Physiology of Reproductive system

Introduction
The f Th function of the reproductive system: i f h d i 1. Reproduction (perpetuation of species) 2. Sexual pleasure (coitus, coupling) Is it not essential for homeostasis? homeostasis? Gonads and gametes Gonads: Testis and Ovaries Function: 1. Gametogenesis: haploid cell formation 2. Endocrine function: steroid hormone synthesis

Features: a. Adolescent growth spurt occurs (peak 12-14 12y ), yrs), facilitated by gonadal and adrenal yg androgens b. Secondary sexual characteristics appear c. Fertility achieved y d. Profound psychological changes take place Onset: variable B Boys: 9-14 years 9Girls: 8-13 years 8Range: 8-20 years 83

Physiology of Puberty

adrenarch at 8 yrs menarche at 14 yrs

In Boys I. Enlargement of the testes

Maturation of Leydig cells Testosterone Testosterone II. Pubarche: at the base of penis & its p extension upwards. III. Male body habitus IV. Appearance of s IV App n f secondary s x l nd sexual characteristics (voice change, beard...) V. Slight Gynaecomastia ( breast growth g y ( g Tenderness) VI. Growth spurt
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FSH Initiation of spermatogenesis

In Girls I. Thelarche (growth & development of breasts) II. Pubarche III. III Menarche IV. Secondary sexual characteristics (vaginal, uterine & endometrial growth) V. Fat distribution VI. Growth spurt

Hypothalamic-PituitaryHypothalamic-Pituitary-Gonadal Axis: Maturation

Gradual maturation of the hypothalamic gonadostat (Synthesis & release of GnRH) Withdrawal of sensitivity of hypothalamic to NFB inhibition to circulating sex steroids allowing LH and FSH Increased responsiveness of gonadotrophs to GnRH Rise in gonadotropin secretion is a result of two processes: (1) maturational changes in the brain that result in increased GnRH secretion by the hypothalamus and (2) decreased sensitivity of gonadotropin secretion to the NFM effects of sex steroid hormones Critical body wt and fat (48kg, 17% fat)
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Human Sexual Response

The sexual response similar in both response,

sexes, is often divided into four phases: a. Excitationa Excitation- arousal b. Plateau c. Orgasm d. resolution. Refractory period- absent in women period8

Functional structures of the male reproductive system

The main difference b/n the male and female depends primarily on the Y-chromosome and a pair of gonads (testis and ovaries) The male reproductive system consists of: 1. 1 Gonads (the testis) Function: Function: -Spermatogenesis (formation of spermatozoa) -Endocrine function (produces male sex hormone, testosterone from Leydig cells and inhibin, estrogen from sertoli cells 2. Accessory sex organs i. Tubular structures. These include: Epididymis: E idid i >6 mts l t long, area of storage and maturation of sperm. f t d t ti f Vas deferens: transport of sperm ii. Accessory glands: provide fluid medium for sperm (seminal plasma) glands: The seminal vesicle: secretes fructose rich fluid containing ascorbic acid vesicle: and flavin, PGs. It produces 60% of the volume of the seminal plasma flavin, The prostate: produces an alkaline acid phosphate, proteolytic enzymes. Prostate secretion makes up 30% of the seminal plasma iii. The b lb iii h bulbourethral ( h l (Cowper's) glands ) l d 3. Copulatory organ (penis):
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The male reproductive structures

Corpora cavernosa Corpus spongiosum

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The male reproductive structures

Corpora cavernosa Corpus spongiosum

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Testis
Functionally the testis is made up of Convoluted semniferous tubules (90% of testicular mass) and contain: Spermatogenic epithelium (spermatogonia-germinal cells) that (spermatogoniagive rise spermatozoa. Leydig ll L di cells: secret testosterone tt t t Sertoli cells (non-germinal cells) (nonFunction of Sertoli cells : Mechanical support and nourishment of spermatozoa Secret inhibin, ABP, estrogen Defence (phagocytosis) eat old sperm cells (phagocytosis), Act as blood testis barrier Blood supply: Abd. Aorta gonadal arteries penile erectile Abd. tissues Testicular apumpniform plexsustesticular vIVC Innervation: Pudendal nerve (PNS) from the sacral plexuses The male urethra is acidic b/c of urine PH
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The male gonad (testis)

Spermatogenesis Occurs in the seminiferous tubules during active sexual life. Seminiferous tubules contain large number of g g germinal epithelial p Cells called spermatogonia. Spermatogonia are continuously proliferate and differentiate to form sperm
Seminiferous tubules Site of spermatogenesis Interstitial cells of Leydig Secret testosterone Blood vessels

