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Environmental Factors and Reproduction

Acknowledgments The authors gratefully acknowledge the contribution of Patrice Sutton of PRHE and Jessica Trowbridge, MPH, UC Berkeley, who contributed to the previous (8th Edition) of this chapter. Funding to support this work was provided to UCSF’s Program on Reproductive Health and the Environment and the Environmental Research and Translation for Health (EARTH) Center by the Barbara and Donald Jonas Family Fund, the JPB Foundation, the…

Nutrition and Reproduction

Introduction In males, pulsatile gonadotropin-releasing hormone (GnRH) and gonadotropin secretion are secreted at a mean interval of every 2 hours, a frequency sufficient to maintain testosterone levels, virilization, and spermatogenesis. In females, a more complex series of gonadal tasks must be accomplished, which include maturation of a single follicle, follicular rupture and ovulation, and corpus luteum formation. The mature female hypothalamic-pituitary-ovarian (HPO) axis must respond dynamically…

Puberty: Gonadarche and Adrenarche

Introduction Puberty in humans is defined as the period of first becoming capable of reproducing and is distinguished by maturation of the genital organs, development of secondary sex characteristics, acceleration in linear growth velocity, changes in affect, and the occurrence of menarche in the female. In humans, the transition into puberty is driven by two physiological processes: gonadarche and adrenarche. Gonadarche comprises the growth and maturation…

Differences of Sex Development

Introduction Our individual sex has a major role in determining the physical attributes of our bodies, the structure of our brains, our behavioral tendencies, and our self-concept. Understanding how biological sex differences arise has both informed and been informed by the advances in the molecular dissection of genes responsible for conditions collectively termed differences of sex development (DSD). New genes have been identified, allowing for rapid…

Immunology and Reproduction

Introduction The relationship between a living organism and its environment is based on a tightly regulated balance between symbiosis and competition. Survival is dependent upon appropriate resource acquisition, permissive physicochemical environments, and competition for limiting resources and ecological niches exerted by other living organisms. The complexity of an organism is directly correlated to the sheer volume of challenges presented to its continued fertility (the ultimate currency…

Male Reproductive Aging

As men age, reproductive function declines in several ways. Although the change is gradual, unlike the relatively abrupt decline that occurs in women at the time of menopause, it is progressive and probably has some adverse consequences. The decline is sometimes called andropause , male menopause , late-onset hypogonadism , and other terms. This chapter reviews the changes in male reproductive function with aging and what…

Menopause and Aging

Epidemiology The age of menopause has been constant over several centuries and is influenced by genetic, ethnic, and environmental variables. The prediction of the age of menopause based on antimüllerian hormone (AMH) trajectories is possible but impractical. Menopause is defined by the last menstrual period. Because cessation of menses is variable and many of the symptoms associated with menopause may occur prior to the cessation of…

The Hypothalamo-Pituitary Unit, Testis, and Male Accessory Organs

Physiology of the Male Gonadal Axis Gonadotropin-releasing hormone (GnRH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (Te), and estradiol (E 2 ) are the major ligands (hormones) of the male gonadal axis. Pulsatile secretion of these hormones allows feedforward (stimulatory) and feedback (inhibitory) signaling through their cognate receptors to maintain androgenization, male sexual behavior, and reproductively competent spermatogenesis. The master regulator of the male gonadal axis…

The Breast

Exclusive breastfeeding can produce amenorrhea for up to 6 months postpartum by inhibiting GnRH secretion. Breastfeeding is associated with a reduced risk of developing endometriosis, type 2 diabetes mellitus, hypertension, and breast and ovarian cancer. Introduction Structural and Histological Features of the Breast The functional unit of the breast is the alveolar-ductal unit which consists of a globular alveolar structure and a cylindrical ductal structure with…

Endocrinology of Human Pregnancy and Fetal-Placental Neuroendocrine Development

Introduction The birth of a healthy baby is dependent on an ordered sequence of biological events during pregnancy. Important among these are: 1. Successful implantation of the developing embryo 2. Adaptation of maternal physiology to accept and retain the embryo and satisfy its nutritional, metabolic, and physical needs 3. Appropriate growth and functional development of key organ and homeostatic control systems in the fetus in preparation…

