The reproductive systems in males and females consist of both primary and secondary sex organs and glands. The primary function is reproduction through fertilization. The male reproductive system includes external organs like the penis and scrotum, and internal organs like the testes, vas deference, and prostate. Sperm are produced in the testes and travel through the vas deference. The female reproductive system includes external organs like the vulva and internal organs like the ovaries, uterus, cervix, and fallopian tubes. The ovaries produce eggs and the uterus provides nourishment to an embryo during pregnancy. The menstrual cycle regulates female fertility through phases like the follicular, ovulatory, and luteal phases.

1. Sexual and reproductive
anatomy and physiology

2. What is the
reproductive
system?
The reproductive
systems in both the
male and female
consist of primary
and secondary sex
organs and sex
glands.
The primary function of the reproductive systems
is to perpetuate the species through sexual or
germ cell fertilization and reproduction.

3. Male organs of reproduction

4. Male Reproductive System
External Structures
• Penis: external male sex organ
- Circumcised: removes some or all of foreskin
- Uncircumcised: foreskin not removed
• Scrotum: sac of skin and muscle containing testicles
Uncircumcised Circumcised

6. Internal Structures
• Prostate: exocrine gland of male reproductive system
• Vas Deferens: tubes connecting epididymis to ejaculatory ducts
• Epididymis: organ where sperm matures
• Testicles: organ where sperm is created
• Urethra: tube that connects bladder to outside of body
• Cowper’s Gland: secretes lubricating fluid
• Seminal Vesicle: make semen (seminal fluid)

7. The oval-shaped
testes are located in
the scrotum, and are
each divided into 250
lobules. Coiled
within the lobule are
seminiferous tubes
where the sperm are
formed.
The mature sperm are stored in the epididymis, a
tube 13-20 feet in length, coiled and lying on the
side of each testicle.
Testes and epididymis…

8. The acrosome
covering the head
of the sperm
contains enzymes
that help it
penetrate the ova.
The head carries
the genetic
material.
The midpiece
supplies energy.
The tail or
flagellum provides
motility.
Sperm carry either an
X/female OR Y/male
chromosome. Since all ova
carry the X/female
chromosome, the male sperm
does influence the baby’s sex.
Sperm

9. The vas deferens are
muscular tubes
transporting sperm from
the epididymis to the
seminal vesicles.
The seminal vesicles
produce a slightly alkaline
fluid that mixes with the
sperm and becomes part of
the semen ejaculated
during the male orgasm.
It protects the sperm from
the acidity of the urethra.
Vas deferens and seminal vesicles

10. The Sperm Pathway
Vas deferens Expulsion
from the body
Testes
Sperm
Epididymis
Seminal vesicles
Ejaculatory duct
Prostate gland
Urethra

11. Female Reproductive system

12. External Structures
 Mons Pubis: soft mound of flesh above genitals
 Labia: lip-like structures on the outside of the vagina
 Clitoris: sex organ whose sole function is pleasure

13. External Organs

14. Female Reproductive System
Internal Structures
 Vagina: tract from uterus to exterior
 Hymen: mucous membrane around vaginal opening
 Cervix: lower, narrow portion of uterus
 Uterus: pear-shaped organ containing growing fetus
 Fallopian Tubes: pathway for egg travel during ovulation
 Ovaries: egg-producing organs

15. Internal Female Reproductive Organs

16. The uterus
The uterus is a hollow,
muscular, pear-shaped organ
about the size of a woman’s
clenched fist.
The top is tipped forward in a
normal ‘anteflexion’ position.
It can be divided into the body
or corpus, and the bottom
cervix.
The rounded top portion,
above the fallopian tubes, is
called the fundus.

17. The uterus is supported and
held in position by a number of
ligaments. Trauma, disease, or
multiple pregnancies can
weaken these ligaments and
result in abnormal positioning.

18. The uterus wall
has 3 layers: the
outside layer
called the
perimetrium, the
muscular inside
layer called the
myometrium, and
the mucous
membrane lining
the uterus called
the endometrium.
Outer layer
(Perimetrium)
Thick layer of muscle
(Myometrium)
Mucous lining
(Endometrium)
The cervical opening is about
the diameter of a pencil.

