§ The ovarian cycle is the

name given to the

physiological changes
that occur in the ovaries
essential for the
preparation and release
of an oocyte.
§ Body structures involved
in the hormonal cycle:
§ Hypothalamus
§ Anterior pituitary glands
§ Ovaries
§ Uterus
Pituitary hormones Ovarian hormones
which regulates which regulates
menstrual cyclic menstrual cyclic
activities activities

1. Follicle Stimulating 1. Estrogen

Hormones (FSH)
2. Progesterone
2. Luteinizing Hormone (LH)
§ The ovarian cycle describes changes that occur in the
follicles of the ovary whereas the uterine cycle describes
changes in the endometrial lining of the uterus.
§ Both cycles can be divided into three phases. The ovarian
cycle consists of the follicular phase, ovulation, and the
luteal phase whereas the uterine cycle consists of
menstruation, proliferative phase, and secretory phase
Phases:
1. Follicular phase
2. Ovulation
3. Luteal phase
§ During this phase, the ovarian follicles mature and get
ready to release an egg
§ Through the influence of a rise in follicle stimulating hormone
(FSH) during the first days of the cycle, a few ovarian follicles are
stimulated.These follicles, which were present at birth and have
been developing for the better part of a year in a process known as
folliculogenesis
§ Under the influence of several hormones, all but one of these
follicles will stop growing, while one dominant follicle in the ovary
will continue to maturity. The follicle that reaches maturity is called
a tertiary, or Graafian, follicle, and it contains the ovum
The cycle of a graafian follicle in the
ovary
A ripe graafian follicle
§ Ovulation is the second phase of
the ovarian cycle in which a
mature egg is released from the
ovarian follicles into the oviduct
§ When the egg has nearly matured,
levels of estradiol reach a threshold
above which this effect is reversed and
estrogen stimulates the production of a
large amount of LH
§ The release of LH matures the egg and
weakens the wall of the follicle in the
ovary, causing the fully developed
follicle to release its secondary oocyte
§ The secondary oocyte promptly
matures into an ootid and then
becomes a mature ovum. The mature
ovum has a diameter of about 0.2 mm
1.MITTLESCMERZ = A CERTAIN DEGREE OF PAIN FELT AT
THE LOWER LEFT OR RIGHT ILIAC
2.CERVICAL MUCUS METHOD OR BILLING’S METHOD =
CHANGES IN CERVICAL MUCUS SECRETIONS TO
CLEAR, ELASTIC & WATERY ( MOST RELIABLE SIGN).
3.SPINNBARKHEIT TEST = TEST FOR ELASTICITY OF
CERVICAL MUCUS
4.INCREASE IN BASAL BODY TEMPERATURE
5.MOOD CHANGES
6.BREAST CHANGES AND ENLARGEMENT
7.INCREASED LIBIDO
§ The luteal phase is the final phase of the ovarian cycle and it
corresponds to the secretory phase of the uterine cycle. During
the luteal phase, the pituitary hormones FSH and LH cause the
remaining parts of the dominant follicle to transform into the
corpus luteum, which produces progesterone
§ The increased progesterone in the adrenals starts to induce the
production of estrogen. The hormones produced by the corpus
luteum also suppress production of the FSH and LH that the
corpus luteum needs to maintain itself
§ Consequently, the level of FSH and LH fall quickly over time,
and the corpus luteum subsequently atrophies
§ From the time of ovulation until progesterone withdrawal has
caused menstruation to begin, the process typically takes about
two weeks, with 14 days considered normal
§ The menstrual cycle is
the name given to the
physiological changes
that occur in the uterus
and which are
essential to receive the
fertilized oocyte. The
menstrual cycle
consist of three
phases.
• The proliferative phase is the part of the menstrual cycle during which
follicles inside the ovaries develop and mature in preparation for ovulation
• The levels of FSH increase in the bloodstream during the proliferative
phase, stimulating the maturation of follicles
• Also during the proliferative phase, the ovaries produce estrogen. The
rising levels of estrogen cause the lining of the uterus to begin thickening.
• Once the levels of estrogen are at their peak, the pituitary gland slows the
secretion of FSH, and instead begins to secrete luteinizing hormone (LH).
As a result of the increase in LH, the mature follicle ruptures and releases
the ovum from inside. Once released from the ovary, the ovum will then
travel to the fallopian tubes.
• Ovulation occurs 14 days before the beginning of the next menstrual
period. Ovulation is the most fertile time during a woman's menstrual
cycle.
• After ovulation occurs, LH causes the burst follicle to develop into a
structure called the corpus luteum. The corpus luteum is a small
yellow structure in the ovary that secretes the hormones estrogen
and progesterone.
• The progesterone and the estrogen are at a high level during the
secretory phase, and they help prepare the endometrium to
secrete nutrients that would nourish a conceptus if a fertilized egg
were to implant in it.
• If conception and implantation do not occur, the pituitary gland
will reduce LH and FSH production. Without the presence of LH, the
corpus luteum deteriorates and subsequently the estrogen and
progesterone levels decrease.
• The drop in estrogen and progesterone levels triggers the
shedding of the endometrium, causing menstruation to begin and
the cycle starts over again.
• Period lasting 1 or 2 days; it coincides with constriction of the
spiral arteries of the endometrium that results from decreasing
secretion of estrogen and progesterone. The ischemia results in
shrinkage and degeneration of the endometrium.
• The menstrual phase is the phase during which the lining of the
uterus, called the endometrium, is shed as menstrual flow out of
the cervix and vagina. This process is what women experience
during their menstrual periods, and the menstrual flow actually
consists of blood, mucus, and tissue.
• Menstruation lasts for approximately 3 to 7 days
• Normal blood shed is 10-35ml
1. ASSISTS WITH THE MATURATION OF THE PRIMARY FOLLICLE

