Physiology: Female Reproduction

Labor contractions: progressively stronger contractions increase stretch of the _______ (positive feedback loop) •Which other substance other than oxytocin will also cause contractions?

cervix Prostaglandins will also cause contractions

milk just before and just after birth (very immunoglobulin rich secretion, anti-inflammatory and antimicrobial) What is this called?

colostrum

Menstrual phase of the endometrial cycle is regulated by what hormone?

no hormones

What is the main job of progesterone?

to keep a woman pregnant

What is the pain function of progesterone?

to keep you pregnant

What is the major function of Human chorionic Gonadotropin (hCG)?

to maintain the corpus luteum

Milk secretion: 1) Decreased _______ and _________ after birth 2) Intermittent secretion of ______ during nursing

1) Decreased estrogen and progesterone after birth 2) Intermittent secretion of prolactin during nursing

What are the three stages of labor?

1) Dilation 2) Expulsion 3) Expulsion and separation of placenta

extreme situation with maternal seizure due to cerebral ischemia dx?

Eclampsia

What is the most common form of estrogen in women?

Estradiol 17 β

1. Enlargement of external genitalia 2. Stimulate growth of uterine wall and mammary ducts Which hormone of pregnancy?

Estrogens

Menopause is due to the fact that none of the eggs left can respond to the FSH Menopause is marked by a dramatic increase in which hormone?

FSH, because everything is feeding back to the hypothalamus to increase GnRH -However, there aren't enough follicles around to be stimulated

1. Suppresses uterine contractions 2. Growth of decidual cells (nutrition for placenta) 3. Prepare breast for the secretion of milk 4. Regulate early embryonic cleavage steps Which hormone of pregnancy?

Progesterone

Secretory phase of the endometrial cycle is regulated by what hormone?

Progesterone

Milk secretion is regulated by what two hormones? Prolactin and hCS

Prolactin and hCS

Definition: gradual increase in GnRH around 8 yrs -We start to increase estrogen at this time

Puberty

•Early embryonic development -Oocyte→ secondary oocyte → a bunch of _________ over a couple of days → it is moving through the fallopian tubes → driven toward the uterus → getting ready for ___________

-Oocyte→ secondary oocyte → a bunch of cleavages over a couple of days → it is moving through the fallopian tubes → driven toward the uterus → getting ready for implantation

Proliferative phase - estrogen -begins about day ___ of the ovarian cycle (the tertiary follicle is getting picked) 1. ______ and _______cells proliferate 2. ______ and blood vessels develop 3. Increased expression of ________ receptors (which hormone?) 4. ______ secretions aid in fertilization

-begins about day 5 of the ovarian cycle (the tertiary follicle is getting picked) 1, Stromal and epithelial cells proliferate 2. Glands and blood vessels develop 3. Increased expression of progesterone receptors 4. Mucus secretions aid in fertilization

Secretory phase - Progesterone -this happens after _______ ; corpus luteum is secreting progesterone 1. Swelling and ________ development of endometrium 2. Further thickening 3. _______ for zygote following fertilization (uterine milk)

-this happens after ovulation; corpus luteum is secreting progesterone 1. Swelling and secretory development of endometrium → secretion to prep for implantation 2. Further thickening 3. Nutrition for zygote following fertilization (uterine milk)

Stages of Labor: 1) ________: increase in diameter of the cervix -8-24 hours Relaxin (placental hormone) may soften tissues → weakens the cervix 2) _________: water will break once dilation maximized and fetus moves into birth canal -1-30 minutes 3) __________________: continuous uterine contractions allows placenta to detach from uterine wall and be expelled

1) Dilation: increase in diameter of the cervix 8-24 hours Relaxin (placental hormone) may soften tissues → weakens the cervix 2) Expulsion: water will break once dilation maximized and fetus moves into birth canal 1-30 minutes 3) Expulsion and separation of placenta: continuous uterine contractions allows placenta to detach from uterine wall and be expelled

Cardiovascular changes during pregnancy 1) ________ causes vasodilation of vessels → decrease peripheral resistance (which hormone?) 2) ______ causes hypervolemia → this will also cause vasodilation and decrease peripheral resistance (which hormone?) 3) ________ cardiac output and pulse pressure (inc or dec?) 4) _______ peripheral resistance and ________ in CO and pulse pressure should hopefully balance out to keep things normal (inc or dec?)

