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Day 1Ovulation and Fertilization
Hormonal ChangesMiscarriages
InfertilityEffects of Age on Pregnancy
What is Ovulation?
the phase of a female's menstrual cycle in which a mature egg is released from the ovarian follicles into the oviduct.
Follicular Phase This phase starts the first day of the last menstrual period and
continues until ovulation. This first half of the cycle can differ greatly for each woman lasting anywhere from 7 days until 40
days.
Luteal Phase The second half of the cycle is called the luteal phase and is from
the day of ovulation until the next period begins. The luteal phase has a more precise timeline and usually is only 12-16 days from the day of ovulation. This ultimately means that the day of ovulation will determine how long your cycle is. This also means that outside factors like stress, illness, and disruption of normal routine can throw off your ovulation which then results in changing the time your period will come. So the old thought that stress can affect your period is only partly true. Stress can affect your ovulation which ultimately determines when your period will come, but stress around the time of an expected period will not make it late.
What is Fertilization? the fusion of gametes to initiate the development of a new
individual organism the process involves the fusion of an ovum with a sperm,
which eventually leads to the development of an embryo.
Hormonal Changes During Pregnancy
Trophoblast secretes Human Chorionic Gonadotropin (hCG) hCG maintains corpus luteum to continue producing estrogen and
progesterone Inhibits the release of follicle-stimulating hormone (FSH) &
Luteinizing Hormone (LH) hCG basis for pregnancy tests
high levels for 2 months Placental estrogen, placental progesterone, & placental lactogen
are all present in the second and third trimester Placental estrogen & progesterone maintain the uterine wall Placental lactogen stimulates breast development and prepares
mammary glands for milk secretion Placental progesterone and relaxin inhibit smooth muscles in
myometrium suppresses uterine contractions until birth process begins
Other Changes… Other hormonal changes:
Relaxin allows for greater movement in the symphysis pubis & sacroiliac joints
Increase of aldosterone from adrenal cortex to promotes renal reabsorption of sodium
Parathyroid glands secrete parathyroid hormone- maintain high concentration of maternal blood calcium
Hormonal Changes After Pregnancy
Hormones are chemicals that help to control how your body works. Pregnancy causes big changes in your hormones. These changes may have a role in postnatal depression. Your level of a hormone called estrogen rises to 50 times the
normal level by the last three months of pregnancy. This is the main hormone made by your ovaries. Your oestrogen level falls back to normal in the three days after your baby is born.
Your level of the hormone progesterone rises to 10 times the normal level when you're pregnant. Then it falls back to normal in the week after your baby is born.
Your level of the hormone cortisol rises to two times to three times the normal level. Then it slowly decreases after birth.
Your level of the hormone prolactin goes up to seven times its normal level when you are pregnant. This hormone helps your breasts make milk. The level drops back to normal in the three months after birth.
Postpartum Depression A type of clinical depression which
can affect women, and less frequently men, typically after childbirth.
Also known as, postnatal depression.
Postpartum depression occurs in women after they have carried a child. Symptoms include sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, and irritability.
Postpartum depression usually begins in the first few months after childbirth. However it can also affect women who have suffered a miscarriage.
Some women have a higher chance of being depressed after pregnancy than others.
Miscarriages A miscarriage is the spontaneous loss of a fetus before the 20th
week of pregnancy. (Pregnancy losses after the 20th week are called preterm deliveries).
There is the shedding of the uterine lining, which leads to mild cramping alongside vaginal bleeding. This is the most common sign of miscarriage.
Other Signs are: Vaginal bleeding that may be light or heavy, constant or irregular. Pelvic cramps, belly pain, or a persistent, dull ache in your lower back.
(Pain may start a few hours to several days after bleeding has begun.)
Why Miscarriages Occur?
The main reason is due to chromosomal abnormalities.
Most chromosomal abnormalities are the cause of a damaged egg or sperm cell, or are due to a
problem at the time that the zygote went through the division process.
Female Infertility Symptoms
The main symptom of infertility is the inability of a couple to get pregnant.
An abnormal menstrual cycle that's too long (35 days or more) or too short (less than 21 days) can be a sign of female infertility.
Causes Damage to fallopian tubes. Hormonal causes. Cervical causes. Uterine causes. Unexplained infertility.
Risk Factors Age. Smoking. Weight. Sexual history. Alcohol. Caffeine.