19. The uterus has 3
functions:
1. The endometrium
sheds the lining of the
uterus every 21 to 40
days by menstruation
2. It provides a place for
the protection and
nourishment of the
fetus during
pregnancy
3. It contracts during labor to expel the fetus

20. The fallopian tubes
The isthmus is
the portion that
connects to
uterus
Tube widens to form the
ampulla
Fimbria are the finger-like
projections around the
opening that trap the egg as
it leaves the ovary
End of tube is
called the
infundibulum
Opening
is called
the
ostium

21. The fallopian tube is 4-6 inches long. The egg, released
from the ovary, is captured by the fimbria and brought
into the fallopian tube.
The egg is moved along inside the tube by muscular
contractions and the waving action of cilia. It takes an
egg about 3-4 days to travel the length of the tube.
If an egg is fertilized, it occurs here.

22. The two ovaries are
attached to each
side of the uterus
by a ligament. They
are oval-shaped,
about the size of a
large olive, and lie
close to the fimbria
at the end of the
fallopian tubes.
The ovaries
Each ovary is filled, already at birth, with egg-
containing sacs called follicles.
Each egg is called an ovum.

23. Once every 21 days,
one follicle in one
ovary ripens. This
mature follicle is a
graafian follicle.
The follicle ruptures in
response to hormones
from the pituitary
gland, releasing the
ovum/egg. A process
called ovulation.
After the follicle ruptures, it
becomes a mass of yellow
cells called the corpus
luteum. This is a temporary,
progesterone-producing
structure.

24. The vagina extends
from the cervix to the
outside of the body.
It is a 3 ½ inch long
muscular tube that
expands in length and
width during sexual
arousal.
The vagina
The vagina is the female organ for copulation
(sexual intercourse), receiving the seminal fluid
from the male penis. It is also a passageway for
menstruation or the birth of a fetus.

25. The vulva is 5 organs making up
the external genitalia of the
female:
1. Mons pubis: triangular-shaped
pad of fatty tissue over the
pubis bone, covered with
pubic hair
The vulva
2. Labia majora: 2 large folds of adipose tissue on the sides
of the vaginal opening
3. Labia minora: 2 smaller folds of adipose tissue on the
inside of the labia majora
4. Vestibule: area between labia with openings for the
vagina, urethra, and two excretory ducts for Bartholin’s
glands (provide lubricant)
5. Clitoris: sensitive fold of tissue partially covered by hood

26. The perineum is the area
located between the vaginal
opening and the anus.
It is a muscular sheet that
can be torn during
childbirth.
Some doctors avoid
uncontrolled tearing of
the perineum by making
a surgical incision called
an episiotomy.
Perineum

27. The breasts are the
mammary glands,
varying in size according
to age, heredity, and the
amount of fatty tissue
present. Each breast has
15-20 glandular lobes
separated by connective
tissue.
After childbirth, the
pituitary gland stimulates
these lobules with the
hormone prolactin… and
they produce milk.
The breast

28. The dark-colored circle at
the tip of the breast is
called the areola.
It contains sebaceous
glands to keep the skin
conditioned.
In the center is the nipple,
where ducts from the
lobules open.
The first secretion from
the breast is not a true
milk, but a thin yellowish
substance called
colostrum.
Colostrum contains
nutrients and the
mother’s immunities
that can protect baby.

29. Reproductive system of both males & females is similar, or sexually
undifferentiated for the 1st 6 weeks of prenatal life.
At 7th week difference between males & female appear in the internal
structures.
Differentiation of the external sexual organs is complete at about 12
weeks.

