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Phase 2: Reproduction, Nephrology and Urology > PBL 2: Assisted Reproductive Technologies > Flashcards

PBL 2: Assisted Reproductive Technologies Flashcards

1
Q

Contrast spermatogenesis from spermiogenesis

A

Spermatogenesis is the process by which spermatogonia become spermatids.

Spermiogenesis the process by which spermatids become spermatozoa

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2
Q

At what stage do sperm cells finally become fully mature?

A
  • Produced in the seminiferous tubules
  • Sperm gain motility in the epididymis.
  • Capacitation- process by which spermatozoa become motile and are fully mature.
  • Capacitation does not occur until the sperm are in the female reproductive tract.
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3
Q

Which testicle lies lower?

A

Left lies lower than the right

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4
Q

The lobules of the testes are composed of what structures?

A

Seminiferous tubules and interstitial tissue

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5
Q

Which structures partitions the testis into lobules?

A

Septa extending inwards from the tunica albuginea, which partition the gland into lobules

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6
Q

Name these coverings of the testes?

A
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7
Q

Where is the epididymis located in relation to the testis?

A

Located above and behind the testis

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8
Q

Describe the structure of the epididymis?

A

Highly coiled duct

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9
Q

What happens to the sperm in the epididymis?

A

It gets stored and undergoes maturation

Gains the ability of motility

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10
Q

What is the arterial supply to the testes and epididymis?

A

Testicular arteries (main supply)

Small extent, the cremasteric artery and artery of the ductus deferens

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11
Q

Describe the venous drainage from the testes?

A

The drainage initially is the pampiniform plexus

This merges into the left and right testicular vein.

Left testicular vein: drains into the left renal vein

Right testicular vein: drains into the inferior vena cava

*** exact same drainage in testicular vein in the female **

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12
Q

Name these parts and arteries of the testes?

A
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13
Q

Name these parts of the testes?

A
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14
Q

The pampiniform plexus surrounds which artery?

A

testicular artery

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15
Q

Name these part of the duct system and accessory glands of the male reproductive tract?

A
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16
Q

During ejaculation, the smooth muscle that lines the ____ contracts _____ to move sperm along the tube

A

A) Ductus deferens

B) Peristaltically

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17
Q

Which part of the duct system in the male reproductive tract runs through the spermatic cord?

A

Ductus deferens

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18
Q

Describe the location of the ejaculatory duct in relation to the prostate?

A

Leads through the body of the prostate gland

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19
Q

The ejaculatory duct is the union of which two structures?

A

Union of the seminal vesicle and the ductus deferens.

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20
Q

The ejaculatory duct empties into which part of the urethra?

A

Prostatic urethra

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21
Q

The seminal vesicles are outpouchs of which part of the male reproductive tract

A

Outpouch of the ductus deferens.

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22
Q

What are the major secretions of the seminal vesicles?

A
  • Secretions include:
    • Alkaline viscous fluid
    • Fructose
    • Prostaglandins
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23
Q

The seminal vesicles are attached to which structure?

A

Posterior wall of the bladder

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24
Q

What is the function of the seminal vesicles?

A
  • Makes up 60% of the total fluid in semen
  • Secretions include:
    • Alkaline viscous fluid
    • Fructose
    • Prostaglandins
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25
Q

What is the function of each of the parts of the seminal vesicles secretions?

A

Alkaline viscous fluid- neutralises the acidic environment in the female tract

Fructose- energy for sperm

Prostaglandins- lower the female immune system response to semen

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26
Q

What is the function of the prostate gland in terms of reproduction?

A
  • Prostate secretes a slightly acidic fluid containing citrate, acid phosphatase and proteolytic enzymes.
  • This fluid liquefies coagulated semen to increase the success of the sperm
    • Sperm can thicken after ejaculation.
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27
Q

Where is the bulbourethral glands located?

A

Posterolaterally to the membranous urethra

Superiorly to the bulb of the penis

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28
Q

What is the function of the bulbourethral glands?

A
  • Produce a mucus-like secretion containing glycoproteins
  • Secretions from the bulbo-urethral gland is known as pre-ejaculate.
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29
Q

What are the 3 main functions of the pre-ejaculate?

A
  • Serves to lubricate the urethra in preparation for the ejaculation.
  • Cleans the pathway for ejaculation by expels any residue such as urine, dead cells and any remaining spermatozoa from previous ejaculation (as sperm can survive for 48hours)
  • Aids in the neutralisation of the acidity in the male urethra
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30
Q

Name the 3 parts of the urethra?

A

3 parts: Prostatic, membranous, penile.

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31
Q

Within each lobule of the testes there is how many seminiferous tubules?

A

there are 1-4 seminiferous tubules per lobule

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32
Q

Name these parts of the histological image of the testes?

