The Female Reproductive System • Produces Gametes (Ova) • Prepares

Home , Cardinal ligament, Crus of clitoris, Ovarian cortex, Perimetrium, Round ligament of uterus, Uterosacral ligament

The Female Reproductive System Female Internal Reproductive Organs

• Produces gametes (ova)

• Prepares to support a developing embryo Suspensory ligament of ovary Infundibulum • Undergoes changes according to the Uterine tube Ovary menstrual cycle Peritoneum Fimbriae Uterosacral Uterus ligament • Menstrual cycle is the monthly cycle as it Round ligament Perimetrium Vesicouterine pouch Rectouterine affects all female reproductive organs pouch Urinary bladder Pubic symphysis Rectum Mons pubis • Includes Posterior fornix Urethra Cervix Anterior fornix Clitoris • Ovaries Vagina External urethral orifice Anus Hymen • Uterine tubes, uterus, and vagina Urogenital diaphragm Labium minus Greater vestibular Labium majus (Bartholin’s) gland

The Female Reproductive System The Ovaries

Suspensory ligament of ovary • Small, almond-shaped organs Uterine (fallopian) tube Uterine tube • Produce ova Ovarian blood Fundus Lumen (cavity) vessels of uterus of uterus Ampulla Mesosalpinx Ovary Isthmus • Held in place by ligaments and mesenteries Mesovarium Infundibulum Broad Fimbriae Broad ligament ligament • Mesometrium Ovarian ligament Round ligament of uterus • Suspensory ligament Endometrium Body of uterus Myometrium Wall of uterus Ureter Perimetrium • Ovarian ligament Uterine blood vessels Internal os Isthmus Cervical canal Uterosacral ligament External os • Ovarian arteries—arterial supply Lateral cervical (cardinal) ligament Lateral fornix • Innervated by both divisions of the ANS Cervix Vagina

Internal Structure of the Ovaries Structure of the Ovary

• Tunica albuginea

• Fibrous capsule of the ovary Tunica albuginea Cortex Granulosa cells Antral follicle • Covered in simple columnar epithelium Degenerating Oocyte Mesovarium and corpus luteum blood vessels • Ovarian cortex—houses developing (corpus albicans) Germinal epithelium Mature ovarian Primary follicles (Graafian) oocytes follicle Antrum • Follicles—multicellular sacs housing oocytes Oocyte Ovarian • Ovarian medulla—loose connective tissue ligament Zona pellucida Theca Medulla • Contains blood vessels, lymph vessels, and folliculi Ovulated nerves oocyte Corpus luteum Corona Developing radiata corpus luteum

1 The Uterine Tubes The Uterine Tubes

• Receive ovulated oocyte • Parts of the uterine tube: • Infundibulum— distal end of uterine tube Muscularis • Surrounded by fimbriae Mucosa Ciliated Ampulla— middle third of uterine tube columnar • epithelium Nonciliated • Usual site of fertilization epithelium Lamina • Isthmus— medial third of uterine tube propria (a) Cross section through the ampulla (b) Enlargement of the mucosa (10×) (180×)

The Uterine Tubes The Uterus

Suspensory • Lies anterior to rectum— posterior to bladder ligament of ovary Uterine (fallopian) tube • Anteverted (anteflexed): usual position of uterus Uterine tube Ovarian blood Fundus Lumen (cavity) • Parts of the uterus: vessels of uterus of uterus Ampulla Mesosalpinx Ovary Isthmus • Fundus—rounded superior portion Mesovarium Infundibulum Broad Fimbriae • Cervix—“neck” of uterus ligament • Cervical canal— communicates with vagina inferiorly Mesometrium Round ligament of uterus Ovarian ligament • Internal os— opening connecting with uterine cavity Endometrium Body of uterus Myometrium Wall of uterus • External os— inferior opening of cervix Ureter Perimetrium Uterine blood vessels Internal os Isthmus Cervical canal Uterosacral ligament External os Lateral cervical (cardinal) ligament Lateral fornix Cervix Vagina

The Uterus Supports of the Uterus

• Uterus is supported by Suspensory ligament of ovary Infundibulum • Mesometrium—anchors uterus to lateral Uterine tube Ovary pelvic walls Peritoneum Fimbriae Uterosacral Uterus • Lateral ligaments—horizontal from cervix ligament Round ligament Perimetrium Vesicouterine pouch and vagina Rectouterine pouch Urinary bladder Pubic symphysis • Round ligaments—bind uterus to the anterior Rectum Mons pubis Posterior fornix Urethra pelvic wall Cervix Anterior fornix Clitoris Vagina External urethral orifice Anus Hymen Urogenital diaphragm Labium minus Greater vestibular Labium majus (Bartholin’s) gland