30. Female Puberty
▪ Begins anywhere from 8 to 15 years of age
▪ Earlier onset of menstruation may be due
to being overweight.
Puberty lasts about 3 to 5 years
▪ Begins when pituitary gland initiates release of FSH and LH,
which increases the ovaries production of estrogen
▪ Increased size of Fallopian tubes, uterus,
vagina, breasts, buttocks, thighs

31. Secondary Sex Characteristics
Pubertal changes typically are manifest as:
 Growth spurt
 Increase in the transverse diameter of the pelvis
 Breast development
 Growth of pubic hair
 Onset of menstruation
 Growth of axillary hair
 Vaginal secretions

32. ▪ Menstruation: Is a cycle of regular uterine bleeding that begins with
puberty & ends with menopause, occurs each month except during
pregnancy.
▪ Menstrual cycle: Initiated in response to the interaction between the
reproductive & endocrine system. It is interrupted by pregnancy.
Average every 28 days.
▪ Menarche: 1st cycle normally occurs between the age of 9- 16th.
Heredity, environment, nutritional status & race affect menarche.
▪ Early menstrual periods are often irregular& scant.
▪ Early menstrual cycles are not usually fertile because
ovulation occurs inconsistently.

33. Female reproductive Cycle:
The female reproductive cycle is often called
Menstrual cycle because menstruation provides
a marker for each cycle’s beginning & end if
pregnancy does not occur
.

34. ▪ The duration of the cycle is about 28 days,
although it may range from 20-45 days.
▪ Significant deviations from the 28days cycle are
associated with reduced fertility.
▪ The female reproductive cycle is divided into two cycles
that reflect changes in the ovaries and uterine
Endometrium.

35. Inside the ovary
immature
eggs
Day 1-13:
egg developing
inside the
growing follicle
Day 14:
ovulation – egg
released from follicle
Day 15-28:
empty follicle turns
into corpus luteum
(yellow body)

36. Ovarian Cycle
• In response to GNRH from the hypothalamus ,
the anterior pituitary secretes FSH & LH.
• FSH & LH stimulates the ovaries to mature an
ovum, release it, & secrete other hormones
that will prepare the Endometrium for
implantation of a fertilized ovum.
• It contains 3 phases:
1 Follicular phase.
2 Ovulatory phase.
3 Luteal phase.

37. 1 Follicular phase : Begins after menstruation ends; lasts 6-13
days; ovarian follicles begin to ripen; estrogen promotes
development of endometrium to 2-5 millimeters thick.
2 Ovulatory phase : Around day 14; about 2 days before
ovulation, LH & FSH secretion rises cause a slight fall in
estrogen production & a rise in progesterone secretion,
stimulating final maturation of a single follicle& release of its
mature ovum.

38. 3 Luteal phase:
After ovulation & under the influence of LH , the
remaining cells of the old follicle persist for about 12
days as a corpus luteum. It secretes estrogen & large
amount of progesterone to prepare the
endometerium for a fertilized ovum.
• Level of FSH & LH decrease in response of high
estrogen & progesterone . If ovum is fertilized, it
secretes HCG that causes the corpus luteum to
persist to maintain an early pregnancy.
• If the ovum is not fertilized, FSH& LH falls & the
corpus luteum regresses & decrease in estrogen &
Progesterone results in menstruation.

39. Ovarian Cycle

40. Endometerial Cycle:
A- Menstrual phase: From day 1-5, Estrogen &
progesterone at low level, Menses initiated, with a
normal range of 20 to 80 ml it is bright or light red in
color discharged through vagina.
Discharge consist of Endo material sloughed, mucous
and blood.
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41. Uterus lining
The lining of the uterus becomes thicker with blood vessels and
more stable during the menstrual cycle. Why is this important?
period
2 4 6 8 10 12 14 16 18 20 22 24 26 28
days after start of period
A fertilized egg will bury itself (implant) in the uterus lining.
The egg needs a plentiful supply of oxygen and nutrients to
develop.
uterus
lining
thickness

42. B- Proliferative phase:
Pituitary gland releases FSH  Stimulate
ovary to prepare mature ovum (graafian folloicle)
 release estrogen which help the endometrium to become
more vascular & thicker
.
Release of LH  graafian follicle rupture  mature
ovum  fallopian tube.
C- Secretory phase: Corpus lutueum secrete estrogen &
progesterone to maintain the vascular lining of the uterus until
placental formation.
If no fertilization corpus luteum survives only 8 days then
disintegrates estrogen & progesterone , menstruation occurs.