2. CAUSES PROLIFERATION OF THE ENDOMETRIUM

3. RESPONSIBLE FOR THE DEVELOPMENT OF SECONDARY SEX

CHARACTERISTICS ( BREAST DEVELOPMENT)
4. INHIBITS FSH PRODUCTION

5. INCREASES CONTRACTIONS OF THE MYOMETRIUM

6. INCREASE CONTRACTIONS OF THE FALLOPIAN TUBES

7. INCREASES QUANTITY AND PH OF CERVICAL MUCUS CAUSING

IT TO BECOME THIN & WATERY & CAN BE STRETCHED TO A
DISTANCE OF 10-13CM ( SPINBARKHEIT TEST OF ELASTICITY)
8. STIMULATES UTERINE CONTRACTIONS
1.INCREASES BBT( THERMOGENIC EFFECT)

2.PREPARES THE ENDOMETRIUM FOR IMPLANTATION BY

INCREASING GLYCOGEN, ARTERIAL BLOOD, SECRETORY
GLANDS, AMINO ACIDS AND WATER.
3.MAINTAINS PREGNACY BY INHIBITING UTERINE
CONTRACTIONS
4.INHIBITS THE PRODUCTION OF LH

5.INCREASES ENDOMETRIAL TORTUOSITY

1.FOLLICLE STIMULATING HORMONE (FSH)
§ STIMULATES THE DEVELOPMENT OF GRAAFIAN FOLLICLE

§ MAKES THE OVUM MATURE

2. LUTEINIZING HORMONE ( LH)

§ STIMULATES OVULATION AND DEVELOPMENT OF CORPUS
LUTEUM
§ Human fertilization, known as conception, is
the fusion of the sperm with the secondary
oocyte, to form the zygote. The process takes
approximately 24hrs and normally occurs in
the ampulla of uterine tube. Following
ovulation, the oocyte, which is about 0.15mm
in diameter, passes into the uterine tube, the
oocyte, having no power of locomotion ,is
wafted along by the cilia and by the peristaltic
muscular contraction of the uterine tube.
§ OVUM:
§ IT IS THE FEMALE SEX CELL OR GAMETE