PLAY Female Reproductive Anatomy

2 Uterine Wall Uterine Wall

• Wall of the uterus composed of: • Uterine arteries—send branches to the • Perimetrium, myometrium, and endometrium uterine wall and divide into arcuate arteries • Embryo burrows into endometrium • Radial arteries reach the endometrium and • Endometrium has two layers: branch into • Functional layer • Straight arteries— to basal layer • Basal layer • Spiral arteries— to functional layer • Spiral arteries undergo degeneration and regeneration with menstrual cycle

The Uterine Wall The Female Menstrual Cycle and Oogenesis

Lumen of uterus Lumen of uterus

Epithelium Epithelium • Monthly menstrual cycle Capillaries Uterine glands Uterine glands • Due to hormonal fluctuations in ovaries and Venous sinusoids Lamina propria of Functional connective tissue uterus layer of the Lamina propria of endometrium connective tissue Spiral (coiled) artery changes in the ovary during the Straight artery • Ovarian cycle— menstrual cycle: stimulates production of ovarian follicles

Endometrial vein and oocytes Smooth muscle fibers Basal layer Radial artery • Uterine cycle— changes in the uterus during the of the endometrium Smooth muscle menstrual: prepares uterine wall for implantation fibers Arcuate artery Portion Radial artery Uterine artery of the (a) myometrium (b)

The Ovarian Cycle The Ovarian Cycle

• Has three successive phases: • Follicular phase • Follicular phase • First half of the ovarian cycle • Ovulation • 6–12 primordial follicles stimulated to develop • Luteal phase • Growth stimulated by FSH from anterior pituitary • Primordial follicle becomes a primary follicle • Zona pellucida—glycoprotein coat surrounding oocyte • Theca folliculi—internal layer secretes hormones

3 The Ovarian Cycle The Ovarian Cycle

• Follicular phase (continued) • Ovulation • Antrum forms • Occurs about halfway through each ovarian • A fluid filled cavity between granulose cells cycle (Day 14) • Primary follicles become a secondary follicle • One mature oocyte exits from one ovary • Corona radiata—coat of granulosa cells • Enters peritoneal cavity surrounding oocyte • Swept into uterine tube • Secondary follicle enlarges and becomes Sudden increase in LH is signal for ovulation • Vesicular (Graafian) follicle—ready to be • ovulated

PLAY Ovulation

The Ovarian Cycle The Ovarian Cycle

• Luteal phase • Occurs after ovulation in last half of the

1 Primordial 2 Primary follicles follicle ovarian cycle 3 Secondary follicle Theca folliculi 3 4 2 Primary oocyte 4 Antral follicle • Remaining follicle becomes a corpus luteum 1 Zona pellucida 8

Antrum Secondary oocyte • Secretes progesterone 5

7 6 Secondary oocyte • Acts to prepare for implantation of an 7 Corona radiata embryo • If no implantation • Corpus luteum dies and becomes a corpus albicans

7 Corpus luteum (forms 6 Follicle ruptures; 5 Mature ovarian follicle carries out from ruptured follicle) secondary oocyte ovulated meiosis I; ready to be ovulated Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. Figure 25.17

The Ovarian Cycle Oogenesis

• Takes many years to complete LH • Primordial follicles are arrested (stalled) in

FSH meiosis I Plasma hormone level Plasma hormone level • Surge of LH ( at puberty) also causes Days 1 5 10 15 20 25 28 Menstrual Proliferative Secretory phase phase phase primary oocyte to compete meiosis I (a) Fluctuation of gonadotropin levels: Fluctuating levels of pituitary gonadotropins (follicle-stimulating hormone and Primary Vesicular Corpus luteinizing hormone) in the blood regulate the events of the follicle follicle luteum ovarian cycle. Secondary Ovulation Degenerating follicle corpus luteum

Follicular Ovulation Luteal phase (Day 14) phase Days 1 5 10 15 20 25 28 Menstrual Proliferative Secretory phase phase phase (b) Ovarian cycle: Structural changes in the ovarian follicles during the ovarian cycle are correlated with (d) changes in the endometrium of the uterus during the uterine cycle.