A
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33
Q

Name these parts of the histological image of the seminiferous tubules?

A
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34
Q

Describe the unique characteristics of the Sertoli cells?

A
  • Abundant cytoplasm
  • Extends from the basement membrane to the seminiferous tubules
  • Found inside the seminiferous tubules
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35
Q

Describe the epithelium of the rete testis?

A

Lined by ciliated cuboidal epithelial cells- contain microvilli

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36
Q

Why is it important that the retes testis is lined with cillia and microvilli?

A
  • Microvilli
    • Absorb excess materials, including protein and potassium, from the seminal fluid
  • Cilia
    • Aids the movement of the spermatozoa from the seminiferous tubules to the epididymis
    • The spermatozoa are immobile until they reach the epididymis
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37
Q

The epididymis and ductus deferens is lined by which epithelium?

A

Lined by pseudostratified columnar epithelium

Epididymis: with sterocilia- to absorb fluid released from the testes along with sperm.

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38
Q

Name the layers of the wall of the ductus deferens?

A
  • Epithelium
  • Muscular
    • Longitudinal layer
    • Circular layer
    • Longitudinal laye
  • Adventitia
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39
Q

Name these layers of the ductus deferens?

A
40
Q

The penis contains 3 columns of erectile tissue:

Name these tissues?

A
  • 2x corpus cavernosa
  • 1x corpus spongiosum
41
Q

Which column of erectile tissue in the penis does the urethra run through?

A

Corpus spongiosum

42
Q

Which tunica surrounds the columns of erectile tissue in the penis?”

A
  • Jointly, the two corpus cavernosa is surrounded by the tunica albuginea.
  • The corpus spongiosum is also surrounded by tunica albuginea but it is distinct from the corpus cavernosa tunica albuginea.
    • Thinner tunica albuginea.
43
Q

Name these parts of the histological image of the penis?

A
44
Q

The development of a mature sperm cell from a spermatogonia is a 2-step process.

What are these two steps?

A

Step 1- Spermatogenesis

Step 2- Spermiogenesis

45
Q

Define spermatogenesis?

A

Defined as the process by which a spermatogonia develops into a spermatid.

46
Q

Describe spermatogonia?

A
  • Located at the basal compartment of the seminiferous tubules
  • Diploid germ cell (46 chromosomes)
  • Two types:
    • Type A
      • Dark- replenishes the reservoir
      • Pale- mitotic division to form Type B
    • Type B- mitotic division to form primary spermatocyte
47
Q

What is the function of the dark Type A spermatogonia?

A

Replenishes the reservoir and can be converted into pale type A

Stem cell population

48
Q

What is the function of the pale Type A spermatogonia?

A

mitotic division to form Type B spermatogonia

49
Q

Compare dark and pale type A spermatogonia?

A
  • Dark- replenishes the reservoir
  • Pale- mitotic division to form Type B
50
Q

Type B spermatogonia undergoes which type of division to form primary spermatocyte?

A

mitotic division

51
Q

Spermatocyte is a type of ____ germ cell

A) Diploid

B) Haploid

A

Diploid germ cell (46 chromosomes)

Still needs to undergo meiotic divisions

52
Q

What are the two types of spermatocytes?

A

Primary and secondary

53
Q

The primary spermatocyte undergoes what kind of division? and becomes what type of cell?

A

Meiotic division (meiosis 1) to form secondary spermatocyte.

54
Q

The secondary spermatocyte undergoes what kind of division? and becomes what type of cell?

A

Meiotic division (meiosis 2) to form spermatids.

55
Q

The pale type A spermatogonia undergoes what kind of division? and becomes what type of cell?

A

Mitotic division to form Type B

56
Q

The type B spermatogonia undergoes what kind of division? and becomes what type of cell?

A

Mitotic division to form primary spermatocyte

57
Q

Spermatogonia is a type of ____ germ cell

A) Diploid

B) Haploid

A

A) Diploid (46 chromosomes)

58
Q

Spermatid is a type of ____ germ cell

A) Diploid

B) Haploid

A

B) Haploid (23 chromosomes)

59
Q

Which compartment of the seminiferous tubules is the spermatogonia located?

A) Basal

B) Adluminal

A

A) Located at the basal compartment of the seminiferous tubules

60
Q

Which compartment of the seminiferous tubules is the spermatocyte located?

A) Basal

B) Adluminal

A

B) Adluminal compartment

61
Q

Which compartment of the seminiferous tubules is the spermatids located?

A) Basal

B) Adluminal

A

B) Adluminal

62
Q

Name these cell type of the spermatogenesis process?

A
63
Q

Name these types of division in the spermatogenesis process?

A
64
Q

Define spermiogenesis?