1) Estrogens causes vasodilation of vessels → decrease peripheral resistance 2) Aldo causes hypervolemia → this will also cause vasodilation and decrease peripheral resistance 3) Increased cardiac output and pulse pressure 4) Decrease peripheral resistance and increase in CO and pulse pressure should hopefully balance out to keep things normal

Placental Diffusion: A. Oxygen: partial pressure driven (mom: 50, fetus:20 mmHg) 1) Fetal hemoglobin has _______ affinity for O2 (higher or lower?) 2) _____ hemoglobin in fetal blood (more or less?) 3) Bohr effect: fetal blood ______CO2 (gains or loses?) B. Carbon dioxide: PCO2 ________ in fetal blood (higher or lower?) C. Foodstuffs: diffusion and transporters D. _______: Urea and uric acid - diffusion gradients

1) Fetal hemoglobin has greater affinity for O2 2) More hemoglobin in fetal blood (that allows us to extract the O2 from the mom) 3) Bohr effect: fetal blood losses CO2 when CO2 concentration is low the Hgb will have a greater affinity for O2

•Ovulation - Rupture of the ovarian follicle (Day 14) 1) Which hormone is required for ovulation? -"____surge" - 2 days before ovulation levels increases from anterior pituitary → at some point around day 12 the anterior pituitary has a positive feedback from ________ level to cause the ____ surge 2) Hormones cause rapid swelling of follicle 3) LH converts theca and granulosa cells into __________ secreting cells 4) Theca externa cells secrete__________ which weakens the follicular wall 5) ____________ from follicular tissue move into follicle causing vasodilation of newly developing follicular blood vessels

1) LH required for ovulation (not FSH alone) -"LH surge" - 2 days before ovulation levels increases from anterior pituitary (FSH increases 2X) → at some point around day 12 the anterior pituitary has a positive feedback from estrogen level to cause the LH surge 2) Hormones cause rapid swelling of follicle 3) LH converts theca and granulosa cells into progesterone secreting cells 4) Theca externa cells secrete proteolytic enzymes which weakens the follicular wall 5) Prostaglandins from follicular tissue move into follicle causing vasodilation of newly developing follicular blood vessels

Luteal Phase - Day 15-28 1) Theca and granulosa cells converted to _______ cells 2) Follicle becomes the __________ -Granulosa cells produce what two hormones? -Theca cells produce ________ which get converted to estrogen by which enzyme in granulosa cells? 3) 7-10 days after ovulation corpus luteum involutes and losses its secretory functions 4) FSH and LH drop off due to _______ and _________ negative feedback on hypothalamus and pituitary 5) After day 12: corpus albicans and then connective tissue 6) Cessation of estrogen and progesterone release around day 26 leads to ______ increase and we start over

1) Theca and granulosa cells converted to lutein cells 2) Follicle becomes the corpus luteum -Granulosa cells produce estrogen and progesterone* -Theca cells produce androgens which get converted by granulosa cell aromatase to estrogen 3) 7-10 days after ovulation corpus luteum involutes and losses its secretory functions 4) FSH and LH drop off due to estrogen and progesterone negative feedback on hypothalamus and pituitary 5) After day 12: corpus albicans and then connective tissue 6) Cessation of estrogen and progesterone release around day 26 leads to GnRH increase and we start over

Fertilization •Events: Acrosome and Cortical reaction 1. Allows for sperm nucleus to condense and merge with egg nucleus 2. Sperm binds to _______ 3. Phospholipase C → IP3 → _____ release from the endoplasmic reticulum 4. ___ turns the sperm on allowing the tail to separate 5. ____ also stimulates the second meiotic division in the egg

1. Allows for sperm nucleus to condense and merge with egg nucleus 2. Sperm binds to glycoproteins 3. Phospholipase C → IP3 → Ca2+ release from the endoplasmic reticulum 4. Ca2+ turns the sperm on allowing the tail to separate 5. Ca2+ also stimulates the second meiotic division in the egg

Other hormones elevated during pregnancy: 1. Anterior pituitary (enlarged): increase in __________, ________ and _______ release; decreased _____ and ____ 2. ________ - may lead to hypertension 3. _______ - mobilization of glucose 4. __________ - Ca2+ for fetus 5. Thyroid hormone

1. Anterior pituitary (enlarged): increase in corticotropin, thyrotropin and prolactin release; decreased FSH and LH 2. Aldosterone - may lead to hypertension 3. Cortisol - mobilization of glucose 4. Parathyroid hormone - Ca2+ for fetus

1. Before 60 days what produces estrogen and progesterone? 2. Eventually what will produce the estrogen and progesterone?