4 Oogenesis Oogenesis Meiotic events Follicle development Before birth in ovary Oogonium (stem cell) Follicle cells Mitosis Oocyte • Oogenesis produces only one ovum and Primary oocyte Primordial follicle three polar bodies Growth Infancy and childhood Primary oocyte Primordial follicle (ovary inactive) (arrested in prophase I; • Polar bodies do not contribute to present at birth) Each month developing embryo from puberty Primary follicle to menopause Primary oocyte (still arrested in Secondary follicle • Meiosis II is completed only if sperm prophase I)

penetration occurs Spindle Mature ovarian follicle Meiosis I (completed by one primary oocyte each month in response to LH surge) Secondary oocyte (arrested in First polar body metaphase II) Ovulation Meiosis II of polar Sperm body (may or may Ovulated secondary Meiosis II oocyte not occur) completed (only if The ruptured follicle sperm penetration becomes a corpus Polar bodies occurs) luteum and ultimately degenerates. (all polar bodies Second Ovum Degenating degenerate) polar body corpus luteum Copyright © 2011 Pearson Education, Inc. Copyright © 2011 Pearson Education, Inc. Figure 25.19

The Uterine Cycle The Menstrual Cycle Structural and hormonal changes • Series of cyclic phases of the endometrium

Endometrial Blood vessels • Phases coordinate with the ovarian cycle glands

Menstrual • Endometrial phases directed by FSH and LH Estrogens flow Functional layer Progesterone Basal layer • Phases of uterine cycle Plasma hormone level Days 1 5 10 15 20 25 28 Days 1 5 10 15 20 25 28 Menstrual Proliferative Secretory Menstrual Proliferative Secretory phase phase phase • Menstrual phase— days 1–5 phase phase phase (c) Fluctuation of ovarian hormone levels: Fluctuating (d) The three phases of the uterine cycle levels of ovarian hormones (estrogens and progesterone) Menstrual: Shedding of the functional layer of • Stratum functionalis (functional layer) is cause the endometrial changes of the uterine cycle. The the endometrium. high estrogen levels are also responsible for the LH/FSH Proliferative: Rebuilding of the functional layer of the endometrium. surge in (a). Secretory: Begins immediately after ovulation. shed Enrichment of the blood supply and glandular secretion of nutrients prepare the endometrium to receive an embryo.

• Proliferative phase— days 6–14 Both the menstrual and proliferative phases occur before ovulation, and together they correspond to the follicular phase of the ovarian cycle. The secretory phase corresponds in time to the luteal phase • Secretory phase— days 15–28 of the ovarian cycle.

The Vagina The Vagina

• Consists of three coats

• Adventitia— fibrous connective tissue Suspensory ligament of ovary • Muscularis— smooth muscle Infundibulum Uterine tube Ovary • Mucosa— marked by transverse folds Peritoneum Fimbriae Uterosacral Uterus ligament • Consists of lamina propria and stratified Round ligament Perimetrium Vesicouterine pouch Rectouterine squamous epithelium pouch Urinary bladder Pubic symphysis Rectum Mons pubis • Hymen— an incomplete diaphragm Posterior fornix Urethra Cervix Anterior fornix Clitoris • Fornix— recess formed at the superior part Vagina External urethral orifice of the vagina Anus Hymen Urogenital diaphragm Labium minus Greater vestibular Labium majus (Bartholin’s) gland

5 The Vagina The External Genitalia and Female Perineum

Suspensory ligament of ovary Uterine (fallopian) tube Uterine tube Ovarian blood Fundus Lumen (cavity) vessels of uterus of uterus Ampulla Mons pubis Ovary Mesosalpinx Isthmus Labia majora Mesovarium Infundibulum Prepuce of clitoris Broad Fimbriae Labia minora ligament Clitoris (glans) Mesometrium Urethral orifice Ovarian ligament Round ligament of uterus Endometrium Vestibule Body of uterus Myometrium Wall of uterus Hymen (ruptured) Ureter Perimetrium Uterine blood vessels Internal os Isthmus Cervical canal Vaginal orifice Uterosacral ligament External os Lateral cervical (cardinal) ligament Anus Opening of the duct Lateral fornix Cervix Vagina of the greater (a) vestibular gland

Deep Structures of the External Genitalia The Mammary Glands and Female Perineum

Clitoris • Breasts—modified sweat glands Labia minora Labia majora • Glandular structure—undeveloped in nonpregnant women Anus Pubic symphysis • Milk production—starts at or after childbirth Body of clitoris, Inferior ramus containing corpora of pubis cavernosa Clitoris (glans) Crus of clitoris Urethral orifice Bulb of Vaginal orifice vestibule Greater vestibular gland (b) Fourchette