A

Defined as the process by which spermatid differentiates into a spermatozoon (mature sperm).

65
Q

What is the difference between spermatogenesis and spermiogenesis?

A

Spermatogenesis is defined as the process by which a spermatogonia develops into a spermatid.

Spermiogenesis is defined as the process by which spermatid differentiates into a spermatozoon (mature sperm).

66
Q

Describe some of the reorganisation steps that the spermatid must undergo to become a spermatozoa?

A
  • Involves numerous steps:
    • Acrosome is formed
    • Flagella is formed
    • Mitochondria is arranged around the midpiece.
    • Bulk of the cytoplasm is casted off as a residual body, leaving only a thing rim of cytoplasm
    • Nucleus material condenses.
67
Q

The paramesonephric duct remains in the female and forms which structures?

A

Uterine tube, uterus and vagina

68
Q

The bulk of the cytoplasm of the spermatids are casted away during spermiogenesis. What is it casted off as?

A

Cast off as a residual body

69
Q

Which cells phagocytosis the residual body (the body contains the excess cytoplasm during spermiogensis)?

A

Sertoli cell

70
Q

Where does the sperm gain the ability of motility?

A

In the epididymis

71
Q

Where does the sperm gain the ability to fertilise the ovum?

A

In the female reproductive tract

72
Q

Which cells in the testes produce testosterone?

A

Leydig cells, located in the interstitium of the testes

73
Q

Luteinising hormone (LH) stimulate which cells in the testes?

A
  • Stimulates the Leydig cells
    • In response to the stimulating the Leydig cells releases testosterone.
  • Stimulates the spermatogenesis process.
    • Without LH, spermatogonia cannot become spermatids.
74
Q

Why is testosterone important in the male reproductive tract

A

Testosterone is responsible for male secondary sexual characteristics and the maintenance of the germinal epithelium.

75
Q

Follicle stimulating hormone (FSH) stimulates which cells in the male reproductive tract?

A
  • Stimulates the Sertoli cells
  • Important in the spermiogenesis process
    • Without FSH, spermatids cannot be differentiated into spermatozoa.
76
Q

Outline the hormones that are involved in the hormonal control of spermatogensis and spermiogenesis?

A
  1. Testosterone
  2. Luteinising hormone (LH)
  3. Follicle stimulating hormone (FSH)
  4. Inhibin
77
Q

Describe inhibins involvement in the hormonal control of spermatogensis and spermiogenesis?

A
  • Secreted by Sertoli cells (located in the seminiferous tubules of the testes)
  • Secreted when sperm count is too high.
  • Inhibin inhibits the release of GnRH (from hypothalamus) and FSH (from anterior pituitary). As a result, slows down spermatogenesis.
78
Q

Which cells in the male reproductive tract produce inhibin?

A

Sertoli cell

79
Q

Which gonadotrophin hormone does inhibin inhibit the release of?

A

FSH only

80
Q

Describe testosterone involvement in the hormonal control of spermatogensis and spermiogenesis?

A
  • Negative feedback
  • Produced by Leydig cells
  • Action of Sertoli cells- stimulating spermatogenesis.
  • Negative feedback to anterior pituitary and hypothalamus
  • Important in regulating the amount of sperm that is produced
81
Q

Name these hormones that have a hormonal control in the spermatogenesis process?

A
82
Q

Sperm survive how long in the female reproductive tract?

A

Sperm survive 24-28 hours in the female reproductive tract

83
Q

Describe capacitation?

A
  • The process of the sperm attaining its final stage of activation- gaining the ability of penetrate the zona pellucida
  • Occurs in the female reproductive tract- not organ specific i.e. occurs anywhere in the female tract.
  • Although spermatozoa are “mature” when they leave the epididymis, their activity is held in check by multiple inhibitory factors secreted by the genital duct epithelia.
  • The fluids in the female reproductive tract causes multiple changes in the sperm
84
Q

Describe the changes that occur in the sperm during capacitation?

A
  • Fluid from the uterine tube and uterus washes away the inhibitory factors that are suppressing the sperm activity.
  • Weakening of the acrosome (cap of the sperm)
    • In the male ducts, the spermatozoa are continuously exposed to cholesterol-rich vesicles, secreted by the seminiferous tubules. The cholesterol embeds into the cellular membrane covering the acrosome, toughening it and prevents the release of the enzymes.
    • In female ducts, the sperm swim away from the cholesterol vesicles to moving towards the uterine cavity. In doing so, they lose much of their excess cholesterol- resulting in the weakening of the acrosome.
  • Increase sperm membrane permeability to calcium ions
    • Calcium ions are able to enter the sperm in abundance, causing a change in the flagella activity.
    • The activity of the flagellum is now a more powerful whiplash motion.
    • The increase in calcium causes changes in the cellular membrane of the acrosome. Resulting in the ability of the acrosome to release its enzymes.
85
Q

Describe the 8 steps of fertilisation?

