SIKLUS REPRODUKSI

Siklus reproduksi, terjadi di ovarium dan endometrium.

3 Siklus Reproduksi di ovarium:

Menstruation and the follicular phase, ovulation, and the luteal phase

Siklus Reproduksi di endometrium: proliferative and secretory phases.

Menstruation and the follicular phase

The first day of menstrual bleeding is considered day 1 of the menstrual cycle.

Tidak ada konsepsi korpus luteum regress turun progesterone dan estrogene menstruasi.

Prostaglandins (in secretory endometrium and menstrual blood) produce contractions of the uterine vasculature and musculature endometrial ischemia and uterine cramping & expulsion of the menstrual blood and tissue.

Setelah menstruasi, estrogen meningkat lagi di awal fase folikular endometrial healing stop menstruasi.

Akhir fase luteal (SEBELUM fase FOLICULAR SELANJUTNYA dimulai):

Estradiol, Progesterone, LH di lowest level FSH mulai meningkat di akhir luteal <sebelum ke fase folikular berikutnya>.

SELAMA MENS, FOLLICULAR GROWTH sudah diiniasiasi untuk siklus reproduksi baru di ovarium.

FOLIKULAR

Estradiol (estrogen) naik FSH turun; LH tetap rendah.

Estrogen terus naik + feedback ke LH LH mulai meningkat di midfollicular.

Although several follicles begin the maturation process, only the follicle with the greatest number of granulosa cells and FSH receptors and the highest estradiol production becomes the dominant folli- cle; the nondominant follicles undergo atresia.

Ovulation

Dominant follicle secretes an increasing amount of estradiol positive feedback to the pituitary gland to secrete LH Hari 11-13 terjadi LH SURGE (34-36 jam sebelum ovulasi, puncaknya 10-12 jam sebelum ovulasi) triggers ovulation granulosa dan theca sel berubah jadi produksi PROGESTERON

Meiosis of the primary follicle resumes after the LH surge and the first polar body is released; the oocyte then arrests in metaphase of the second meiotic division until fertilization occurs.

OVULASI oosit dilepas dari folikel folikel jadi korpus luteum

Some women experience a twinge of pain (“mittel- schmerz”) at the time of ovulation and can precisely iden- tify the time of ovulation. Other women do not experience this brief discomfort, but can recognize characteristic symptoms that occur due to progesterone production after ovulation.

Luteal phase

The luteal phase of the menstrual cycle is characterized by an alteration in the balance of sex steroid secretion from predominance of estrogen to predominance of progesterone.

Follicular development increased numbers of LH receptors on the granulosa and theca cells.

The mid-cycle LH surge stimulates LH receptors converts the enzymatic machinery of these cells to produce and secrete progesterone; this process is called luteinization.

Progesterone negative feedback on pituitary secretion of FSH and LH both hormones are suppressed during the luteal phase. <FSH LH TURUN>

The corpus luteum also produces estradiol in a pattern that parallels progesterone secretion. 24 hours before ovulation and rises rapidly thereafter.

Sedikit catatan:

Maximal progesterone production occurs 3 to 4 days after ovulation.

The lifespan of the corpus luteum ends approximately 9 to 11 days after ovulation;

If conception does not occur the corpus luteum undergoes involution (a progressive decrease in size) and progesterone production sharply declines withdrawal of progesterone releases FSH (negative feedback FSH levels begin to rise prior to menstruation and the initiation of a new cycle.

The carefully orchestrated sequence of estrogen production and then progesterone production is essential for proper endometrial development to allow implantation of an embryo.

If the oocyte becomes fertilized and implantation occurs resulting zygote begins secreting human chorionic gonadotropin (hCG) sustains the corpus luteum for another 6 to 7 weeks Adequate progesterone production by the corpus luteum sustain the early pregnancy.

By 9 to 10 weeks of pregnancy, placental steroidogenesis is well-established and the placenta assumes progesterone production.

