retention
7-Thermogenic effect (++body temperature by 0.5 C at ovulation)++respiratory rate alveolar CO2Produce natriuresisNo anabolic functions
Thank you