Learning Objectives
By the end of this chapter, you will be able to:
The human male and female reproductive cycles are controlled by the interaction of hormones from the hypothalamus and anterior pituitary with hormones from reproductive tissues and organs. In both sexes, the hypothalamus monitors and causes the release of hormones from the pituitary gland. When the reproductive hormone is required, the hypothalamus sends a gonadotropin-releasing hormone (GnRH) to the anterior pituitary. This causes the release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the anterior pituitary into the blood. Note that the body must reach puberty in order for the adrenals to release the hormones that must be present for GnRH to be produced. Although FSH and LH are named after their functions in female reproduction, they are produced in both sexes and play important roles in controlling reproduction. Other hormones have specific functions in the male and female reproductive systems.
At the onset of puberty, the hypothalamus causes the release of FSH and LH into the male system for the first time. FSH enters the testes and stimulates the Sertoli cells to begin facilitating spermatogenesis using negative feedback, as illustrated in
Figure 24.14. LH also enters the testes and stimulates the interstitial cells of Leydig to make and release testosterone into the testes and the blood.
Testosterone, the hormone responsible for the secondary sexual characteristics that develop in the male during adolescence, stimulates spermatogenesis. These secondary sex characteristics include a deepening of the voice, the growth of facial, axillary, and pubic hair, and the beginnings of the sex drive.
Figure 24.14. Hormones control sperm production in a negative feedback system.
A negative feedback system occurs in the male with rising levels of testosterone acting on the hypothalamus and anterior pituitary to inhibit the release of GnRH, FSH, and LH. The Sertoli cells produce the hormone inhibin, which is released into the blood when the sperm count is too high. This inhibits the release of GnRH and FSH, which will cause spermatogenesis to slow down. If the sperm count reaches 20 million/ml, the Sertoli cells cease the release of inhibin, and the sperm count increases.
The control of reproduction in females is more complex. As with the male, the anterior pituitary hormones cause the release of the hormones FSH and LH. In addition, estrogens and progesterone are released from the developing follicles. Estrogen is the reproductive hormone in females that assists in endometrial regrowth, ovulation, and calcium absorption; it is also responsible for the secondary sexual characteristics of females. These include breast development, flaring of the hips, and a shorter period necessary for bone maturation. Progesterone assists in endometrial re-growth and inhibition of FSH and LH release.
In females, FSH stimulates development of egg cells, called ova, which develop in structures called follicles. Follicle cells produce the hormone inhibin, which inhibits FSH production. LH also plays a role in the development of ova, induction of ovulation, and stimulation of estradiol and progesterone production by the ovaries. Estradiol and progesterone are steroid hormones that prepare the body for pregnancy. Estradiol produces secondary sex characteristics in females, while both estradiol and progesterone regulate the menstrual cycle.
The Ovarian Cycle and the Menstrual Cycle
The ovarian cycle governs the preparation of endocrine tissues and release of eggs, while the menstrual cycle governs the preparation and maintenance of the uterine lining. These cycles occur concurrently and are coordinated over a 2232 day cycle, with an average length of 28 days.
The first half of the ovarian cycle is the follicular phase shown in Figure 24.15. Slowly rising levels of FSH and LH cause the growth of follicles on the surface of the ovary. This process prepares the egg for ovulation. As the follicles grow, they begin releasing estrogens and a low level of progesterone. Progesterone maintains the endometrium to help ensure pregnancy. The trip through the fallopian tube takes about seven days. At this stage of development, called the morula, there are 30-60 cells. If pregnancy implantation does not occur, the lining is sloughed off. After about five days, estrogen levels rise and the menstrual cycle enters the proliferative phase. The endometrium begins to regrow, replacing the blood vessels and glands that deteriorated during the end of the last cycle.
Which of the following statements about hormone regulation of the female reproductive cycle is false?
Just prior to the middle of the cycle (approximately day 14), the high level of estrogen causes FSH and especially LH to rise rapidly, then fall. The spike in LH causes ovulation: the most mature follicle, like that shown in Figure 24.16, ruptures and releases its egg. The follicles that did not rupture degenerate and their eggs are lost. The level of estrogen decreases when the extra follicles degenerate.
