PART 16: Endocrinology and Metabolism
SECTION 1 Endocrinology
347 The Female Reproductive System, Infertility, and Contraception
 | Figure 347-1 Stages of ovarian development from the arrival of the migratory germ cells at the genital ridge through gonadotropin-independent and gonadotropin-dependent phases that ultimately result in ovulation of a mature oocyte. FSH, follicle-stimulating hormone; LH, luteinizing hormone. |
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 | Figure 347-2 Ovarian germ cell number is maximal at mid-gestation, then decreases precipitously. |
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 | Figure 347-3 Development of ovarian follicles. The Graffian follicle is also known as a tertiary or preovulatory follicle. (Courtesy of JH Eichhorn and D Roberts, Massachusetts General Hospital; with permission.) |
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 | Figure 347-4 Establishment of a functional GnRH system requires the participation of a number of genes that are essential for development and migration of GnRH neurons from the olfactory placode to the hypothalamus in addition to genes involved in the functional control of GnRH secretion and action. |
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 | Figure 347-5 Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are increased during the neonatal years but go through a period of childhood quiescence before increasing again during puberty. Gonadotropin levels are cyclic during the reproductive years and increase dramatically with the... |
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 | Figure 347-6 Estrogen production in the ovary requires the cooperative function of the theca and granulosa cells under the control of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). HSD, hydroxysteroid dehydrogenase; OHP, hydroxyprogesterone. |
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 | Figure 347-7 The reproductive system in women is critically dependent on both negative feedback of gonadal steroids and inhibin to modulate follicle-stimulating hormone (FSH) secretion and on estrogen positive feedback to generate the preovulatory luteinizing hormone (LH) surge. GnRH,... |
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 | Figure 347-8 Relationship between gonadotropins, follicle development, gonadal secretion, and endometrial changes during the normal menstrual cycle. FSH, follicle-stimulating hormone; LH, luteinizing hormone; E2, estradiol; Prog, progesterone; Endo, endometrium. |
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 | Figure 347-9 Causes of infertility. FSH, follicle-stimulating hormone; LH, luteinizing hormone. |
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