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Spermatogensis
S f t by hi h t i Sequence of event b which spermatogonia are transformed to spermatocytes
Proliferation (25 days) Growth & meiosis-I (9 days) meiosisMaturatioin & miosis-II ( 19 days) miosisTransformation (differentiation, spermiogenesis) (21 days)

A process in which chromosome number of germ cells (Diploid) is reduced by half (Haploid) (Diploid) (Haploid) and the shape of the cells is altered It begins at puberty (12-15 years) where 12- years) spermatogonia which have been dormant for years begin to increase in number under the influence of gonadotropin hormones
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Spermatogenesis
At puberty, spermatogonia migrate along Sertoli cells towards its lumen while proliferating (requires FSH) Those that cross Sertoli barrier enlarge and begin Meiosis-I (primary spermatocytes, largest cells in ST) During their growth primary Spermatocytes duplicate their DNA (diploid), Meiosis-I continues, homologous chromosomes separate, and 2nd spermatocytes form (2n) Meiosis-II occurs in secondary spermatocytes to convert them t t t t t th to spermatids, sister chromatids separate to form haploid (n) spermatid
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Spermatid differentiate into mature sperm cells, by spermiogenesis

Spermiogenesis
Process of transforming spermatids to sperm cells In the process the spermatid develop
Head Tail (flagellum) ( g )
Body (middle) piece (contain mitochodria) mitochodria) Chief (principal) piece End piece

The tail contain microtubules (axoneme) (axoneme) whose arrangement allows sliding movement between them that propels sperm in flagellar movement at velocity of 1-4 mm/min. 1It requires ATP
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Events of spermiogensis
Acrosome formation Condensation of elongated nucleus Tail formation T il f ti Organelle and cytoplasm discharge

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Mature sperm cell

Mature sperm cells contain: the head, neck and tail. Acromosomes at the head contain enzymes, hyaluronidase or proteases. h l id Proteases are meant for effective penetration of egg during fertilization. Maturation occurs in the epididymis and requires testosterone

Head

Neck

Tail

Maturation Acromosomal development Cytoplasmic reduction Flagellar growth Discharge of organelles Condensation of nucleus

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Factors affecting spermatogenesis

A.

Hormones

Pituitary gonadotropic hormones FSH: -Stimulates Sertoli cells to produce ABP -Facilitates spermatogenesis p g LH: -Stimulates Leydig cells to produce testosterone Inhibin: -Inhibits the release of FSH T3/T4: Required for the normal process of Prolactin spermatogenesis B. Temperature: an optimum testicular temperature is 32-35oC. In case of 32undescended testis (cryptorchidism), no spermatogenesis occurs, infertility b/c BT arrests sperm Testicular temperature adjusting mechanisms: 1. Testicular muscles: Dartos muscle and cremaster muscle 2. Arteriovenus anastomosis (counter-current mechanism) ( (counter) 3. Lack of adipose tissue in the scrotal skin, abundant swt.glands C. Diet: -Vit-A (deficiency leads to keratinization of the SNT) Vit-Vit-B12 and folic acid (for DNA, RNA synthesis) Vit-Vit-E (deficiency results in degeneration of seminefrous tubules) VitD. Irradiation: X-ray, atomic radiation Irradiation: X19

Vitamins and spermatogenesis

Vitamin B12 and folic acid are necessary for nuclear maturations Vitamin Vit i A Prevent seminiferous tubules from Vitamin E degeneration and keratinization

Chemicals
Hypoxia Alcohol Smoke Lead Drug cocaine

Reduce spermatogenesis Oligospermia

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Seminal fluid
Semen is the fluid ejaculated during the male sexual act. act It is made up of spermatozoa and seminal plasma which is the combined secretion of the testis, epididymis, seminal vesicles and prostate. An average volume per ejaculation is 2.5-3 ml with 108 sperms/ml. 50% of men have sperm count 20-40x106/ml. <20x106/ml are sterile p Function Vehicle for sperm Diluent Motility Buffering medium Energy source Secreted by E idid i Epididymis Seminal vesicles Prostate Cowpers gland

Seminal plasma

Its volume and composition depends on testosterone

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Color:

Gray-white-yellow

Male sexual act

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Stimulus for sexual sensations

1. 1

Elements of sexual stimulation

Glans penis Perineal structures Urethra Bladder Prostate Seminal vesicle Testis T ti Vas deferens

Irritation or distension

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2. Erection Degree of physical or psychic stimuli---stimuliPudendal P d d l nerve or Sacral 2,3,4--- Activation l of nerve ergenti (pelvic splanchnic nerve) --PSNS out flow--- Release of NO (cGMP) at flow--cGMP) NMJ---Relax NMJ---Relax arterioles of penis & relax smooth muscle fibers of the erectile tissue (Corpus cavernosum and corpus spongiosum)--(C d spongiosum) i - engorgement of their large venous sinus--sinus--Ballooning of the erectile tissue (surrounded by strong fibrous tissue) and secretion. secretion. Sildenafil (viagra) inhibit PDE5 and PDE6, viagra) PDE5 PDE6 thereby increasing cGMP level. level. Detumiscence: Detumiscence: Release of SNS vasoconstrictors
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3.Sexual orgasm = Emission+ Ejaculation

