PHYSIOLOGY OF REPRODUCTION PUBERTY CONTRACEPTIVES BARRIER CONTRACEPTIVES: •condoms •contraceptive sponges with spermicide •diaphragms •cervical caps HORMONAL: • oral pills •implants under the skin •injections •patches •IUDs •vaginal ring INTRAUTERINE DEVICES: •copper IUDs •IUD with levonorgestrel STERILIZATION: •tubal ligation •vasektomy BEHAVIORAL: •fertility awareness methods •coitus interruptus •lactation ORAL PILLS 0,4 0 0,1 0,2 0,3 1 7 14 21 28 day P E ORAL PILLS ORAL PILLS •Progestational effects include: •Inhibition of ovulation by suppressing luteinizing hormone (LH); •Thickening of cervical mucus, thus hampering the transport of sperm; •Possible inhibition of sperm capacitation; •Hampered implantation by the production of decidualized endometrium with exhausted and atrophic glands •Estrogenic effects include: •Partial inhibition of ovulation in part by the suppression of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), depending on dose; •Alteration of secretions and cellular structures of the endometrium within the uterus • BENEFITS AND RISCS OF HC reducing the risk of total cancer by 12%: ―ovarian cancer ―endometrial cancer ―colorectal cancer ―ovarian cysts acne ―venous thromboembolism (VTE) ―arterial thrombosis (AT) ―breast cancer ―diseases associated with VTE and AT FERTILIZATION FERTILIZATION PRVNÍ POLÁRNÍ TĚLÍSKO GRANULÓZNÍ BUŇKY ZONA PELLUCIDA OOPLAZMA OOLEMMA DRUHÉ POLÁRNÍ TĚLÍSKO MUŽSKÝ PRONUKLEUS ŽENSKÝ PRONUKLEUS I. MITOTICKÉ DĚLENÍ FIMBRIE OPLODNĚNÍ PRVNÍ DĚLENÍ MORULA BLASTOCYSTA IMPLANTACE PLACENTAL FUNCTION I.Transport and metabolism a.Transfer of respiratory gases b.Transport and metabolism of carbohydrates c.Transport and metabolism of amino acids d.Transport and metabolism of lipids e.Transfer of water, inorganic ions, minerals and vitamins II.Endocrine functions a.Oestrogens b.Progesterone c.Chorionic gonadotrophin d.Placental lactogen e.Placental growth factors III.Protektivní funkce a.Cytochrome P450 (xenobiotics) b.A barrier against transmission of many bacteria c. c. !!! IgG a. HORMONAL PROFILE OF PREGNANCY 1 2 3 4 8 12 16 20 24 28 32 36 40 nebezpečí HCG 1 2 3 4 8 12 16 20 24 28 32 36 40 HCG (Human Chorionic Gonadotropin) •glycoprotein •secreted by the syncytial trophoblast cells •prevents involution of the corpus luteum • prevent menstruation and cause the endometrium to continue to grow •can first be measured in the blood 8 to 9 days after implantation •effect on the fetal testes •↓ - ectopic pregnancy, dead fetus •↑ - multiple pregnancy and diagnosis of trisomy 21 - Down syndrome HORMONAL PROFILE OF PREGNANCY nebezpečí HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 RX RX (Relaxin) •relaxes the pubic symphysis and other pelvic joints and softens •dilates the uterine cervix •mediate hemodynamic changes (pregnancy) •RLX1, RLX2 (organs of reproduction) and RLX3 (brain tissue, stress and food intake regulation) HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY HCS/HPL 1 2 3 4 8 12 16 20 24 28 32 36 40 HCS (Human Chorionic Somatomammotropin) placental growth hormone - Human placental lactogen (hPL) •has weak actions similar of growth hormone •causes retention of nitrogen, potassium, calcium •causes decreased insulin sensitivity and decreased utilization of glucose in the mother •secretion of this hormone increases progressively in direct proportion to the weight of the placenta HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 PROL PROL (Prolactin) luteotropic hormone or luteotropin •stimulates the mammary glands to produce milk (lactation) •“luteotrophic” action of prolactin (enhanced progesterone secretion) •plays an important role in maternal behavior (psychosomatic reactions including pseudopregnancy) •inhibits maturation of ovum HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 OX OX (Oxytocin) •secreted by the neurohypophysis (nucleus paraventricularis) •causes uterine contraction •mediates the let-down reflex HORMONAL PROFILE OF PREGNANCY nebezpečí HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY P 1 2 3 4 8 12 16 20 24 28 32 36 40 P (Progesteron) •causes decidual cells to develop in the uterine endometrium •decreases the contractility of the pregnant uterus •contributes to the development of the conceptus even before implantation •prepares the mother’s breasts for lactation HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY 1 2 3 4 8 12 16 20 24 28 32 36 40 HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY E 1 2 3 4 8 12 16 20 24 28 32 36 40 E (Estrogen) •enlargement of the mother’s uterus •enlargement of the mother’s breasts and growth of the breast ductal structure •and enlargement of the mother’s female external genitalia • relax the pelvic ligaments of the mother •dampen the formation of the pituitary gonadotropins - not mature further follicles, miss menstrual cycles HORMONAL PROFILE OF PREGNANCY nebezpečí TĚHOTENSKÉ HORMONY HCG P E HPL 1 2 3 4 8 12 16 20 24 28 32 36 40 PROL OX RX HORMONAL PROFILE OF PREGNANCY nebezpečí FETOPLACENTAL UNIT nebezpečí FETOPLACENTAL UNIT FETUS HPA axis CORTISOL PLACENTAL ENDOCRINE AXIS UTERINE GROWTH ACTIVATION STIMULATION EXTENSION OF UTERUS P E (+) (-) •oxytocin •PGs •Gap junctions PARTURITION GROWTH OF FETUS nebezpečí PARTURITION FETOPLACENTAL UNIT MATERNAL COMPARTMENT hypotalamus neurohyp. OT cortisol FETUS cortisol hypotalamus adenohyp. adrenal gl. cortisol CRH ACTH (lungs) cortisol uterus PGs placental OT estrogens cholesterol placental CRH (vasodilation of the placenta) PARTURITION nebezpečí LACTATION nebezpečí LACTATION PHYSIOLOGICAL CHANGES DURING PREGNANCY nebezpečí THANK YOU FOR YOUR ATENTION nebezpečí