The Mammary Glands Pregnancy

First rib • Events leading to fertilization Skin (cut) • Sperm binds to the zona pellucida Pectoralis major muscle • Undergoes the acrosomal reaction Suspensory ligament Adipose tissue • Release of enzymes to form a slit in the zona pellucida Lobe • Fusion of oocyte and sperm plasma membranes Areola Nipple • Cortical reaction Opening of • Enzymes prevent any other sperm from binding to the lactiferous duct egg Lactiferous sinus Lactiferous duct • Fertilization—chromosomes of male and female gametes Lobule containing alveoli join Hypodermis (superficial fascia) Intercostal muscles (a) (b)

6 Events Leading to Fertilization Implantation

Sperm Corona radiata Zona pellucida First polar body • Blastocyst begins implantation Oocyte in second meiotic • About 6 days after conception division • Blastocyst consists of (b) • An inner cell mass and outer trophoblast Sperm nucleus • Trophoblast forms two layers Acrosome • Cytotrophoblast—inner layer Acrosomal reaction Granulosa cells • Syncytiotrophoblast—outer layer of corona radiata Zona pellucida Extracellular space Oocyte plasma Fusion of oocyte Cortical reaction membrane and sperm plasma Cortical granule membranes Oocyte cytoplasm Sperm nucleus engulfed (a) by oocyte cytoplasm Copyright © 2011 Pearson Education, Inc. Figure 25.22 Copyright © 2011 Pearson Education, Inc.

Implantation Implantation Endometrium

Decidua basalis Maternal blood vessels Maternal Maternal blood blood vessels Proliferating Amnion syncytiotrophoblast Proliferating syncytiotrophoblast Cytotrophoblast Chorionic villus Cytotrophoblast Amniotic cavity Yolk sac Amniotic cavity Bilayered embryonic disc Umbilical blood Bilayered Extraembryonic embryonic disc mesoderm vessels in Lumen of uterus umbilical cord Chorion Endometrial epithelium being formed Amnion 1 (a) Implanting 7 /2-day blastocyst. (b) 12-day blastocyst. Implantation is complete. Extraembryonic The syncytiotrophoblast is eroding mesoderm is forming a discrete layer beneath the cytotrophoblast. the endometrium. Amniotic cavity

Lacuna Amniotic cavity (intervillous space) Yolk sac containing maternal Primary blood germ layers

Chorionic villus Ectoderm Extraembryonic Chorion Mesoderm coelom Endoderm Amnion Chorion Forming Lumen body stalk of uterus Decidua Yolk sac Allantois capsularis

Extraembryonic mesoderm 1 (d) 4 / -week embryo. The decidua capsularis, decidua basalis, are well Lumen of uterus 2 Extraembryonic coelom formed. The chorionic villi lie in blood-filled intervillous spaces within the endometrium. The embryo is now receiving its nutrition via the umbilical (c) 16-day embryo. Cytotrophoblast and associated mesoderm have become the chorion, and chorionic villi are elaborating. The body stalk forms the basis of the vessels that connect it (through the umbilical cord) to the placenta. umbilical cord. Copyright © 2011 Pearson Education, Inc. Figure 25.25 Copyright © 2011 Pearson Education, Inc. Figure 25.25d

Formation of the Placenta Anatomy of the Placenta

• Embryonic and maternal tissues contribute to • Exchanges across the chorionic villi between the placenta maternal and fetal blood Placenta Decidua basalis • Provide fetus with nutrients and oxygen Chorionic villi • Dispose of its wastes Yolk sac Amnion • Allow hormonal signals to be sent to the Amniotic mother cavity • By Week 13 the placenta is fully formed Umbilical cord

7 Anatomy of the Placenta Anatomy of the Placenta

Placenta Decidua Maternal Maternal Chorionic basalis arteries veins • Placental barrier consists of villi • All three layers of the chorionic villi Myometrium • Sugars, fats, and oxygen diffuse from mother to fetus Umbilical cord • Urea and carbon dioxide diffuse from fetus to mother Stratum basalis of endometrium Uterus • Syncytiotrophoblast—secretes substances that regulate Lumen of events of pregnancy Decidua uterus Maternal portion capsularis of placenta Maternal antibodies transported across placenta (decidua basalis) • Chorionic villus containing fetal Fetal portion • Viruses, alcohol, and heroin cross the placental barrier capillaries of placenta (chorion) Maternal blood in lacuna (intervillous space) Fetal arteriole Umbilical arteries Fetal venule Umbilical vein Amnion Connection to Umbilical cord yolk sac