43. Hormonal changes causes:
• Basal body temperature  one degree just before the day of
ovulation due to low progesterone level.
• Basal body temperature  one degree following ovulation due
to high progesterone level & temperature remain at this level until
the end of menses.
• If conception occurs Fertilized ovum implants on the endometrium
of the uterus Corpus luteum remains 16-20 wks of pregnancy.
• If conception doesn’t occur Unfertilized ovum atrophies after 4-5
days & corpus luteum regresses.

44. Summary of Ovarian and Menstrual Cycles

45. Ovulation:
❑Each month Anterior pituitary release FSH which
stimulate Primordial follicle to grow & mature.
❑The cell of Primordial follicle produce clear fluid high in
estrogen (Estridol) & some progesterone.
❑Estrogen: Produced by the ovaries, encourages the
uterus to start building up a thick lining in preparation
for pregnancy.
❑As the primordial follicle grows it become visible as a
clear water blister on the surface of the ovaries.
❑Then it becomes as Graafian follicle small ovum has
follicle membrane & fluid.

46. Ovum mature & set on the surface of the
ovaries.
Ovulation period
FSH LH
FSH Enhance rupture graafian follicle then go to the
fallopian tube.
LH Act on the follicle cell to produce follicular fluid
yellow, rich in progesterone, (Corpus luteum)

48. Changes in cervical mucous
❑During most of the female reproductive cycle. The
mucous of the cervix is scant & thick.
❑Just before ovulation cervical mucous becomes thin,
clear & elastic to promote passage of sperm into the
uterus & fallopian tube, where they can fertilize the
ovum.

49. Menstrual Problems
1- Premenstrual syndrome (PMS): is a combination of
emotional, physical, psychological, and mood disturbances that
occur after a woman's ovulation and typically ending with the
onset of her menstrual flow.
The most common mood-related symptoms are irritability,
depression, crying, oversensitivity, and mood swings with
alternating sadness and anger
.
The most common physical symptoms are fatigue, bloating,
breast tenderness (mastalgia), acne, and appetite changes with
food cravings

50. General management includes a healthy lifestyle
including:
• Exercise.
• Family and friends can provide emotional support
during the time of a woman's cycle.
• Avoid salt before the menstrual period.
• Reduce caffeine intake.
• Quite smoking.
• Reduce alcohol& refined sugars.
• some studies suggest that vitamin B6, vitamin E, calcium, and
magnesium supplements may have some benefit.

51. • In severe cases Non steroidal anti inflammatory
medications.
• Oral contraceptive pills (OCPs).

52. 2- Dysmenorrhea: Menstrual cramps are pains in the belly
and pelvic areas that are experienced by a woman as a result
of her menstrual period
There are two types of dysmenorrhea, primary and
secondary.
Primary dysmenorrhea: there is no underlying gynecologic
problem causing the pain. This type of cramping may begin
within six months to a year following menarche (the
beginning of menstruation), the time when a girl starts
having menstrual periods. Menstrual cramps typically do not
begin until ovulatory menstrual cycles (when an egg is
released from the ovaries) occur, and actual menstrual
bleeding usually begins before the onset of ovulation.

53. Secondary dysmenorrhea: some underlying
abnormal condition contributes to the
menstrual pain.
Secondary dysmenorrhea may be evident at
menarche but, more often, the condition
develops later
.

54. Treatment for primary dysmenorrhea:
• Every woman needs to find a treatment that works
for her. There are a number of possible remedies for
menstrual cramps.
1- include not only adequate rest and sleep, but also
regular exercise (especially walking). Some women find
that abdominal massage, yoga, or orgasmic sexual
activity may bring relief.
2-A heating pad applied to the abdominal area may
relieve the pain and congestion and decrease
symptoms.
3-The main agents for treating moderate menstrual
cramps are the nonsteroidal antiinflammatory drugs
For mild cramps, aspirin or acetaminophen

55. • For severe low doses of birth control pills (oral
contraceptives) containing estrogen and
progestin in a regular or extended cycle.
• This type of approach can prevent ovulation
(the monthly release of an egg) and reduce
the production of prostaglandins which, in
turn, reduces the severity of cramping and
causes a light menstrual flow.