Figure 24.16. This mature egg follicle may rupture and release an egg. (credit: scale-bar data from Matt Russell)
Following ovulation, the ovarian cycle enters its luteal phase, illustrated in Figure 24.15 and the menstrual cycle enters its secretory phase, both of which run from about day 15 to 28. The luteal and secretory phases refer to changes in the ruptured follicle. The cells in the follicle undergo physical changes and produce a structure called a corpus luteum. The corpus luteum produces estrogen and progesterone. The progesterone facilitates the regrowth of the uterine lining and inhibits the release of further FSH and LH. The uterus is being prepared to accept a fertilized egg, should it occur during this cycle. The inhibition of FSH and LH prevents any further eggs and follicles from developing, while the progesterone is elevated. The level of estrogen produced by the corpus luteum increases to a steady level for the next few days.
If no fertilized egg is implanted into the uterus, the corpus luteum degenerates and the levels of estrogen and progesterone decrease. The endometrium begins to degenerate as the progesterone levels drop, initiating the next menstrual cycle. The decrease in progesterone also allows the hypothalamus to send GnRH to the anterior pituitary, releasing FSH and LH and starting the cycles again. Figure 24.17 visually compares the ovarian and uterine cycles as well as the commensurate hormone levels.
Which of the following statements about the menstrual cycle is false?
As women approach their mid-40s to mid-50s, their ovaries begin to lose their sensitivity to FSH and LH. Menstrual periods become less frequent and finally cease; this is menopause. There are still eggs and potential follicles on the ovaries, but without the stimulation of FSH and LH, they will not produce a viable egg to be released. The outcome of this is the inability to have children.
The side effects of menopause include hot flashes, heavy sweating (especially at night), headaches, some hair loss, muscle pain, vaginal dryness, insomnia, depression, weight gain, and mood swings. Estrogen is involved in calcium metabolism and, without it, blood levels of calcium decrease. To replenish the blood, calcium is lost from bone which may decrease the bone density and lead to osteoporosis. Supplementation of estrogen in the form of hormone replacement therapy (HRT) can prevent bone loss, but the therapy can have negative side effects. While HRT is thought to give some protection from colon cancer, osteoporosis, heart disease, macular degeneration, and possibly depression, its negative side effects include increased risk of: stroke or heart attack, blood clots, breast cancer, ovarian cancer, endometrial cancer, gall bladder disease, and possibly dementia.
A reproductive endocrinologist is a physician who treats a variety of hormonal disorders related to reproduction and infertility in both men and women. The disorders include menstrual problems, infertility, pregnancy loss, sexual dysfunction, and menopause. Doctors may use fertility drugs, surgery, or assisted reproductive techniques (ART) in their therapy. ART involves the use of procedures to manipulate the egg or sperm to facilitate reproduction, such as in vitro fertilization.
Reproductive endocrinologists undergo extensive medical training, first in a four-year residency in obstetrics and gynecology, then in a three-year fellowship in reproductive endocrinology. To be board certified in this area, the physician must pass written and oral exams in both areas.
The male and female reproductive cycles are controlled by hormones released from the hypothalamus and anterior pituitary as well as hormones from reproductive tissues and organs. The hypothalamus monitors the need for the FSH and LH hormones made and released from the anterior pituitary. FSH and LH affect reproductive structures to cause the formation of sperm and the preparation of eggs for release and possible fertilization. In the male, FSH and LH stimulate Sertoli cells and interstitial cells of Leydig in the testes to facilitate sperm production. The Leydig cells produce testosterone, which also is responsible for the secondary sexual characteristics of males. In females, FSH and LH cause estrogen and progesterone to be produced. They regulate the female reproductive system which is divided into the ovarian cycle and the menstrual cycle. Menopause occurs when the ovaries lose their sensitivity to FSH and LH and the female reproductive cycles slow to a stop.