1. Before 60 days corpus luteum produces estrogen and progesterone 2. Eventually the placenta will produce the estrogen and progesterone

Implantation and Placenta development: 1. Decidual cells of endometrium invaded by _________cells -_________cells will drive villi down and start to develop the placenta 2. By day ___ placenta ready

1. Decidual cells of endometrium invaded by trophoblast cells -Trophoblastic cells will drive villi down and start to develop the placenta 2. By 16th day placenta ready

Production of a mature oocyte 1. Early in the ovarian cycle the egg finishes off meiosis I → this gives us the _________ oocyte. 2. The second division doesn't happen until after ___________ 3. Which hormone stimulates the growth of the layer around the oocyte making the granulosa cell layer? -It is now called the ________ follicle 4. As the amount of _____ increases we grow more layers around the oocyte → this becomes the ________ follicle 5. FSH will increase receptors on the follicle for _______ 6. ______ cells will start to develop around the outside of the granulosa cells. These cells will then secrete androgens → convert to __________ 7. _________ will stimulate further growth into a tertiary follicle 8. The follicle with the highest ________ to FSH and LH will undergo ovulation, rupture and release of the egg

1. Early in the ovarian cycle the egg finishes off meiosis I → this gives us the secondary oocyte. This is where the eggs stays until the sperm comes up to the oocyte 2. The second division doesn't happen until after fertilization 3. FSH stimulates the growth of the layer around the oocyte making the granulosa cell layer -it is now called the primary follicle 4. As the amount of FSH increases we grow more layers around the oocyte → this becomes the secondary follicle 5. FSH will increase receptors on the follicle for LH 6. Theca cells will start to develop around the outside of the granulosa cells. Theca cells are responsive to LH. Theca cells will then secrete androgens → convert to estrogen 7. Estrogen will stimulate further growth into a tertiary follicle 8. The follicle with the highest sensitivity to FSH and LH will undergo ovulation, rupture and release of the egg

Estrogen functions: 1. Enlargement of _______ genitalia 2. Stimulate growth of ______ wall and ________ ducts

1. Enlargement of external genitalia 2. Stimulate growth of uterine wall and mammary ducts

Ovulation summary 1. _________ feeds back near the end of the follicular phase to cause one follicle to grow 2. Then we have the positive feedback of ________ which causes the ____ surge 3. This will cause ________ 4. The remaining follicle will become the _________ and secrete _______ and _________

1. Estrogen feeds back near the end of the follicular phase to cause one follicle to grow 2. Then we have the positive feedback of estrogen which causes the LH surge 3. This will cause ovulation 4. The remaining follicle will become the corpus luteum and secrete estrogen and progesterone

Female sex act •Changes during intercourse: 1. Excitement: increased blood flow and muscle tone: clitoris, labia, breasts and nipples (____and ____) (which hormones?) 2. Vaginal wall becomes engorged and epithelium ________ vagina and cervix 3. Uterus shifts: tenting effect (erect) and _______ of cervix to allow for the penis to enter 4. Orgasm - skeletal muscle movement and muscle _______ in the uterus and fallopian tubes (aid in fertilization), glandular secretions -Women can have multiple orgasms in a short period

1. Excitement: increased blood flow and muscle tone: clitoris, labia, breasts and nipples (VIP and NO) 2. Vaginal wall becomes engorged and epithelium lubricates vagina and cervix 3. Uterus shifts: tenting effect (erect) and dilation of cervix to allow for the penis to enter 4. Orgasm - skeletal muscle movement and muscle contraction in the uterus and fallopian tubes (aid in fertilization), glandular secretions -Women can have multiple orgasms in a short period

Ovarian Cycle: Hormones involved in regulating female reproduction 1. Which hormone is released from the hypothalamus in a pulsatile manner -This increases the release of which two hormones? 2. Which hormone follows the pulsatile manner of the hypothalamus? 3. Which hormone rises gradually? 4. Pulses of GnRH are about every 1-2hrs (in males it is about every 5-25 minutes) 5. Effects on cells surrounding the follicle: a) LH stimulates ______ cells to produce what? b) FSH stimulates ________ cells to produce what? 6. _______ will inhibit the hypothalamus and anterior pituitary releases of GnRH, FSH and LH 7. ____________ will also feedback inhibit but not as much 8. The granulosa cells will also secrete _______ which inhibits FSH release from the anterior pituitary