§ FOLLOWING OVULATION, AS THE OVUM IS EXTRUDED FROM THE

GRAAFIAN FOLLICLE, IT IS SURROUNDED BY A RING OF FLUID “
ZONA PELLUCIDA”, & A CIRCLE OF CELLS CALLED “ CORONA
RADIATA”
§ ** ONLY ONE OVUM REACHES MATURITY EVERY MONTH.
§ ** OVUM CAN STAY VIABLE & IS CAPABLE OF BEING FERTILIZED
FOR 12-24 HOURS AFTER OVULATION BUT CAN LIVE UP TO 3-4
DAYS
§ SPERMATOZOA DEPOSITED IN THE VAGINA REACHES THE
WAITING EGG IN THE FALLOPIAN TUBE IN ABOUT 5 MINUTES
§ THE FUNCTIONAL LIFE OF SPERMATOZOA IS 48-72 HRS
(3DAYS) BUT CAN STAY ALIVE IN THE VAGINA FOR 5 -7 DAYS.
§ ONLY ONE SPERMATOZOON IS ABLE TO PENETRATE THE
CELL MEMBRANE OF THE OVUM AFTERWHICH CELL
MEMBRANE BECOMES IMPERVIOUS TO OTHER
SPERMATOZOA.
§ REPRODUCTIVE CELLS, DURING GAMETOGENESIS DIVIDE BY
MEIOSIS ( HAPLOID NUMBER OF DAUGHTER CELLS)
§ ( THE REST OF THE BODY CELLS HAVE 46
CHROMOSOMES)
§ SPERMS THEREFORE CONTAIN ONLY 23
CHROMOSOMES 22 AUTOSOMES & 1 X SEX
CHROMOSOME OR 1 Y SEX CHROMOSOME.
§ THE UNION OF AN X CARRYING SPERM
(GYNOSPERM)& A MATURE OVUM RESULTS
IN A BABY GIRL (XX)
§ THE UNION OF A Y CARRYING
SPERM(ANDROSPERM) & A MATURE OVUM
RESULTS IN A BABY BOY (XY)
§ ONLY FATHERS CAN DETERMINE THE
SEX OF THEIR CHILDREN
§ SEX OF A CHILD IS DETERMINED AT THE TIME OF
FERTILIZATION
§ SEX OF A CHILD CAN BE DISTINGUISHED THROUGH AN
ULTRASOUND AT 3 MONTHS.
§ FACTORS AFFECTING SPERM MOTILITY
§ ALCOHOLISM
§ CHAIN SMOKING
§ POOR RESISTANCE TO SMOKING
§ MEN WHO WEAR TIGHT JEANS
§ IT IS THE UNION OF A MATURED EGG AND A
SPERM & THE PRODUCT IS CALLED A
CONCEPTUS OR ZYGOTE.
§ IT OCCURS AT THE DISTAL 3RD OF THE
FALLOPIAN TUBE – THE AMPULLA
§ TWO CHANGES THAT TAKE PLACE IN THE SPERM AS IT
REACHES THE OVUM
1. CAPACITATION – REMOVAL OF THE PROTECTIVE
COATING OF THE SPERM
2. ACROSOME REACTION = PERFORATION OF THE HEAD
AND RELEASE OF ENZYMES ( HYALURONIDASE) THEREBY
DISSOLVING THE COVERING OF THE OVUM ( ZONA
PELLUCIDA & CORONA RADIATA.)
§ IS THE FIRST CELL FORMED FROM THE
FERTILIZATION OF SPERM & OVUM.
§ T CONTAINS 46 CHROMOSOMES: 44 AUTOSOMES &
EITHER XX CHROMOSOMES IF THE OFFSPRING IS A
FEMALE, OR XY CHROMOSOME, IF THE OFFSPRING
IS A MALE.
§ IT JOURNEYS FROM THE FALLOPIAN TUBE TO THE
UTERUS FOR 3-5 DAYS
§ 16 HOURS AFTER FERTILIZATION, IT UNDERGOES
ITS FIRST CELL DIVISION ,” BLASTOMERE”
§ WHEN THERE ARE ALREADY 16 OR MORE
BLASTOMERES, THE ZYGOTE IS TERMED
“MORULA”( MORUS – MULBERRY)
§ WHEN IT REACHES THE UTERUS IT IS
TRANSFORMED INTO A “BLASTOCYST” – A BALL
LIKE STRUCTURE COMPOSED OF AN INNER CELL
MASS , CALLED EMBRYONIC DISC OR
BLASTOCELE & AN OUTER LAYER OF RAPIDLY
DEVELOPING CELLS CALLED TROPHOBLASTS OR
TROPHODERM.
§ THE TROPHOBLASTS SECRETES A
HORMONE CALLED “ HUMAN CHORIONIC
GONADOTROPIN
§ NECESSARY IN PROLONGING THE LIFE OF
THE CORPUS LUTEUM.
§ THE BLASTOCELE OR EMBRYONIC DISC
GIVES RISE TO THE THREE PRIMARY GERM
LAYERS: ECTODERM, MESODERM,
ENDODERM.
TISSUE LAYER BODY PORTIONS FORMED

ECRODERM (OUTER • NERVOUS SYSTEM

LAYER)
• SKIN
• HAIR
• NAILS
• SENSE ORGANS
• MUCUS MEMBRANES OF NOSE & MOUTH

MESODERM (MIDDLE • CONNECTIVE TISSUE

LAYER)
• BONES
• CARTILAGE
• MUSCLES
• TENDONS
• KIDNEYS, URETERS,
• REPRODUCTIVE SYSTEM
• HEART
• CIRCULATORY SYSTEM
• BLOOD CELLS
TISSUE LAYER BODY PORTIONS FORMED

