Human Reproductive Biology

Fall 2005

Human reproductive system. (Image courtesy of the U.S. National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) Program.)

Course Highlights

This course features downloadable lecture notes and a full bibliography of readings.

Course Description

This course is designed to give the student a clear understanding of the pathophysiology of the menstrual cycle, fertilization, implantation, ovum growth development, differentiation and associated abnormalities. Disorders of fetal development including the principles of teratology and the mechanism of normal and abnormal parturition will be covered as well as the pathophysiology of the breast and disorders of lactation. Fetal asphyxia and its consequences will be reviewed with emphasis on the technology currently available for its detection. In addition the conclusion of the reproductive cycle, menopause, and the use of hormonal replacement will be covered.

Syllabus

Course Overview

Emphasis on quantitative techniques, when applicable, including modern approaches to fetal surveillance and in vitro fertilization as well as prenatal diagnosis will be employed.

Each lecture will be complemented by a brief clinical pathologic conference (CPC) emphasizing relevant clinical applications of basic principles discussed in the lectures.

Requirements

Weekly thought questions will be assigned and a multiple choice final examination is given.

Grading

The course is graded Pass/Fail for M.D. students, and A/B/C/F for graduate students.

Calendar

Course calendar.
SES #	Topics
1	Introduction to the Course (15 min.) - Dr. Henry Klapholz Male Reproductive Anatomy (1 hr.) - Dr. Abe Morgentaler Male System Physiology (1 hr.) - Dr. Abe Morgentaler Clinical Pathological Conference: Male Reproductive System (30 min.) - Dr. Abe Morgentaler
2	Impotence (1 hr.) - Dr. Abe Morgentaler Male Fertility, Temperature and the Testes (1 hr. 15 min.) - Dr. Abe Morgentaler
3	Female System Anatomy (1 hr.) - Dr. Henry Klapholz Endometriosis (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Female Reproductive System (45 min.) - Dr. Henry Klapholz
4	The Normal Menstrual Cycle (1 hr.) - Dr. Alan Penzias Abnormalities of the Menstrual Cycle (1 hr.) - Dr. Alan Penzias Clinical Pathological Conference: Menstrual Cycle (45 min.) - Dr. Alan Penzias
5	Uterine Pathology: Fibroids (1 hr.) - Dr. Henry Klapholz Ovarian Pathology (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Gynecologic Pathology (15 min.) - Dr. Henry Klapholz
6	Non-hormonal Contraception I (1 hr.) - Dr. Henry Klapholz Non-hormonal Contraception II (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Contraception (45 min.) - Dr. Henry Klapholz
7	Hormonal Contraception (1 hr.) - Dr. Henry Klapholz Phytoestrogens (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Menstrual Cycle (45 min.) - Dr. Alan Penzias
8	The Placenta (1 hr.) - Dr. Drucilla Roberts Placental Pathology (1 hr.) - Dr. Drucilla Roberts Clinical Pathological Conference: Menstrual Cycle (15 min.) - Dr. Alan Penzias
9	The Cervix (1 hr.) - Dr. Henry Klapholz Cervical Pathology and Cancer (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Cervix (45 min.) - Dr. Henry Klapholz
10	Sexual Differentiation I (1 hr.) - Dr. Patricia Donahoe Sexual Differentiation II (1 hr.) - Dr. Patricia Donahoe Clinical Pathological Conference: Sexual Differentiation (45 min.) - Dr. Henry Klapholz
11	Infertility (1 hr.) - Dr. Selwyn Oskowitz Assisted Reproductive Technology (1 hr.) - Dr. Selwyn Oskowitz Clinical Pathological Conference: Infertility (15 min.) - Dr. Selwyn Oskowitz
12	Maternal Physiology I (1 hr.) - Dr. Henry Klapholz Maternal Physiology II (1 hr.) - Dr. Henry Klapholz Clinical Pathological Conference: Maternal Physiology (45 min.) - Dr. Henry Klapholz
13	Hypertension in Pregnancy (1 hr.) - Dr. Kee-Hak Lim Film Viewing: Eclampsia (45 min.)
14	Uterine Physiology (1 hr.) - Dr. Henry Klapholz Parturition (1 hr.) - Dr. Henry Klapholz Video - Normal Labor and Delivery (45 min.)
15	Polycystic Ovarian Syndrome (PCO) (1 hr. 15 min.) - Dr. Robert Barbieri Ovarian Failure (1 hr.) - Dr. Jan Shifren
16	Toxoplasmosis (1 hr.) - Dr. Henry Klapholz Isoimmunization (1 hr.) - Dr. Henry Klapholz
17	Teratology (1 hr. 25 min.) - Dr. Lewis Holmes Ultrasound Prenatal Diagnosis (1 hr. 30 min.) - Dr. Beryl Benacerraf
18	Energy and Radiation Impact on Pregnancy (1 hr.) - Dr. Henry Klapholz Prenatal Genetic Diagnosis (1 hr.) - Dr. Henry Klapholz
19	Fetal Surveillance (1 hr.) - Dr. Henry Klapholz Pregnancy Termination Technology (1 hr. 15 min.) - Dr. Henry Klapholz
20	Film Viewing: The Way It Was (1 hr.) Film Viewing: Life's Greatest Miracle (1 hr. 15 min.)