56. 3- Amenorrhea:
• Amenorrhea is the medical term for the
absence of menstrual periods, either on a
permanent or temporary basis. Amenorrhea
can be classified as primary or secondary.
Primary amenorrhea: menstrual periods have
never begun (by age 16),
Secondary amenorrhea : absence of
menstrual periods for three consecutive cycles
or a time period of more than six months in a
woman who was previously menstruating.

57. What causes amenorrhea?
The normal menstrual cycle occurs because of
changing levels of hormones made and secreted
by the ovaries.
The ovaries respond to hormonal signals from
the pituitary gland located at the base of the
brain, which is, in turn, controlled by hormones
produced in the hypothalamus of the brain.
Disorders that affect any component of this
regulatory cycle can lead to amenorrhea.
Treatment: According to the causative Factor,
mainly hormonal therapy.

58. 4- Oligomenorrhea: Infrequent menses may result
from hormonal imbalances.
5 - Menorrhagia: Excessive menstrual flow.
6 -Metrorrhagia: Bleeding at various time during
7 - Menopause: Cessation of menses & the cycle.
Reproductive capability in older adult women ~at 50
50 yrs. Occurs due to in ovarian activity & in
circulating estrogen.

59. Conception and ovum development

60. Gametogenesis:
• Gametes (ovum and spermatazon) are formed by meiosis ; each
has one set of 23 chromosomes; other body cells have two sets (46
chromosomes, 23 pairs)
• Oogenesis the process of egg ( ovum/oocyte) formation in female.
• Spermatogenesis the process of sperm
(spermatocyte)formation in male.

61. Oögenesis – Oögonia to Oöcytes
• Germ cells from yolk sac migrate to ovary and
become potential egg cells called oögonia
• In fetus, millions of oögonia produced by mitosis
but most of them degenerate .
• Some develop into immature egg cells called
primary oöcytes during fetal development
– 200,000 to 2 millions present at birth
– 40,000 remain at puberty but only 400 mature during a
woman’s reproductive life
• Each month about 20 primary oöcytes become
secondary oöcytes but usually only one survives to
be ovulated from Graffian follicle

62. Oögenesis
Egg forming cells (oöcytes) go through
two divisions
1º = primary
2º = secondary
•Starts with a 2n=46 1ºoöcyte that
divides, resulting in two n=23 cells,
but one is a large 2º oöcyte and one
is a small 1st polar body that may
itself divide
•Second division only occurs if
2º oöcyte is fertilized. Results in
one large n=23 ovum (egg) and one
small n=23 2nd polar body
•Thus oögenesis results in one large
fertilized egg (zygote) and possibly
three small polar bodies

63. Spermatogenesis
•Begins during puberty in the male.
•Primitive sperm cells spermatogonia develop
during fetal life & begin multiplying by mitosis
during puberty.
•Male produces new spermatogonia that can
mature into sperm throughout his life time.

64. ❑The halves form a new cell & restore the
chromosome number 46.
❑Mother’s ovum carries a single X-
chromosome.
❑Father’s spermatozoa carries either an X or Y
chromosome.
❑If an X – bearing spermatozoon fertilizes the
ovum the off spring’s genetic cell is female.
❑If a Y- bearing spermatozoon fertilizes the
ovum a male off spring results.

65. Ejaculation
❑Male ejaculates ~ 200- 500 million sperm, are
deposited in the upper vagina & over the cervix.
❑Sperm are suspended in seminal fluid which nourishes
& protects them from the acidic vaginal environment.
❑To hold the semen deeply in the vagina the seminal
fluid coagulates some what after ejaculation.
❑Sperm are relatively immobile for about 15-30 min until
other seminal enzymes dissolve the coagulated fluid &
allow the sperm to begin moving upward throughout
the cervix.

66. Conception:
Timing between release of a mature ovum at
ovulation & ejaculation of enough healthy,
mature, motile sperm into the vagina.
Ovum lives waiting for fertilization 24-72 hrs.
Mature sperm live 24-48 hrs although a few
may remain fertile in the woman’s
reproductive tract as long as 5 days.

