1. Female Reproductive System Ob & Gy Dept. First Hospital, Xi’An Jiao Tong University

2. Components Ovaries Uterine (ovarian, fallopian) tubes Uterus Vagina [skip] External genitalia [skip] 24.10ab

3. Ovaries - location Oval, 3 cm x 1.5 cm Lateral wall of true pelvis Mesovarium covering Broad ligament of uterus Ovarian arteries 24.10ab

4. 3-D Concept of Broad Ligament Like a cape Not like Cape Cod More like a vampire’s cape

5. 3-D Concept of Broad Ligament Body=uterus Cape=broad ligament Hand=ovary Arm=uterine tube Wall=posterior pelvic wall Head=fundus of uterus

6. Ovaries – gross anatomy Tunica albuginea – capsule Medulla Loose CT, blood vessels Cortex Oocytes + follicles 24.12

7. Ovarian cycle 28 days Follicle phase – first 14 days Ovulation – day 14 Luteal phase – second 14 days Oogenesis 24.13

8. Follicle phase Primordial follicle Oocyte 1 layer squamous follicle cells 24.13

9. Follicle phase Primary follicle (early) Growth stimulated by FSH from pituitary Cuboidal follicle cells Granulosa cells – stratified Oocyte grows 24.13

10. Follicle phase Primary follicle (late) Zona pellucida forms Theca folliculi around granulosa cells CT and secretory cells 24.13

11. Follicle phase Secondary follicle Follicle grows Antrum forms Oocyte grows 24.13

12. Follicle phase Vesicular (Graafian, mature) follicle Follicle migrates to surface of ovary ready to ovulate 24.13

13. Ovulation ~1 oocyte per cycle Controlled by LH from pituitary ~day 14 24.13

14. Luteal phase Corpus luteum Remaining granulosa and theca cells Secretes estrogen and progesterone 24.13

15. Oogenesis Oogonia Develop up to birth Primary oocytes Begin meiosis I Do not complete 24.15

16. Oogenesis Secondary oocyte Ovulation Fertilized by sperm 24.15

17. Oogenesis Ovum Completion of meiosis After fertilization Fusion of male and female nuclei – zygote 24.15

18. Uterine tubes Fimbriae Uterine tubes Site of fertilization [ectopic and tubal pregnancy] 24.10a

19. Uterus – location Pelvic cavity Anterior to rectum Posterior- superior to urinary bladder [prolapse of uterus-inferior movement] 24.10b

20. Uterus – gross anatomy Body Fundus Cervix Mesometrium (part of broad ligament) 24.10a

21. Uterus – layers Perimetrium Parietal peritoneum Myometrium thick wall of smooth muscle Endometrium Mucous membrane Stratum functionalis Stratum basale Varies with menstrual cycle 24.10a

22. Uterus - histology Stratum functionalis Surface epithelium Lamina propria Cyclic growth Shed during menstruation 24.18ab

23. Uterus – histology Stratum basale Deep lamina propria Not shed Regenerates new stratum functionalis 24.18ab

24. Uterine cycle Menstrual phase Days 1-5 Stratum functionalis shed 24.19d

25. Uterine cycle Proliferative phase Days 6-14 Stratum basale regenerates stratum functionalis 24.19d

26. Uterine cycle Secretory phase Days 15-28 Endometrium prepares for implantation 24.19d

27. Fertilization 4 days to reach uterus, 2 days floating in uterus Implantation (6 days old - blastocyst) Secretory phase continues Placenta develops (10-12 days to become functional. 24.25a 7.5 dys 9 dys 16 dys

28. No fertilization No implantation Stratum functionalis shed 24.19d