1. GnRH is released from the hypothalamus in a pulsatile manner -This increases LH and FSH 2. LH follows a pulsatile manner 3. FSH rise gradually 4. Pulses of GnRH are about every 1-2hrs (in males it is about every 5-25 minutes) 5. Effects on cells surrounding the follicle: a) LH stimulates theca cells: Produces androgens and Progestins b) FSH stimulates granulosa cells: produce estrogens and progestins 6. Estrogen will inhibit the hypothalamus and anterior pituitary releases of GnRH, FSH and LH 7. Progesterone will also feedback but not as much 8. The granulosa cells will also secrete inhibin which inhibits FSH release from the anterior pituitary

Follicular phase summary 1. GnRH → increases what 2 hormones? 2. LH → ______ cells → secrete what? 3. FSH → _______ cells → secrete what? 4. Follicle grows 5. ______ and _______have negative feedback to hypothalamus and ant. pit

1. GnRH → FSH and LH 2. LH → Theca cells →Androgens 3. FSH → granulosa cells → Estrogen 4. Follicle grows 5. Estrogen and inhibin have negative feedback to hypothalamus and ant. pit

Parturition Regulation by increased activity of uterine smooth muscle: 1. Hormones: a) __ E:P ratio (inc or dec?) → __________ declines and ________ increases b) ___________ 2. Mechanical a) Stretch of ______ muscle b) Stretch of the _______ c) These leads to _______ release → causes contraction of uterine smooth muscle

1. Hormones: a) ↑ E:P ratio (mo. 7) → progesterone declines and estrogen increases b) Oxytocin 2. Mechanical a) Stretch of uterine muscle b) Stretch of the cervix c) These leads to oxytocin release → causes contraction of uterine smooth muscle

Physiological Changes of Pregnancy Circulatory 1. ________ blood volume due to water retention and blood cell production (inc or dec?) 2. ________ cardiac output (inc or dec?)

1. Increased blood volume due to water retention and blood cell production (aldosterone goes up) 2. Increased cardiac output

Physiological Changes of Pregnancy Respiratory 1. Increased tidal volume and hyperventilation due to increased progesterone (hypocapnia and respiratory ________) (acidosis or alkalosis?)

1. Increased tidal volume and hyperventilation due to increased progesterone (hypocapnia and respiratory alkalosis)

Functions of Progesterone 1. Increases _________ functions of uterine endometrium -Monthly cycle 2. __________ frequency of uterine muscle contractions (inc or dec?) 3. Breast development: growth of lobules and alveoli -Cells become ________ in nature -_______ release of milk into the ducts during pregnancy (stimulates or inhibits?)

1. Increases secretory functions of uterine endometrium -Monthly cycle 2. Decreases frequency of uterine muscle contractions -Maintains pregnancy 3. Breast development: growth of lobules and alveoli -Cells become secretory in nature → gets the cells ready to become milk secreting -Inhibits release of milk into the ducts during pregnancy

Preeclampsia (eclampsia): hypertension, proteinuria and edema 1. Loss of excess _______ in urine leads to excess volume retention 2. _________ in kidneys, liver and brain - contributes to volume retention 3. Causes: what are some causes of pre-eclampsia?

1. Loss of excess proteins in urine leads to excess volume retention 2. Vasospasm in kidneys, liver and brain - contributes to volume retention 3. Causes: damage to placental vasculature endothelium, changes to placental arteries result in vasoconstriction, factors from the damaged tissues are then released into the maternal circulation to have negative effects

•Ovaries contain follicles which will develop into ova 2. Oogonia divide to give primordial oocytes which develop into the ___________ -Oocytes get stuck in what phase of the cell cycle? 3. Only about 30,000 make it to the primordial follicle stage -_________________ factor - stops further oocyte development: this holds the oocytes in check so that they can't move on in the process of maturation

1. Oogonia divide to give primordial oocytes which develop into the primordial follicle Oocytes get stuck in Meiosis I 2. Oocyte maturation inhibitory factor - stops further oocyte development

Functions of Estrogens 1. Proliferation and growth of ___________ tissues -Puberty (GnRH increases) - growth of internal and external _________ -Vaginal epithelium changes to _______→ makes it more resistant to infection -More glandular proliferation in uterus and fallopian tubes 2. __________ development: initiate ______ and milk producing structures 3. Inhibits ________ activity, activates ________ and closure of epiphyseal plates (osteoblast or osteoclast?) 4. _________ protein synthesis, BMR and fat deposition (inc or dec?) 5. Estrogen causes peripheral _______ (vasodilation or vasoconstriction?; it _______total peripheral resistance (inc or dec?)