A

Step 1 – The sperm cell weaves past the follicular cells and binds to the ZP3 glycoprotein on the zona pellucida.

Step 2 – The sperm: ZP3 interaction triggers the acrosomal reaction. During the acrosomal reaction, an increase in calcium triggers the exocytosis of the acrosomal content, including hydrolytic enzymes.

Step 3 – Hydrolytic enzymes in the acrosome are released. They have a local action to dissolve the zona pellucida. The whip-like motility of the flagella pushes the sperm head towards the oocyte membrane.

Step 4- The head of the sperm now lies sideways, with the microvilli of the oocyte surrounding the sperm head. These two membranes fuse; resulting in the contents of the sperm cell entering the oocyte

Step 5- As the spermatozoon penetrates the oocyte’s plasma membrane, it initiates the formation of IP3 and causes calcium to be released from internal stores. A rise in calcium inside the oocyte triggers the cortical reaction, in which there is an exocytosis of granules. The enzymes that are released leads to changes in the zona pellucida proteins, causing the zona pellucida to harden (preventing entry of other sperm cells).

Step 6- The rise in calcium (in step 5) induces the completion of the oocyte’s second meiotic division.

Step 7- The head of the sperm enlarges to become the male pronucleus.

Step 8- Female and male pronucleus fuse.

86
Q

Name the 4 major types of assisted reproductive technology

A
  • IUI – intra uterine insemination
  • IVF – In vitro fertilisation
  • IVF with ICSI (Intracytoplasmic sperm injection).
  • IVF / ICSI using donor gametes
87
Q

Name the assisted reproductive techniques?

A
  • IVF
  • Selective salpingography- proximal tubal blockage
  • Clipping/ salpingectomy
88
Q

Describe intrauterine insemination (IUI)?

A
  • This involves injecting, via catheter, the sperm into the uterus at the correct time for fertilisation.
    • Sperm from the partner or donor is washed and prepared
    • Pregnancy test after 2 weeks to assess if successful.
  • Requires careful monitoring of the menstrual cycle to assess when ovulation has occurred
  • Can involve ovulation induction.
89
Q

Describe ovarian induction in relation to assisted reproductive technology?

A

Women’s natural cycle is suppressed, either by GnRH agonist or antagonist. Afterwards, high dose of FSH is injected into the women, stimulating multiple follicles to develop. The result is multiple dominant follicles.

90
Q

Describe in vitro fertilisation (IVF)?

A
  • Involves removing the oocytes (prior to ovulation) and attaining sperm from the partner.
  • Oocyte and sperm are introduced- fertilisation occurs.
  • Developing embryo is transferred into the uterus, via a catheter. The stage of development in which the embryo is transferred varies.
91
Q

Describe in vitro fertilisation with intracytoplasmic sperm injection (IVF with ICSI)?

A
  • Similar to IVF except the introduction between oocyte and sperm.
  • In ICSI, a single sperm is injected directly into the oocyte- causing the fertilisation.
92
Q

If the woman is aged under 40 years and has not conceived after 2 years of regular unprotected intercourse, how many courses of IVF is offered on the NHS in Scotland?

A

Offer 3 cycles of IVF, with/without ICSI.

93
Q

If the woman is aged over 40 years and has not conceived after 2 years of regular unprotected intercourse, how many courses of IVF is offered on the NHS in Scotland?

A

Offer 1 cycle of IVF, with/without ICSI only if:

  • Women has never had IVF previously
  • No evidence of low ovarian reserve
94
Q

Outline some of the criteria that a couple must achieve in order to be considered for ARTs?

A
  • Both partners must be nicotine free and non-smoking for at least 3 months before referral for treatment and continue to be nicotine free and non-smoking during treatment
  • Both partners must abstain from illegal and abusive substances.
  • Both partners must be Methadone free for at least one year prior to referral for treatment and continue to be Methadone free during treatment
  • BMI of female partner must be above 18.5 and below 30.
  • Neither partner to have undergone voluntary sterilisation, even if sterilisation reversal has been self-funded
95
Q

Describe how polyspermy is prevented during fertilisation?

A

As the spermatozoon penetrates the oocyte’s plasma membrane, it initiates the formation of IP3 and causes calcium to be released from internal stores. A rise in calcium inside the oocyte triggers the cortical reaction, in which there is an exocytosis of granules. The enzymes that are released leads to changes in the zona pellucida proteins, causing the zona pellucida to harden (preventing entry of other sperm cells).

Phase 2: Reproduction, Nephrology and Urology (25 decks)

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