As the function of the corpus luteum declines, it decreases in volume and loses its yellow color. After a few months, the corpus luteum becomes a white fibrous streak within the ovary, called the corpus albicans.

DARI BUKU MERAH

Siklus bulanan 28 hari. Mens akibat pertumbuhan dan pengelupasan lapisan endometrium uterus. Akhir mens endometrium menebal lagi / fase proliferasi endometrium Setelah ovulasi pertumbuhan endometrium berhenti, kelenjar dan

Glandula lebih aktif/ fase sekresi endometrium

Perubahan endometrium dikontrol siklus ovarium.Siklus ovarium:

1. Folikular (yang bisa memanjang harinya)2. Ovulasi3. Luteal (tetap 14 hari)

MENS NORMAL dipengaruhi/ diatur oleh:1. HPO axis 2. Respon folikel dan ovarium3. Fungsi uterus

SIKLUS OVARIUMHari 1-8:FSH LH relatif tinggi memacu perkembangan 10-20 folikel ( tapi hanya 1 yang dominan) di midfolikular (pertengahan folikular) yang sisa hanya folikel dominan, yang lain atresia <FSH LH tinggi> estrogen progesterone turun di akhir siklus. Selama mens dan habis mens: Estrogen rendah tapi mulai meningkat karena folikel mulai berkembang.

Hari 9-14:Ukuran folikel meningkat akumulasi cairan sekitar granulosa peningkatan pengisian cairan di ruang sentral (antrum)>> folikel primer berubah jadi grafian folikel. Oosit dikelilingi 2-3 lapis sel granulosa disbt cumulus ooforus. <GAMBAR BISA DILIHAT DI BUKU MERAH kalau tidak salah hal. 133>

Estrogen <esp. estradiol> meningkat (dibuat oleh sel granulosa folikel yang berkembang) puncak 18 jam sebelum ovulasi (-) feedback gonadotropin <cegah hiperstimulasi ovarium dan pematangan banyak folikel>

Sel granulosa produksi inhibin faktor mencegah jumlah folikel matang

OvulasiHari 14:Pembesaran folikel berlangsung cepat. Protrusi permukaan korteks ovarium dan pecahnya folikel, Oosit keluar dari cumulus ooforus yang ditempeli.

Estrogen meningkatkan LH (melalui hipotalamus) meningkatkan androgen estrogen (+) feedback.

Sebelum ovulasi: estradiol turun cepat, progesterone naik. 8 jam mid cycle surge LH OVULASI

LUTEAL Hari 15-28Sisa folikel tertahan di ovarium dipenetrasi kapiler dan fibroblast dari teka. Granulosa mengalami luteinisasi jadi korpus luteum sumber utama steroid seks, estrogen, progesterone, disekresi ovarium pasca ovulasi.

Korpus luteum produksi estradiol progesterone

Di fase luteal gonadotropin tetap rendah sampai regresi korpus luteum hari 26-28.

Bila terjadi konsepsi: korpus lutem tidak regresi (dipertahankan gonadotrofin oleh trofoblas),

SIKLUS UTERUS/ ENDOMETRIUM

Endometrium tdd. lapisan superfisial dan basal. Superfisial yang mengelupas selama haid. Basal tidak mengelupas. Basal kuat, tapi karena pengaruh hormone jadi

berkelok sehingga a. spiralis bisa berkembang.

Fase proliferasi

Fase folikular di ovarium endometrium dibawah pengaruh estrogen.

Akhir haid regenerasi (proses pembaharuan) berjalan cepat fase proliferasi. Kelenjar tubular tersusun rapi dan sejajar, sedikit ekskresi.

Fase sekretorik.

Setelah ovulasi, produksi progesterone menyebabkan perubahan sekresi endometrium. Sekretori dari vakuol dalam epitel kelenjar di bawah nukleus, sekresi material ke dalam lumen kelenjar dan menjadi berkelok-kelok.

Darah mens tidak clot aktivitas fibrinolitik lokal dalam pembuluh darah endometrium yang mencapai puncak saat haid.