Diagnosis Ovulation Testing Hysterosalpingography Laparoscopy Ovarian Reserve Testing Hormone Testing
Treatment Surgery Drugs
Male Infertility Symptoms
The inability to conceive a child Problems with sexual function — for
example, difficulty with ejaculation or difficulty maintaining an erection (erectile dysfunction)
Pain, swelling or a lump in the testicle area
Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
Having a lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)
Causes Medical problems such as infection,
tumors, hormonal imbalances, and varicocele
Environmental causes such as radiation and overheating the testicles
Health and lifestyle choices such as smoking, stress, weight, alcohol use, illegal drug use, and prolonged bicycling
Risk Factors Smoking tobacco Using alcohol Using certain illegal drugs Being overweight Having certain past or present
infections Being exposed to toxins Overheating the testicles Having a prior vasectomy or vasectomy
reversal Being born with a fertility disorder or
having a blood relative with a fertility disorder
Having certain medical conditions, including tumors and chronic illnesses
Taking certain medications or undergoing medical treatments, such surgery or radiation used for treating cancer
Performing certain prolonged activities such as bicycling or horseback riding, especially on a hard seat or poorly adjusted bicycle
Male Infertility continued… Diagnosis
General physical examination and medical history
Semen analysis Scrotal ultrasound Transrectal ultrasound Hormonal testing Post-ejaculation urinalysis Testicular biopsy Genetic Testing
Treatment Surgery Drugs
Effects of Age on Pregnancy Gradual decrease in fertility after the age of 30 Why? What factors? Menstrual cycles are irregular and shorter as they age Lining of the womb- endometrium becomes thinner and less
hostile Ovarian reserve- fewer viable eggs left Older women have greater risks of developing medical disorders
diabetes, hypertensive disorders affect pregnancy and birth
Rates of Caesareans rises with age Complicated delivery
Day 1 -A mature human egg waits in the
fallopian tube. -Just released from the ovary, it is the
largest cell in the human body. -The egg will die if a sperm does not
penetrate the egg’s tough outer membrane within the next 24 hours.
-When the sperm does penetrate, cortical granules are released to prevent any other sperm from penetrating the egg.
Days 2-3 - A fertilized egg moves through the
fallopian tube, pushed toward the uterus by filaments lining the inside of the tube.
- Still dependent on nutrients and genetic instructions contributed by the egg, the embryo divides to form two cells, then four cells, then eight.
- At the eight-cell stage the embryo somehow activates its genes.
Days 4-5 - A three-day-old human embryo
enters the uterus, containing 16 identical cells packed together to form a sphere called a morula.
- During the next 48 hours, the morula will become a blastocyst — a hollow oval with about 100 cells divided into two different types.
- Cells that will form the placenta make up the outer layer of the blastocyst.
Days 6-7 - Blastocysts attached to the
endometrium and secretes HCG (Human Chronic Gonatotropin).
- HCG stimulates morning sickness and detects pregnancy.
Stages of Pregnancy
Stages of PregnancyDays 8-10
The Blastula becomes Gastrula which is a 3 layered structure
The 3 layers are ectoderm, mesoderm, and endoderm.
Ectoderm- skin, nervous system. Endoderm- lining of gut and internal
organs Mesoderm- muscles, bones and heart
Days 11-14 This is when the pregnancy become
established. Amniotic cavity starts to form. Yolk sac forms which will make blood
cells and germ cells. The placenta also starts to form.
Days 15-21 At this time tissue, muscle, and
bones begin to form. Pharyngeal arches begin to form
which is the beginning structures of the face, neck, mouth and nose.
Day 22 and on.. Development of all organ systems
begins On day 22 the heart beat begins
Stages of PregnancyWeek 4
This week marks the beginning of the embryonic period
The baby is an embryo the size of a poppy seed, consisting of two layers: the epiblast and the hypoblast
The primitive placenta is also made up of two layers at this point
Its cells are tunneling into the lining of the mother’s uterus, creating spaces for the mother’s blood to flow
Present now are the amniotic sac, the amniotic fluid, and the yolk sac
Week 5 At this point, the baby is about the size of a
sesame seed Now made up of three layers — the
ectoderm, the mesoderm, and the endoderm The neural tube is starting to develop in the
top layer, called the ectoderm The heart and circulatory system begin to
form in the middle layer, or mesoderm The third layer, or endoderm, will house
many things. The primitive placenta and umbilical cord, which deliver nourishment and oxygen to the baby, are already on the job.