1. Proliferation and growth of reproductive tissues -Puberty (GnRH increases) - growth of internal and external genitalia -Vaginal epithelium changes to cuboidal → makes it more resistant to infection -More glandular proliferation in uterus and fallopian tunes 2. Breast development: initiate breast and milk producing structures 3. Inhibits osteoclast activity, activates osteoblasts and closure of epiphyseal plates -Osteoporosis after menopause due to ↑ osteoclast activity, decreased matrix, Ca2+ and PO4- deposition 4. Increase protein synthesis, BMR and fat deposition (estrogen can activate hormone sensitive lipase which breaks down fats and can put it in other places) 5. Estrogen causes peripheral vasodilation; it reduces total peripheral resistance→ post-menopausal women will have an increase in TPR which can lead to heart disease

Human chorionic Gonadotropin (hCG) functions 1. Secreted by blastocyst and placenta 2. Growth of ____________- keep hormones coming

1. Secreted by blastocyst and placenta 2. Growth of corpus luteum - keep hormones coming

Human chorionic Samatomammotropin (hCS) functions: 1. Secreted by placenta around week 5 2. ______ development, GH actions 3. Decreases maternal _____ use freeing glucose for fetus and releases ffa's

1. Secreted by placenta around week 5 2. Breast development, GH actions 3. Decreases maternal insulin use freeing glucose for fetus and releases ffa's

Milk Letdown: Galactokinesis 1. ___________ decreases dopamines inhibitory effect on prolactin 2. Prolactin increases the function of the alveolar ducts 3. Now we have milk __________ 4. Suckling also gives us ________ which helps with milk ejection 5. The same signal that causes an increase in prolactin causes a decrease in release of _____, ______ and ________ 6. Lactating women are very unlikely to become _________ because of the decrease in these hormones

1. Suckling decreases dopamines inhibitory effect on prolactin 2. Prolactin increases the function of the alveolar ducts 3. Now we have milk synthesis 4. Suckling also gives us oxytocin which helps with milk ejection 5. The same signal that causes an increase in prolactin causes a decrease in release of GnRH, LH and FSH 6. Lactating women are very unlikely to become pregnant because of the decrease in GnRH, LH and FSH

Progesterone functions: 1. ________ uterine contractions (stimulates or suppresses?) 2. Growth of _______ cells (nutrition for placenta) 3. Prepare breast for the secretion of _____ 4. Regulate early embryonic cleavage steps

1. Suppresses uterine contractions 2. Growth of decidual cells (nutrition for placenta) 3. Prepare breast for the secretion of milk 4. Regulate early embryonic cleavage steps

Luteal phase summary 1. The corpus luteum is producing _________ and ________ which have negative feedback on release of GnRH, FSH and LH 2. Inhibin also inhibits the release of ______ 3. If there is no fertilization the corpus luteum will degenerate → decrease in _________ and _________→ menstruation → cycle starts over again

1. The corpus luteum is producing progesterone and estrogen which have negative feedback on release of GnRH, FSH and LH 2. Inhibin also inhibits the release of FSH 3. If there is no fertilization the corpus luteum will degenerate → decrease in progesterone and estrogen → menstruation → cycle starts over again

Hormone changes during pregnancy 1. ____ will peak very early 2. Can tell if your pregnant around __-___ days 3. _____ keeps the corpus luteum alive which will increase progesterone and estrogen

1. hCG will peak very early (pregnancy test) 2. Can tell if your pregnant around 6-10 days 3. hCG keeps the corpus luteum alive which will increase progesterone and estrogen

Physiological Changes of Pregnancy Digestive: 1. morning sickness 2. _______ GI motility (inc or dec?) and heartburn 3. ______ nutritional and vitamin demand (inc or dec?)