Answers
estrogenreproductive hormone in females that assists in endometrial regrowth, ovulation, and calcium absorption
follicle stimulating hormone (FSH)reproductive hormone that causes sperm production in men and follicle development in women
gonadotropin-releasing hormone (GnRH)hormone from the hypothalamus that causes the release of FSH and LH from the anterior pituitary
inhibinhormone made by Sertoli cells; provides negative feedback to hypothalamus in control of FSH and GnRH release
interstitialcell of Leydigcell in seminiferous tubules that makes testosterone
luteinizing hormone (LH)reproductive hormone in both men and women, causes testosterone production in men and ovulation and lactation in women
menopauseloss of reproductive capacity in women due to decreased sensitivity of the ovaries to FSH and LH
menstrual cyclecycle of the degradation and re-growth of the endometrium
ovarian cyclecycle of preparation of egg for ovulation and the conversion of the follicle to the corpus luteum
ovulationrelease of the egg by the most mature follicle
progesteronereproductive hormone in women; assists in endometrial re-growth and inhibition of FSH and LH release
Sertoli cellcell in seminiferous tubules that assists developing sperm and makes inhibin
testosteronereproductive hormone in men that assists in sperm production and promoting secondary sexual characteristics
Read the original here:
24.4. Hormonal Control of Human Reproduction Concepts of ...
- World Health Organization reference values for human semen characteristics [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Economic consequences of overweight and obesity in infertility: a framework for evaluating the costs and outcomes of fertility care [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Maternal metabolism and obesity: modifiable determinants of pregnancy outcome [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Brain imaging studies of appetite in the context of obesity and the menstrual cycle [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Options for fertility preservation in prepubertal boys [Last Updated On: August 17th, 2024] [Originally Added On: April 6th, 2010]
- Xenografting of testicular tissue from an infant human donor results in accelerated testicular maturation [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Karyotype of miscarriages in relation to maternal weight [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Endoglandular trophoblast, an alternative route of trophoblast invasion? Analysis with novel confrontation co-culture models [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Regulation of extravillous trophoblast invasion by uterine natural killer cells is dependent on gestational age [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional regulation of thymic stromal lymphopoietin on proliferation and invasion of trophoblasts in human first-trimester pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Home self-administration of vaginal misoprostol for medical abortion at 50-63 days compared with gestation of below 50 days [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Prospective study of the forearm bone mineral density of long-term users of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Functional attenuation of human sperm by novel, non-surfactant spermicides: precise targeting of membrane physiology without affecting structure [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- The risk of post-molar gestational trophoblastic neoplasia is higher in heterozygous than in homozygous complete hydatidiform moles [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Cumulative ongoing pregnancy rate achieved with oocyte vitrification and cleavage stage transfer without embryo selection in a standard infertility program [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Pregnancy outcome in female childhood cancer survivors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Offering excess oocyte aspiration and vitrification to patients undergoing stimulated artificial insemination cycles can reduce the multiple pregnancy risk and accumulate oocytes for later use [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoidance of weekend oocyte retrievals during GnRH antagonist treatment by simple advancement or delay of hCG administration does not adversely affect IVF live birth outcomes [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Who should pay for assisted reproductive techniques? Answers from patients, professionals and the general public in Germany [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Sperm donor limits that control for the 'relative' risk associated with the use of open-identity donors [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Long-term cryostorage of sperm in a human sperm bank does not damage progressive motility concentration [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Screening for biomarkers of spermatogonia within the human testis: a whole genome approach [Last Updated On: August 17th, 2024] [Originally Added On: April 14th, 2010]
- Avoiding transgenerational risks of mitochondrial DNA disorders: a morally acceptable reason for sex selection? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Cross border reproductive care in six European countries [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Morphometric dimensions of the human sperm head depend on the staining method used [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- ESX1 gene expression as a robust marker of residual spermatogenesis in azoospermic men [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Innovative virtual reality measurements for embryonic growth and development [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Consecutive or non-consecutive recurrent miscarriage: is there any difference in carrier status? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- A longitudinal study of contraception and pregnancies in the same women followed for a quarter of a century [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of bleeding and user satisfaction during consecutive use of the levonorgestrel-releasing intrauterine system [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Direct proportional relationship between endometrioma size and ovarian parenchyma inadvertently removed during cystectomy, and its implication on the management of enlarged endometriomas [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Large prospective, pregnancy and infant follow-up trial assures the health of 1000 fetuses conceived after treatment with the GnRH antagonist ganirelix during controlled ovarian stimulation [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Altered aquaporin expression in women with polycystic ovary syndrome: hyperandrogenism in follicular fluid inhibits aquaporin-9 in granulosa cells through the phosphatidylinositol 3-kinase pathway [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Fast-release orodispersible tramadol as analgesia in hysterosalpingography with a metal cannula or a balloon catheter [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Xenotransplantation of cryopreserved human ovarian tissue into murine back muscle [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Predictors of psychological distress in patients starting IVF treatment: infertility-specific versus general psychological characteristics [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological adjustment, knowledge and unmet information needs in women undergoing PGD [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Psychological well-being and sexarche in women with polycystic ovary syndrome [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Is human fecundity declining in Western countries? [Last Updated On: August 17th, 2024] [Originally Added On: May 20th, 2010]
- Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current achievements and future research directions in ovarian tissue culture, in vitro follicle development and transplantation: implications for fertility preservation [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Human studies on genetics of the age at natural menopause: a systematic review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Beyond oxygen: complex regulation and activity of hypoxia inducible factors in pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Current knowledge of the aetiology of human tubal ectopic pregnancy [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Economic contraction and birth outcomes: an integrative review [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Teratogenic mechanisms of medical drugs [Last Updated On: August 17th, 2024] [Originally Added On: June 5th, 2010]
- Levels of semenogelin in human spermatozoa decrease during capacitation: involvement of reactive oxygen species and zinc [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Apoptosis and meiotic segregation in ejaculated sperm from Robertsonian translocation carrier patients [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- In humans, zona pellucida glycoprotein-1 binds to spermatozoa and induces acrosomal exocytosis [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Variants of the EPPIN gene affect the risk of idiopathic male infertility in the Han-Chinese population [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Epidermal clitoral inclusion cysts: not a rare complication of female genital mutilation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- PCOSMIC: a multi-centre randomized trial in women with PolyCystic Ovary Syndrome evaluating Metformin for Infertility with Clomiphene [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Single versus double intrauterine insemination in multi-follicular ovarian hyperstimulation cycles: a randomized trial [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Soluble HLA-G is an independent factor for the prediction of pregnancy outcome after ART: a German multi-centre study [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Obstetric outcomes after transfer of vitrified blastocysts [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Occasional involvement of the ovary in Ewing sarcoma [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Y chromosome microdeletions, sperm DNA fragmentation and sperm oxidative stress as causes of recurrent spontaneous abortion of unknown etiology [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Development and preliminary validation of the fertility status awareness tool: FertiSTAT [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Xenotransplantation of human ovarian tissue to nude mice: comparison between four grafting sites [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Involvement of CFTR in oviductal HCO3- secretion and its effect on soluble adenylate cyclase-dependent early embryo development [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Effect of endometriosis on the protein expression pattern of follicular fluid from patients submitted to controlled ovarian hyperstimulation for in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Activin A regulates trophoblast cell adhesive properties: implications for implantation failure in women with endometriosis-associated infertility [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Clinical significance of sperm DNA damage in assisted reproduction outcome [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Fall in implantation rates following ICSI with sperm with high DNA fragmentation [Last Updated On: August 17th, 2024] [Originally Added On: June 17th, 2010]
- Prevalence of unsuspected uterine cavity abnormalities diagnosed by office hysteroscopy prior to in vitro fertilization [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Ultra-conservative fertility-sparing strategy for bilateral borderline ovarian tumours: an 11-year follow-up [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Fertility after autologous ovine uterine-tubal-ovarian transplantation by vascular anastomosis to the external iliac vessels [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Uterus transplantation in the baboon: methodology and long-term function after auto-transplantation [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Prestimulation parameters predicting live birth in anovulatory WHO Group II patients undergoing ovulation induction with gonadotrophins [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Transfer of a selected single blastocyst optimizes the chance of a healthy term baby: a retrospective population based study in Australia 2004-2007 [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Disclosure patterns of mode of conception among mothers and fathers-5-year follow-up of the Copenhagen Multi-centre Psychosocial Infertility (COMPI) cohort [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Assisted reproductive technology in Europe, 2006: results generated from European registers by ESHRE [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- A decade of sperm washing: clinical correlates of successful insemination outcome [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Sperm DNA integrity in cancer patients before and after cytotoxic treatment [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- Speriolin is a novel human and mouse sperm centrosome protein [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- No influence of body mass index on first trimester fetal growth [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]
- HLA sharing among couples appears unrelated to idiopathic recurrent fetal loss in Saudi Arabia [Last Updated On: August 17th, 2024] [Originally Added On: July 21st, 2010]