Intensive sexual stimuli--- activation of SNS center stimuli--(T12(T12-L2)---- SNS outflow in hypogastric and pelvic plexus----Contraction plexus----Contraction of
Vas Deferens Ejaculatory duct Prostate Seminal vesicles Mixing of sperm with fluids from SV, prostate, and Bulbourethral glands to form semen then pushed into internal urethra (Emission)

Feeling of sudden fulness in internal urethra --pudendal nerve ---Sacral center ---- Rhythmical ---Sacral contraction of Ischiocavernosus, bulbocavernosus Ischiocavernosus, muscles at th b l t the base of penis, pelvic muscles and f i l i l d muscles of trunks Wave like increase in pressure in trunks erectile tissue and internal genital ducts---Ejaculation. g ducts---Ejaculation. j In two minutes resolution occurs
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Physiological changes during male sexual act HR BF MR CO ABP Energy out put Stimulation of the CNS Hyperventilation yp Sympathetic stimulation Sexual flash Emotional excitement Sensation of pleasure

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Abnormalities of male sexual function

1 1. Erectile impotency Sensory nerve damage PSNS damage Diabetic neuropathy damage Testicular failure Reduced libido due to low failure T Atherosclerotic lesions Cavernosum artery lesions stenosis Hyperprolactinemia Reduce GnRh Drugs --- Increase Proctin level
Cimetidine, ti Cimetidine Ci tidi , antipsychotic, antienxiety, h ti antienxiety, ti i t antihypertensive, alcohol, heroin.

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2. 2 Absence of Emission
SNS damage following polyneuritis Androgen deficiency Low seminal volume

3. Premature ejaculation A i t and emmotion -- SNS --- Ejaculation Anxiety d ti j l i 4. Priapism- Failure of resolution Priapism-

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Hormonal regulation of male reproduction

OC

GnRH MB

Gonadotropes LH FSH PRL

Interstitial cells Of Leydig Testosterone 0.65g/dl

Spermatogenesis Sertoli cells Inhibin ABP Estradiol

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Testosterone
Secreted by the interstitial cells of Leydig under the influence of LH. LH acts via cAMP to stimulate testosterone synthesis Fetal F l testosterone secretion is stimulated by placental i i i l db l l HCG Function: 1. Determines the primary sexual characteristics. characteristics. During IUL D i IUL, testosterone initiates PGC to develop i ii d l into the male genital structures. 2. Descending of testis (deficient production = cryptorchidism) cryptorchidism) Cause descent of testis 2-3 months before birth 23. D Determines secondary sexual characteristics i d l h i i
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Development of male secondary sex characteristics

Enlargement of p g penis, scrotum and testis ( ) , (8X) (DHT) Masculine body hair distribution (DHT) Frontal hair recession (DHT) Hypertrophy of larnyx DHT0 Increase thickness of skin and activity of its sebacious gland (acne) (T) Development of male sex drive and libido (T)

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Increase total bone matrix and its calcium (T) deposition (treat osteoporosis), narrow and long p g pelvic outlet ( ) (T) It allows elongation of bone and y ( ) epiphyseal fusion (T) Increased BMR (5-10%) due to anabolic (5effect. Increased water and electrolyte retention from DT (5-10%) (T) . (5-

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Function of testosterone (contd) (cont

During puberty hypothalamus produces GnRH that stimulates the anterior pituitary gland to produce LH and FSH, which intern stimulate testis for spermatogenesis and S hi h i i l i f i d testosterone secretion. Testosterone is essential for the onset of male pubertal changes. p changes. g It stimulates the brain to develop the male sexual behavior and set up. Spermatogenesis: It stimulates spermatogenesis and required for sperm maturation General metabolic effect: It is a protein anabolic hormone hormone, increases muscle mass and bone matrix.

4. 5. 6. 6

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Causes of male sterility

C it l b f t ti Congenital absence of testis Cryptorchidism Infection with STD Destruction of the seminiferous tubules Irradiation Oligospermia, azoospermia, asthenospermia, amotile sperm Oli i i h i il Drugs, alcohol, smoking Impotence Hypogonadism Genetic defects Functional disorders of prostate and seminal vesicles Genital tract obstruction Spermatogenesis arrest due to hypovitaminosis Testicular failure
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Causes of abnormal semen

Occupational hazard Heat Radiation Testicular injury Chemicals

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