1. morning sickness 2. Reduced GI motility (constipation) and heartburn 3. greater nutritional and vitamin demand

1. Secreted by blastocyst and placenta 2. Growth of corpus luteum - keep hormones coming! Which hormone of pregnancy?

Human chorionic Gonadotropin (hCG)

1. Secreted by placenta around week 5 2. Breast development, GH actions 3. Decreases maternal insulin use freeing glucose for fetus and releases ffa's Which hormone of pregnancy?

Human chorionic Samatomammotropin (hCS)

Definition: beginning of menstruation

Menarche

Definition: cessation of female sexual cycle

Menopause

Menstruation - no hormones (____________ goes away so there is no estrogen or progesterone) 1. _________ stimulation of endometrial cells and thickness (inc or dec?) 2. Vasospasm (from lack of ________) decreases blood supply and causes necrosis of endometrial tissue and blood vessels (fibrinolysin) 3. Loss of tissues and ___________ stimulate uterine contractions to expel the excess lining

Menstruation - no hormones (corpus luteum goes away so there is no estrogen or progesterone) 1. Decreased stimulation of endometrial cells and thickness 2. Vasospasm (from lack of progesterone) decreases blood supply and causes necrosis of endometrial tissue and blood vessels (fibrinolysin) 3. Loss of tissues and prostaglandins stimulate uterine contractions to expel the excess lining

Placenta - provide _______ and ________ to the fetus and remove waste 1. Early - ____ diffusion (low or high?), ______membrane (thin or tough?) and ______ (large or small?) 2. Later - more diffusion (low or high?), _____membrane (thin or tough) and ______ (large or small?)

Placenta - provide foodstuffs and oxygen to the fetus and remove waste 1. Early - low diffusion, tough membrane and small 2. Later - more diffusion, thin membrane and large

hypertension, proteinuria and edema Dx?

Pre-eclampsia

List the physiologically important components of breast milk

Water Fat Lactose Casein Lactalbumin and other proteins Ash: calcium and minerals

Physiological Changes of Pregnancy Renal 1. Rising levels of what two hormones lead to salt and water retention, increased GFR, and compression of bladder?

aldosterone and progesterone

Implantation occurs around day ____ after fertilization

day 6

Proliferative phase of the endometrial cycle is regulated by what hormone?

estrogen

Lactation (Fill in the blanks with hormones) •Breast development: Hormonal regulation •Early: _______, _______, _______ and ___________and _______ •Late: Above + _________- lobules develop (secretory) → _________stimulates the production of milk •________and __________inhibit the actual secretion of milk by the breast

•Breast development: Hormonal regulation •Early: Estrogen, Prolactin, GH and glucocorticoids and Insulin •Late: Above + Progesterone - lobules develop (secretory) → progesterone stimulates the production of milk •Estrogen and Progesterone inhibit the actual secretion of milk by the breast

•Follicular Phase (0-14 days) 1) Enlargement of the follicle and growth of __________ layers: primary follicle 2) Increase in _____(first), ____(second) FSH causes 6-12 __________ to grow ______ cells develop outside granulosa cells 3) Granulosa cells secrete fluid containing ________(into the antrum) 4) _________ causes granulosa cells numbers to increase and FSH receptors to increase (↑ sensitivity) 5) ____ receptors increase on granulosa cells 6) Estrogen and LH cause proliferation and secretion from ______ cells 7) One follicle grows more than the others after about 10 days, others become atretic

•Follicular Phase (0-14 days) 1) Enlargement of the follicle and growth of granulosa layers: primary follicle 2) Increase in FSH (first), LH (second) FSH causes 6-12 primary follicles to grow Theca cells develop outside granulosa cells 3) Granulosa cells secrete fluid containing estrogen (into the antrum) 4) Estrogen causes granulosa cells numbers to increase and FSH receptors to increase (↑ sensitivity) 5) LH receptors increase on granulosa cells 6) Estrogen and LH cause proliferation and secretion from theca cells 7) One follicle grows more than the others after about 10 days, others become atretic

Production of estrogen: •LH on the theca cells causes the production of __________ •The ________ will fuse into the granulosa cells →conversion to ___________ •The primary enzyme here is ____________

•LH on the theca cells causes the production of androgens •The androgen will fuse into the granulosa cells which can convert androgen into estrogens •The primary enzyme here is aromatase (aka CPY19)