67. • Fertilization usually occurs in the ampulla of the
fallopian tube.
• Estrogen levels increases during ovulation,
aiding fertilization and easing transit of the
ovum down the fallopian tube.
The ovum membrane is surrounded by two layers
of tissues:
a. Zona pellucida : an inner layer
b. Corona radiate : outer layer
.

68. Conception

69. Preparation for conception in the female
❑Before ovulation , several oocytes begin to
mature under the influence of FSH & LH,
from the anterior pituitary gland.
❑Maturing oocytes are contained in a sac
called Graafian follicle which produce
estrogen + progestron to prepare the
endometrium for possible pregnancy.

71. Fertilization and tubal transport of the zygote. From fertilization to implantation,
the zygote travels through the fallopian tube, experiencing rapid mitotic division
(cleavage). During the journey toward the uterus the zygote evolves through
several stages, including morula and blastocyst.

72. Zygote Development: Cell
Division & Implantation

73. Preparation of sperm for fertilization
Sperm undergoes two processes before it is able to
penetrate the ovum.
1- Capacitation: Structural changes occur once in the
female genital tract.
2- Acrosomal reaction: the sperm releases enzymes.
•Hyaluronidase: causes separation of the corona radiate.
•Acrosin and neuraminidase allow the sperm enter the
zona pellucida.

74. • Fertilization:
The joining of the egg and sperm is
fertilization, usually in the outer 1/3 of the fallopian
tube.
• It occurs about 24 hours after ovulation when sperm
enters the ovum.
• The new cell contains 23 chromosomes from the sperm
and 23 chromosomes from the ova.
• The fertilized ovum is termed zygote; the chromosome
number is thus restored to two sets (46 chromosomes)
• After fertilization changes in the zona pellucida
surrounding the ovum prevent the sperm from entering.

76. • Cleavage:
• Rapid mitotic division of zygot
produces a morula( a ball of 16 cells) that divides
to form a blastocyst.
• Morula divides into trophoblast( which become
the placenta and chorion) and embryoblast which
becomes the embryon.
• The total structure of the developing embryo is
called blastocyst

77. 8/23/2021 Maternity Nursing 77

78. A- Pre-embryonic (zygotic)stage.
Fertilized ovum  Fallopian tube  Uterus takes ~ 3 days.
• Zygote undergoes Mitotic Division (Cleavage)

Plastomers ( Further Multiplication)

Morula (floats in uterus for 3-4 days)under going changes

Mass cell

Blastocyst( Inner solid mass)
(Amnion )

Trophoblast
(Chorion )

79. Inner cell mass
Destined to
become fetus
Fertilization
Trophoblast
Accomplishes
implantation
and develops
into fetal
portions of
placenta
Blastocyst
(cross
section)
Blastocoele Becomes amniotic sac
Morula
Cleavage
Spermatozoa
Ovum
(cross
section)
Secondary
oocyte
(ovum)
Ovulation
Ovary
Implantation
Endometrium
of uterus

80. B- Implantation:
Trophoblast outer layer of mass cell secrete
enzyme that help the Blastocyst embed in
the uterine lining.
Time from conception to implantation ~ 7
days.
Endometrium is very thick and vascular
.
Blastocyst: Implant into the rich vascular
endometrium until completely covered &
implant it self.

81. The site of implantation is important because it is
the place were the placenta develops.
Implantation occurs in the upper uterus
posterior portion.
After implantation Endometrium called Decidua
.
Decidua continues its thicking under the
implanted blastocyst.
Trophoblast develops finger like projections called
chorionic villa contain blood of the developing
zygot & gives O2 & nutrient from mother’s blood
vessels walls by osmosis & diffusion.

82. Endometrium has 3 separate areas:
Decidua basalis: Part of endometrium lying
directly under the embryo or where the
Trophoblast cells are establishing communication
with maternal blood vessels.
Decidua Capsularis: The portion of
endometrium that stretches or encapsulates the
surface of the Trophoblast.
Decidua vera: Remaining portion of the uterine
lining.

83. Thank you