Childbirth Childbirth

• Parturition—266 days after fertilization • Labor—events that expel the infant from the uterus

Umbilical Perineum cord

Placenta (c) Expulsion Uterus

Uterus Pubic Placenta symphysis (detaching) Cervix Vagina Sacrum Umbilical cord (b) Dilation (late) (a) Dilation (early) (d) Placental

Reproductive System Cancers in Males Reproductive System Cancers in Males

• Testicular cancer • Prostate cancer • Affects 1 of 50,000 males • Slow-growing—arises from peripheral glands • Commonly from early-stage spermatogenic • Risk factors cells • Fatty diet • Increase of 50% from 1974 to 1990 • Genetic predisposition • Cured in 95% of cases

8 Reproductive System Cancers in Females Reproductive System Cancers in Females

• Ovarian cancer—arises from cells in the • Breast cancer—second most common germinal epithelium cause of cancer deaths in women • Endometrial cancer—arises from the • 97% occurs in women over 50 endometrium of the uterus • Treatment • Cervical cancer—slow-growing, arises from • Surgical removal of the mass (lumpectomy) epithelium at the tip of the cervix • Radiation therapy • Administration of selected hormones • Chemotherapy

Reproductive System Cancers in Females Embryonic Development of the Sex Organs

• Embryo at 5–6 weeks is sexually indifferent • Mesonephric ducts—future male ducts • Paramesonephric ducts—future female ducts

(a) Mammogram procedure

Malignancy

Embryonic Development of the Sex Organs Embryonic Development of the Sex Organs

Mesonephros Mesonephric • Male embryos—sexual differentiation begins (Wolffian) duct in Week 7 (due to SRY (“sex-determining Gonadal ridge Paramesonephric region of the Y chromosome”) triggering (Müllerian) duct secretion of testes-determining factor) Metanephros • Mesonephric duct becomes (kidney) Cloaca • Epididymis • Ductus deferens • Ejaculatory duct • Paramesonephric ducts degenerate

5- to 6-week embryo: sexually indifferent stage

9 Embryonic Development of the Sex Organs Embryonic Development of the Sex Organs

• Female embryos—sexual differentiation • Development of the external genitalia begins in Week 8 (with lack of SRY) Genital • Cortical portion of immature ovaries form Urethral fold tubercle ovarian follicles Labioscrotal • Paramesonephric duct becomes Anus swelling • Uterus Tail (cut) • Uterine tubes Urethral groove • Superior part of vagina • Mesonephric ducts degenerate (a) Indifferent Approximately 5 weeks

Embryonic Development of the Sex Organs Decent of the Gonads Muscular wall Parietal peritoneum of abdomen Epididymis Testis Inguinal canal Glans penis Ductus deferens Glans clitoris Labioscrotal Urethral folds Pubis Fascial covering of Urogenital sinus swellings Labioscrotal Vaginal process spermatic cord (scrotum) swellings Vaginal process Urethral folds (labia majora) Gubernaculum (labia minora) Penis Anus Anus Scrotal swelling

(a) 3-month fetus (b) 7-month fetus

Glans penis Closed proximal Glans clitoris Penis portion of vaginal process Scrotum Labia majora Cremaster muscle Labia minora Anus Anus Spermatic cord Tunica vaginalis (b) Male development (c) Female development Cavity of Scrotum tunica vaginalis Gubernaculum

Puberty Puberty

• Period of life between ages 10–15 • Male secondary sex characteristics • Reproductive organs grow to their adult size • Enlargement of the scrotum and testes • Events of puberty occur in the same (about age 13) sequence in all individuals • Appearance of pubic, axillary, and facial hair • Age at which events of puberty occur varies • Lengthening of vocal folds—deepening voice widely • Musculoskeletal system increases in mass • Sexual maturation—mature sperm in semen

10 Puberty Menopause

• Female secondary sex characteristics • Female reproductive peak—late 20s • Budding breasts (around age 11) • Around age 35—rate of follicle degeneration • Menarche—the first menstruation increases • Other estrogen-induced secondary sex • Ovulation and menstruation cease—age 46– characteristics 54 • Increase in subcutaneous fat Ovaries stop secreting estrogen • Widening and lightening of the bones of the • pelvic girdle • Reproductive organs and breasts begin to • Appearance of axillary and pubic hair atrophy • Estrogen-induced growth spurt from age 12-17