Structure, Function, and Evaluation of the Female Reproductive Tract

The fallopian tubes, endometrium, myometrium, and cervix function in concert to receive gametes, facilitate fertilization, support embryo growth, and ultimately orchestrate the timely expulsion of a mature fetus. The preparation of a reproductive tract conducive to pregnancy is governed by ovarian steroid hormones acting directly on their cognate receptors and indirectly through multiple steroid-regulated growth factors, cytokines, and other extracellular and intracellular signaling molecules. This complex…

Meiosis, Fertilization, and Preimplantation Embryo Development

Introduction Not so long ago, the intricate journey of the individual gametes through maturation, merging, and then becoming a developmentally competent preimplantation embryo was a complete mystery. Now, these aspects of establishing an early pregnancy are carried out routinely in the clinic by a combination of hormonal treatments, in vitro gamete manipulations, and embryo culture. The goal of this chapter is to illuminate the complex physiological mechanisms…

The Ovarian Life Cycle

Introduction The ovary is a dynamic organ that undergoes some of the most dramatic changes in structure and function of any adult human tissue ( Fig. 8.1 ). Follicles at all stages of development, from tiny primordial follicles to large preovulatory, Graafian follicles and postovulatory corpora lutea coexist throughout the reproductive lifespan. These structures interact with each other in a paracrine fashion through generation of secretory…

Neuroendocrine Control of the Menstrual Cycle

The Reproductive Axis Normal reproductive function in women involves repetitive cycles of follicle development, ovulation, and preparation of the endometrium for implantation should conception occur in that cycle. This pattern of regular ovulatory cycles is achieved through precise functional and temporal integration of stimulatory and inhibitory signals from the hypothalamus, the pituitary, and the ovary ( Fig. 7.1 ). The reproductive system functions in a classic…

Growth Factors and Reproduction

Acknowledgments The authors wish to thank Dr. Martin Matzuk, Dr. Amanda Rodriguez, and Dr. Caterina Clementi for their contributions to the previous versions of this chapter. Studies in the Pangas and Monsivais laboratories have been supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD076980 supporting Dr. Pangas, HD096057 supporting Dr. Monsivais, and National Cancer Institute CA138628 to Dr. Pangas). Diana…

Steroid Hormone Action

Steroid Hormone Receptors Act as Ligand-Dependent Transcription Activators or Repressors Steroid hormones are derived from the metabolic conversion of cholesterol into biologically active steroid products that bind to intracellular receptors with high specificity. The canonical mechanism of action for the steroid hormone receptors involves regulating gene transcription through transactivation and transrepression. Precise regulation of gene transcription is essential for development, physiology, and homeostasis. Steroids are small,…

Steroid Hormones and Other Lipid Molecules Involved in Human Reproduction

Lipids serve as metabolic substrates, structural components of cellular membranes, and signaling molecules. This chapter reviews the diversity of lipid molecules that participate in signal transduction related to human reproduction, including the nomenclature, the general features of their synthesis and metabolism, the ways in which these processes are controlled physiologically, the ways in which they can be modified by pharmacologic intervention, and some disorders that interfere…

Prolactin in Human Reproduction

Introduction Prolactin (PRL) is a single chain (23 KDa) polypeptide hormone, which is secreted by anterior pituitary lactotroph cells. Several lines of evidence indicate that PRL has an essential role in reproduction and lactation. In addition, animal data have supported a role for PRL in a variety of metabolic processes. However, such PRL actions have not been unequivocally confirmed in humans. The present chapter reviews PRL…

The Gonadotropin Hormones and Their Receptors

Introduction Derived from the Greek meaning of “that which generates,” the gonads are the female and male organs that produce egg and sperm, respectively. Pituitary glycoprotein hormones which bind to target receptors on granulosa and theca cells in the ovary or Sertoli and Leydig cells in the testis have therefore been named gonadotropin hormones. The IUPAC (International Union of Pure and Applied Chemistry) nomenclature for human…

Neuroendocrinology of Reproduction

Central Control of Reproduction Successful reproduction is essential to the survival of a species. The reproductive system represents a highly complex functional organization of diverse tissues and signaling pathways that, when properly functioning, ensures a number of key endpoints. The most important of these are the adequate production and development of gametes (ova and sperm), successful delivery of gametes for fertilization, and physiologic preparation for possible…