Readings

Primary literature references for required readings are correlated with syllabus topics below. A bibliography of optional readings is also listed by topic.

Required Readings

Cancer

vanNagell, J. R., and P. D. DePriest. "Management of Adnexal Masses in Postmenopausal Women." Am J Obs Gyn 193 (2005): 30-35.

Tiffen, J., and S. M. Mahon. "Ovarian Cancer Screening: Are There Any Options?" Clin J Onc Nurs 9 (2005): 369-372.
Endometriosis

Berkley, K. J., A. J. Rapkin, and R. E. Papke. "The Pains of Endometriosis." Science 308 (2005): 1587-89.

Giudice, L. C., and L. C. Kao. "Endometriosis." Lancet 364 (2004): 1789-99.
Fetal Monitoring

Armour, K. "Using Surveillance to Improve Maternal and Fetal Outcomes." AWHONN Lifelines 8: 232-240.
Hormonal and Non-hormonal Contraception

Supplement Article: J AIDS 38 (2005): S1-S23.

Kaunitz, A. M. "Beyond the Pill: New Data and Options in Hormonal and Intrauterine Contraception." Am J Obs Gyn 192 (2005): 998-1004.

Hoffman, S., J. Mantell, T. Exner, and Z. Stein. "The Future of the Female Condom." Pers Sex Reprod Health 36 (2004): 120-125.
Implantation

Nie, G., A. R. Butt, L. A. Salamonsen, and J. K. Findlay. "Hormonal and Non-Hormonal Agents at Implantation as Targets for Contraception." Reprod Fertil Dev 9 (1997): 65-76.
Menopause

Beck, V., U. Rohr, and A. Jungbauer. "Phytoestrogen Derived from Red Clover: An Alternative to Estrogen Replacement Therapy?" J Ster Bioch Mol Bio 94 (2005): 499-518.

National Institutes of Health. "State-of-the-Science Conference Statement: Management of Menopause-Related Symptoms." Ann Int Med 142 (2005): 1003-1013.
Menstrual Cycle

Emperaire, J. C., and R. G. Edwards. "Time to Revolutionize the Triggering of Ovulation." Reprod BioMed 5 (2004): 480-483.
Non-Hormonal Contraception

Wilkinson, D., M. Tholandi, G. Ramjee, and G. W. Rutherford. "Nonoynol-9 Spermicide for Prevention of Vaginally Acquired HIV and Other Sexually Transmitted Infections: Systematic Review and Meta-Analysis of Randomized Controlled Trials Including more than 5000 Women." Lancet 2 (2002): 613-617.
Pre-Eclampsia

Karumanchi, S. A., S. E. Maynard, I. E. Stillman, F. H. Epstein, and V. P. Sukhatme. "Preeclampsia: A Renal Perspective." Kid Int 67 (2005): 2101-2113.
Pregnancy

Lapinsky, S. E. "Cardiopulmonary Complications of Pregnancy." Crit Care Med 33 (2005): 1616-1622.

Ross, L. E., B. J. Murray, and M. Steiner. "Sleep and Perinatal Mood Disorders: A Critical Review." J Psych Neurosci 30 (2005): 247-256.
Prenatal Screening

Lambert-Messerlian, G. M., H. Pinar, E. Laprade, U. Tantravahi, A. Schneyer, and J. A. Canick. "Inhibins and Activins in Human Fetal Abnormalities." Molec and Cell End 255 (2004): 101-108.

Kuliev, A., and Y. Verlinsky. "Place of Preimplantation Diagnosis in Genetic Practice." Am J Med Gen 134A (2005): 105-110.
Puberty

Havelock, J. C., R. J. Auchus, and W. E. Rainey. "The Rise in Adrenal Androgen Biosynthesis: Adrenarche." Sem Repr Med 22 (2004): 337-347.