ENDODERM / • LINING OF THE GI TRACT

ENTODERM
• RESPIRATORY TRACT,
(INNER LAYER)
• TONSILS, PARATHYROID,
• THYROID, THYMUS GLANDS,
• BLADDER, URETHRA
§ THE BLASTOCYST REMAINS FREE FLOATING IN THE
UTERINE CAVITY FOR 3-5 DAYS & IMPLANTS IN THE
ENDOMETRIUM 6-7 DAYS AFTER FERTILIZATION.
§ AS IT ATTACHES ITSELF TO THE WALL OF THE
UTERUS, ITS TROPHOBLAST CELLS RELEASE
ENZYMES ALLOWING IT TO BURROW DEEP INTO
THE ENDOMETRIUM RESULTING IN RUPTURE OF
VESSELS & BLEEDING AT THE IMPLANTATION SITE.
“ IMPLANTATION BLEEDING”.
§ IDEAL SITE OF IMPLANTATION IS THE FUNDAL
PORTION.
§ AT ABOUT 3 WEEKS, THE TROPHOBLAST CELLS
DIFFRENTIATE INTO TWO DISTINCT LAYERS:
1. CYTOTROPHOBLAST OR LANGHAN’S LAYER:
§ INNER LAYER THAT PROTECTS THE FETUS AGAINST
SYPHILIS UNTIL THE 2ND TRIMESTER.
2. SYNCYTIOTROPHOBLAST OR SYNCYTIAL
LAYER:
§ OUTER LAYER THAT PRODUCES HORMONES HCG, HPL.
ESTROGEN & PROGESTERONE.
§ AS EARLY AS 12 DAYS AFTER
FERTILIZATION,TINY PROJECTIONS
AROUND THE ZYGOTE, CALLED VILLI, CAN
BE SEEN.
§ THE CHORIONIC VILLI IN CONTACT WITH
THE DECIDUA BASALIS PROLIFERATE VERY
RAPIDLY BECAUSE THEY RECEIVE RICH
BLOOD SUPPLY. IT WILL LATER ON FORM
THE FETAL SIDE OF THE PLACENTA.
§ AFTER IMPLANTATION, THE ENDOMETRIUM IS NOW
REFERRED TO AS THE DECIDUA.
LAYERS:
1. DECIDUA BASALIS –LAYER WHERE IMPLANTATION
TAKES PLACE. IT WILL LATER ON FORM THE
MATERNAL SIDE OF THE PLACENTA.
2. DECIDUA CAPSULARIS – LAYER WHICH ENCLOSES,
ENVELOPES THE BLASTOCYST & BECOMES THE BAG
OF WATER.
3. DECIDUA VERA – NO FUNCTION
DECIDUA PARIETALIS – LOCATED UNDER THE
DECIDUA BASALIS.
1. CHORION – TOGETHER WITH THE
DECIDUA BASALIS BECOMES THE
PLACENTA.
2. AMNION – SMOOTH, THIN, TOUGH &
TRANSLUCENT MEMBRANE DIRECTLY
ENCLOSING THE FETUS & THE AMNIOTIC
FLUID. IT IS CONTINUOUS WITH THE
UMBILICAL CORD & COVER THE FETAL
SURFACE OF THE PLACENTA & UMBILICAL
CORD.
§ 500 ML TO 1200 ML AT TERM; AVERAGE 1000
ML
§ 99% WATER & 1% SOLID PARTICLES
CONTAINING ALBUMIN, UREA, URIC ACID,
CREATININE, LECITHIN, SPHINGOMYELIN,
BILIRUBIN & VERNIX CASEOSA.
§ SHOULD BE CLEAR, COLORLESS TO STRAW
COLORED WITH TINY SPECKS OF VERNIX
CASEOSA.
1.GREEN TINGES OR MECONIUM STAINED –
SIGNIFIES FETAL DISTRESS
2.GOLD OR YELLOW – SIGNIFIES HEMOLYTIC
DISEASE SUCH AS Rh OR ABO
INCOMPATIBILITY
3.GRAY – INDICATES INFECTION
4.PINK – SIGNIFIES BLEEDING
1. PROTECTS THE FETUS FROM TRAUMA
2. ALLOWS FREEDOM OF MOVEMENT WHICH
PERMITS SYMMETRICAL GROWTH &
DEVELOPMENT
3. MAINTAINS A CONSTANT TEMPERATURE.
4. SOURCE OF ORAL FLUID INTRAUTERINE.
5. AIDS IN DIAGNOSIS OF MATERNAL & FETAL
COMPLICATIONS.
6. AIDS IN FETAL DESCENT DURING LABOR BY
PROVIDING LUBRICATION IN THE BIRTH CANAL.
§ STRUCTURE THAT CONNECTS THE FETUS TO THE
PLACENTA. MAIN FUNCTION IS TO CARRY O2 &
NUTRIENTS FROM THE PLACENTA TO THE FETUS &
RETURN THE UNOXYGENATED BLOOD & FETAL WASTE
PRODUCTS TO THE PLACENTA.
§ 50 -55 CMS LONG. APPEARS DULL WHITE,MOIST &
COVERED BY AMNION.
§ COMPOSED OF 2 ARTERIES & 1 VEIN ( AVA)
§ IF ONLY TWO BLOOD VESSELS, SUSPECT RENAL
ANOMALIES.
§ WHARTON’S JELLY – GELATINOUS SUBSTANCE THAT
COVERS THE UMBILICAL CORD TO PREVENT KINKING,
ANDTRAUMA TO THE CORD.