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23 Cards in this Set

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At what gestational week do PGC's appear in yolk sac and migrate to genital ride and PGC's undergo mitosis?
WEEK 4!
How much testosterone does the ovary produce?
~25%
At what gestational week do PGC's arrive at genital ridge and sex cord formation supports germ cells?
WEEK 6!
During what gestational weeks do ovarian differentiation / reproductive tract differentiation / meiosis and meiotic arrest occur?
WEEKS 8 - 12! Remember that at week 7, things are STILL UNDIFFERENTIATED.
What do sex cord cells become?
Granulosa cells! Differentiated supoprt cells that support GERM CELLS...

Combine with germ cells to become FOLLICLES
What do you get when you combine sex cord cells with PGC's?
Follicles!!! Sex cord cells become granulosa cells.
How many oocytes remain at birth?
Original number of ~5-7 million at birth undergoes ATRESIA to ~1 million at birth.

~80% loss!!!
TRUE/FALSE

Follicles are wholly dormant during pre-pubescence.
FALSE!

Follices undero development, but lack of hormonal signaling results in follicular atresia. Gonadotropin levels are suppressed by age 1.
How many germ cells are present at puberty?

How many germ cells are ovulated?
~300K - 500K at puberty.

~400-500 eggs are ovulated.
How much time does it take from primary follicle recruitment until ovulation?
85 days!
What is the concept of a dominant follicle?
At antral follicular stage (beginning of hormonal dependence), there are ~20 eggs that can respond to FSH. However, only ONE follicle is dominant and will be selected.
What are two "number" points where atresia rates increase?
At 25,000 remaining follicles.

~10 - 15 years pre-menopause.

At this point of increased atresia, hormonal levels are varying and MENSTRUAL CYCLE IRREGULARITY becomes more common.
What is the HALLMARK of PERIMENOPAUSE?

How long is perimenopause. Around what age?
Menstrual Cycle IRREGULARITIES.

Approximately 5 years. Average age 46.
What is HALLMARK of menopause?

What is average age of menopause?

What are FSH/LH/Estradiol levels of menopausal women.
Point in time where menstruation ceases due to loss of ovarian activity.

Between 50 - 52 years.

FSH / LH are high. Estrogen levels are low. Therefore there is NO INHIBITORY FEEDBACK OF ESTROGEN ON LH/FSH.
Which of the three affects age of menopause?

Smoking, OCP, Age of menarche?
Smoking
What is definition of Premature Ovarian Failure?

How do you biochemically diagnose this?
Cessation of ovarian function by age 40.

Elevated FSH/LH levels on multiple occasions more than ONE MONTH APART.
What are some causes of premature ovarian failure?
Congenital - Chromosomal (TURNERS SYNDROME)

Autoimmune - Polyglandular Autoimmune

Infectious - mumps

Chemo/radio
What is TURNERS SYNDROME?

Why is signficant to premature ovarian aging?
TURNERS SYNDROME = females with only one X chromosome. Therefore, female DOESN'T MAKE SUFFICIENT HORMOME. Balance of atresia/follicular development is tilted to ATRESIA.

Symptoms include:

Delayed puberty/early menopause... Short stature ... renal/cardio abnormalities.
What is a particularly bad chemo drug for premature ovarian aging?
ALKYLATING AGENTS b/c they are not cell-cycle specific and so NON-PROLIFERATING cells can be damaged.

Primary target for alkylating agents is GRANULOSA CELL.
What is the LD50 of oocytes in radiation exposure?
4 GRAY.

Radiation levels and subsequent ovarian damage ARE DOSE-DEPENDENT. More is bad.
What is the mechanism behind autoimmune premature ovarian failure?

How many types are there?
CROSS-REACTIVITY with auto-antibodies directed at other tissues because ovarian autoantibodies are rarely positive.

Two types:

TYPE 1: 60% risk of ovarian failure.

TYPE 2: 10% risk of ovarian failure.
What is major risk and major benefit of Hormone Replacement for women with Premature ovarian failure?
Benefits: Osteoporosis prevention. Hot flashes reduced.

Risk: DVT!
Which is more effective?

Oocyte cryopreservation or Embryo cryopreservation?
EMBRYOS!

Oocyte cryopreservation is in trials.