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• Reproduction

  A 33 year old woman and her 32 year old husband havebeen trying to have a baby for over a year. Unfortunately, theyhave not yet been able to conceive. The woman has been tracking hercycle and does not have a regular 28 day cycle. Both husband andwife are somewhat healthy, non-smokers and occasional drinker,although the women has given up drinking since they have startedtrying for a baby.

  1. Since the women does not have a regular cycle, you first wantto determine if she is ovulating. You decide to test her hormonallevels.
  1. Where are gonadotropins produced?
  2. What hormones signal the production of gonadotropins?
  3. What hormones signal the release of gonadotropins?
  4. On which tissues do gonadotropins act in the female body?
  5. What hormonal surge causes ovulation?
  6. How is the hormonal surge produced?
  7. In what phase of the menstrual cycle does the surge begin tooccur?
  8. How does the hormonal surge cause ovulation?
  1. You determine that the woman is not ovulating regularly, whichis perhaps due to low levels of estrogen. After furtherinvestigation you determine that her family has a history of highcholesterol, she avoids eating many types of foods, including fatsand cholesterol. This lack of cholesterol has lead to a loss ofnormal estradiol production, and an irregular menstrual cycle.  
  1. What structures produces estrodiol?
  2. How does cholesterol play a role in producing estrodiols?
  3. Production of which other hormones may have been affected bylow cholesterol levels?
  1. The woman receives proper nutritional consultation and adjustsher diet in a healthy way. Her menstrual cycle becomes regular andher hormonal levels indicate that she is ovulating. You nextdetermine whether she is actually ovulating. To do so, you useultrasound imaging to survey her ovaries.
  1. What structure will be present if she has just ovulated?
  2. What hormone does it produce?
  3. What is the hormones role?
  4. What is the structure called after a few weeks postovulation?
  1. The woman does in fact ovulate, so you now determine if herreproductive organs are also functioning and are properlyformed.
  1. In which structure does conception occur?
  2. In which structure does implantation occur?
  1. The woman’s reproductive system is healthy and no longerpresents any obvious issues. However, the couple are still not ableto get pregnant. You now test the husband’s sperm.
  1. What role do the Leydig cells play in sperm production?
  2. What role do the Sertoli cells play in sperm production?
  3. Where is testosterone produced?
  4. What stimulates the production of testosterone?
  5. What prevents the production of testosterone?
  6. What role does the ejaculate play in maintaining spermhealth?
  1. You determine that the husband does not have any sperm, dead oralive, in the ejaculate. You investigate if there is a problem withhis reproductive structures.
  1. What structure links the testes to the urethra?
  2. What role does the blood-testes-barrier play in spermproduction?
  1. You are able to determine that the husband has under developedvas deferens, preventing sperm release. You are able to retrievehealthy sperm and inseminate the woman.   

  Success! The couple is pregnant.

  1. Where are mature sperm stored?
  2. What hormone contributes to the development of the vasdeferens?
  3. When does the development of the vas deferens occur?
  4. What structure would you look for to determine if the sperm wasmature?
  5. How many chromosomes does mature sperm have?
  6. What hormone helps to maintain the pregnancy?
  7. How does it help to maintain the pregnancy?