Week 6 The nose, mouth, and ears will begin
developing The baby has an oversize head and dark
spots where your its eyes and nostrils are starting to form
The arms and legs are protruding buds, the intestines are developing, and the pituitary gland is forming
The heart is beating about 100 to 160 times a minute
Right now, the baby is a quarter of an inch long
Week 7 Hands and feet are emerging from
developing arms and legs Technically, the baby is still considered an
embryo and has something of a small tail, which is an extension of her tailbone
The baby has doubled in size since last week and now measures half an inch long
Stages of PregnancyWeek 8
Webbed fingers and toes are poking out from the baby's hands and feet, the eyelids practically cover its eyes, breathing tubes extend from its throat to the branches of its developing lungs
In his brain, nerve cells are branching out to connect with one another, forming primitive neural pathways
The baby is about the size of a kidney bean Week 9
The baby is nearly an inch long — about the size of a grape — and weighs just a fraction of an ounce
The baby's heart finishes dividing into four chambers, and the valves start to form
The embryonic "tail" is completely gone The external sex organs are there but won't
be distinguishable as male or female for another few weeks
Its eyes are fully formed, but her eyelids are fused shut and won't open until 27 weeks
The placenta is developed enough now to take over most of the critical job of producing hormones
Week 10 The baby has now completed the most
critical portion of its development This is the beginning of the so-called fetal
period, a time when the tissues and organs in its body rapidly grow and mature
Vital organs are in place and starting to function
The baby's limbs can bend nowMonth 4
The babys hair and teeth are starting to form The digestive system and the intestines are
now present at this time. stool appears in this intestines. at the end of this month the babys gender
could be determined
Stages of PregnancyMonth 5
The baby has a thin mucus like layer protecting her skin called vernix caseosa.
The fingerprints are now developed. The baby can now suck on its thumb.
Month 6 Now the immune system is developed
and the baby is creating antibodies. Alveoli are forming and the lungs are
developing. Reflexes are starting to occur in the
hand. lanugo which is fine hairs is now
covering the whole body of the fetus.
Month 7 Bones are now fully developed The baby is very active with
movement and is able to hiccup in the womb making it feel like a jumping movement.
Eyes are fully developed and the baby is able to cry.
Month 8 Not much growth is happening during
this month. the baby has grown almost full to term and the space in the womb is very limited. the baby is now getting lots of rest to prepare for life outside of the uterus.
A considerable amount of fat is now on the trunk of the fetus.
Month 9 The head of the baby with reposition
facing down in preparation for birth.
Ectopic Pregnancy What is it?
A complication of pregnancy in which the embryo implants outside theuterine cavity
Dangerous for the mother, since internal haemorrhage is a life-threatening complication
With rare exceptions, ectopic pregnancies are not viable Most ectopic pregnancies occur in the Fallopian tube (so-
called tubal pregnancies) Can also occur in the cervix, ovaries, and abdomen Can lead to death for the mother
Causes and SymptomsCAUSES
Anything that blocks or slows the movement of this egg through these tubes can lead to ectopic pregnancy:
Birth defect in the fallopian tubes Scarring after a ruptured
appendix Endometriosis Scarring from past infections or
surgery of the female organs Things that can increase your risk: Age over 35 Getting pregnant while having an
intrauterine device (IUD) Some infertility treatments Having your tubes tied (tubal
ligation)
SYMPTOMS May have early pregnancy
symptoms, such as breast tenderness or nausea
Abnormal vaginal bleeding Low back pain Mild cramping on one side of the
pelvis No periods Pain in the lower belly or pelvic
area If area around abnormal
pregnancy ruptures and bleeds, symptoms worsen. Symptoms include:
Fainting or feel faint Low blood pressure Severe, sharp, and sudden pain in
the lower abdomen
Tests and TreatmentTESTS
Pelvic exam Pregnancy test Vaginal ultrasound Checking of the blood level of
hormone HCG
TREATMENT The developing cells must be
removed to save the mother. If the area breaks open: leads
to bleeding and shock Shock treatments Blood transfusion Fluids given through a vein Oxygen Surgery is done whether or
not area is ruptured Must remove pregnancy and
stop blood loss Expectations for mother:
greater chance of having another ectopic pregnancy than a regular pregnancy.