Waylen, A., and D. Wolke. "Sex 'n' Drugs 'n' Rock 'n' Roll: The Meaning and Social Consequences of Pubertal Timing." Eur J End 151 (2004): 151-159.
Rh isoimmunization

Thaplial, A., U. Ramachandran, K. K. Sharma, P. Gautam, and N. Sarkar. "Rh Iso-Immunisation with Syndrome of Hepatocellular Damage. An Unusual Presentation with Review of Literature." Int J Clin Pract 58, no. 11 (November 2004): 1056-60.
Sex Differentiation

MacLaughlin, D. T., and P. K. Donahoe. "Sex Determination and Differentiation." N Eng J Med 350 (2004): 367-378.
Teratogenesis

De Santis, M., E. D. Gianantonio, G. Straface, A. F. Cavaliere, A. Caruso, F. Schiavon, R. Berletti, and M. Clementi. "Ionizing Radiations in Pregnancy and Teratogenesis: A Review of Literature." Reprod Tox 20 (2005): 323-329.
Termination of Pregnancy

Zindler, L. "Ethical Decision Making in First Trimester Pregnancy." J Perinat Neonat Nurs 19 (2005): 122-131.

Say, L., R. Kulier, M. Gulmezoglu, and A. Campana. "Medical versus Surgical Methods for First Trimester Termination of Pregnancy." Cochrane Database Syst Rev 1 (January 25, 2005): CD003037.
Trophoblastic Disease

Seki, K., H. Matsui, and S. Sekiya. "Advances in the Clinical Laboratory Detection of Gestational Trophoblastic Disease." Clinica Chimica Acta 349 (2004): 1-13.

Devriendt, K. "Hyatidiform Mole and Triplody: The Role of Genomic Imprinting in Placental Development." Hum Reprod Up 11 (2005): 137-142.

Soper, J. T., D. G. Mutch, and J. C. Schink. "Diagnosis and Treatment of Gestational Trophoblastic Disease: ACOG Practice Bulletin No. 53." Gyn Onc 93 (2004): 575-585.
Toxoplasmosis

Kravetz, J. D., and D. G. Federman. "Toxoplasmosis in Pregnancy." Am J Med 118 (2005): 212-216.
Uterine Physiology

Bulletti, C., D. De Ziegler, P. L. Setti, E. Cicinelli, V. Polli, and C. Flamigni. "The Patterns of Uterine Contractility in Normal Menstruating Women: From Physiology to Pathology." Ann NY Acad Sci 1034 (2004): 64-83.
Optional Readings
Eggs and Sperm

Surani, M. A. "Stem Cells: How to Make Eggs and Sperm." Nature 427, no. 6970 (January 8, 2004): 106-7.

Geijsen, N., M. Horoschak, K. Kim, J. Gribnau, K. Eggan, and G. Q. Daley. "Derivation of Embryonic Germ Cells and Male Gametes from Embryonic Stem Cells." Nature 427, no. 6970 (January 8, 2004): 148-54. Epub 2003 December 10.
Germ Cells

Saitou, M., S. C. Barton, and M. A. Surani. "A Molecular Programme for the Specification of Germ Cell Fate in Mice." Nature. 148, no. 6895 (July 18, 2002): 293-300.

Blackwell, T. K. "Germ Cells: Finding Programs of Mass Repression." Curr Biol 14, no. 6 (March 23, 2004): R229-30.
Oocytes

Johnson, J., J. Bagley, M. Skaznik-Wikiel, H. J. Lee, G. B. Adams, Y. Niikura, K. S. Tschudy, J. C. Tilly, M. L. Cortes, R. Forkert, T. Spitzer, J. Iacomini, D. T. Scadden, and J. L. Tilly. "Oocyte Generation in Adult Mammalian Ovaries by Putative Germ Cells in Bone Marrow and Peripheral Blood." Cell 122, no. 2 (July 29, 2005): 303-15.

Hubner, K., G. Fuhrmann, L. K. Christenson, J. Kehler, R. Reinbold, R. De La Fuente, J. Wood, J. F. Strauss 3rd, M. Boiani, and H. R. Scholer. "Derivation of Oocytes from Mouse Embryonic Stem Cells." Science 300, no. 5623 (May 23, 2003): 1251-6. (Epub May 1, 2003)
Primordial Germ Cells

McLaren, A. "Primordial Germ Cells in the Mouse." Dev Biol 262, no. 1 (October 1, 2003): 1-15.
Refusing Emergency Contraception

Cantor, J., and K. Baum. "The Limits of Conscientious Objection--may Pharmacists Refuse to Fill Prescriptions for Emergency Contraception?" N Engl J Med 351, no. 19 (November 4, 2004): 2008-12.