Anaemia/iron deficiency list of publications


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It houses the developing fetus during pregnancy. The lower portion of the uterus is called the cervix and opens into the vagina, or birth canal. An opening in the cervix allows for the passage of sperm into the uterus and the exit of menstrual blood. This same opening dilates during labor to allow passage of the baby through the birth canal. Arising from the upper portion of the uterus on each side are the Fallopian tubes.

These are channels that allow eggs from the ovaries to enter the uterus. The process of fertilization of an egg by a sperm cell typically happens in the Fallopian tubes, and the fertilized egg moves into the uterus where it is implanted. Beside the uterus on each side and near the opening of the Fallopian tubes are the small, oval ovaries. They produce hormones and contain eggs. At birth, a female has 1 to 2 million eggs already present in the ovaries, but only about of them will mature during a woman's lifetime.

The labia majora are two fleshy protrusions that protect and envelop the other external reproductive organs. They are covered with hair after puberty. They contain glands that produce sweat and oils. Inside the labia majora are the labia minora, smaller protrusions of flesh that surround the openings to the urethra that allows passage or urine and the vagina.

Located next to the vaginal opening are glands that produce mucus known as Bartholin's glands. At the junction of the labia minora is the clitoris, a small structure that is covered by a skin fold called the prepuce.

The clitoris is comparable to the male penis and is highly sensitive. The menstrual cycle is the monthly cycle of follicle and egg maturation, release of an egg ovulation , and preparation of the uterine lining for pregnancy.

If a woman does not become pregnant , the uterine lining tissue is shed as menstrual blood. Most menstrual cycles occur every 28 days. Menarche is the time during adolescence when menstrual periods begin. Menstrual periods continue to occur until a woman reaches menopause. The follicular phase is the beginning of the menstrual cycle. It starts on the first day of menstrual bleeding and usually lasts about 14 days.

The hormones follicle-stimulating hormone FSH and luteinizing hormone LH are released from the pituitary gland to stimulate the ovaries. In turn, the ovaries produce estrogen and stimulate the maturation of about 15 to 20 eggs in the ovaries inside small cystic areas known as follicles. Once estrogen levels begin to rise, the secretion of FSH is reduced by a feedback system so that follicle stimulation ceases at the appropriate time. With time, one of the egg follicles or rarely, two or more becomes dominant, and maturation of the other follicles is interrupted.

The dominant follicle continues to make estrogen. Ovulation occurs at the midpoint of the menstrual cycle. Estrogen production from the dominant follicle leads to a sharp rise in LH secretion, causing the dominant follicle to release its egg. The egg is swept into the Fallopian tube by thin structures on the ends of the tubes known as fimbriae. At this time, the cervix produces an increased amount of thin mucus that assists sperm in the passage into the uterus.

The luteal phase of the menstrual cycle begins at ovulation egg release. After the egg is released, the empty follicle turns into a cystic mass of cells called the corpus luteum. The corpus luteum then produces progesterone , a hormone that readies the lining of the uterus for implantation of a fertilized egg. If an egg has been fertilized, the fertilized egg travels down one of the Fallopian tubes into the uterus and implants in the uterine lining tissue.

If fertilization of an egg has not occurred, the lining of the uterus eventually breaks down and is shed resulting in menstrual bleeding. Menopause is defined at the point in time at which a woman has not had a menstrual period for 12 consecutive months.

It signals the end of a woman's fertility and occurs, on average, at 51 years of age, though the time of menopause can vary widely. Learn about the signs and causes of infertility in women and men. Get facts on fertility drugs and infertility treatments.

A midwife and doula are not the same thing. A doula's job is to provide non-medical, emotional, and personal support to a woman throughout her pregnancy, labor, delivery, and postpartum experience. A certified nurse midwife is a medical health care professional that manages the overall general health of the mother and baby; for example, performs exams, orders laboratory tests, and procedures, and performs fetal monitoring from the pregnant woman's first prenatal visit to post-partum and aftercare.

A midwife can deliver the baby, whereas a doula cannot. An ovarian follicle consists of an oocyte , or immature egg, surrounded by an epithelium, the cells of which are referred to variously as follicular, nurse, or granulosa cells. In cyclostomes, teleosts, and amphibians, the epithelium is one layer thick. In the hagfish and those vertebrates in which the oocyte receives heavy deposits of yolk elasmobranchs, reptiles, birds, and monotremes , the epithelium appears to be two cells thick, apparently the result of layering of nuclei in a simple columnar epithelium i.

Above monotremes the follicular epithelium appears to be many cells thick; in at least one species, however, this is considered an artifact , and all granulosa cells are said to extend between the outer boundary of the epithelium and the oocyte.

The follicular epithelium originates as a few flattened cells derived from the germinal epithelium. Primary follicles are usually situated just under the tunica albuginea; secondary follicles lie deeper in the cortex. The primitive role of the follicular cells appears to be the secretion of the yolk-forming material onto or into the oocyte. Evidence from mammals indicates that the follicular cells may also have a role in converting substances produced elsewhere into female hormones, or estrogens.

In some hibernating bats the granulosa cells are filled with glycogen, or animal starch, which may be a source of energy. Mammalian follicles above monotremes are unique in that they develop a fluid-filled cavity antrum within the granulosa layer.

During antrum formation cell division of the granulosa cells increases, and fluid-filled spaces develop among the cells. The spaces coalesce to form the antrum. Under the influence of pituitary gonadotropic hormones, many antral follicles thereafter continue to grow, forming large so-called Graafian follicles—less than microns, or 0.

Graafian follicles contain mature eggs and appear as large blisters on the ovary. At this stage the ovum, suspended within the fluid of the antrum liquor folliculi by a slender stalk of granulosa cells, is surrounded by a cluster of these cells, the cumulus oophorus, or discus proligerus. The remaining follicular cells form a thin wall surrounding the antrum. Antra are lacking in a few insectivores Hemicentetes , Euriculus because the granulosa cells swell and multiply to form corpora lutea, masses of yellow tissue.

In the bat Myotis the antrum is likewise compressed and disappears just before discharge of the egg, or ovulation. In all vertebrates, oocytes that have begun to grow and mature may, at any time until just before ovulation, cease development and undergo atresia, or degeneration. This is a normal process that reduces the number of eggs ovulated. In small laboratory rodents, atresia takes place in 50 percent of the Graafian follicles in each ovary one or two days before ovulation, thus reducing the number of ovulatable eggs by 50 percent.

A similar reduction takes place in hagfish prior to ovulation. Atretic follicles eventually become lost in the stroma of the cortex of the ovary. In mammals especially, follicles lacking oocytes and antra, called anovular follicles, as well as polyovular follicles i. The ovarian follicle of vertebrates, commencing with hagfish, is surrounded by a theca , or sheath, composed of two concentric layers of stromal cells. The outer layer theca externa is chiefly connective tissue but may contain smooth muscle fibres.

The inner layer theca interna has more blood vessels and, in vertebrates that produce heavily yolked eggs, the largest vessels carry venous blood. In these species the cell membranes of the oocyte and granulosa cells have many microvilli i. Mature follicles in the marsupial Dasyatus are said to lack theca, and in some bats only one thecal layer has been described. During the growth phase, eggs in species with massive amounts of yolk may increase in size 10 6 1,, or more times as a result of vitellogenesis deposit of yolk.

In goldfish, on the other hand, when vitellogenesis commences, the egg has a diameter of microns 0. Mammalian eggs contain little yolk and vary little in size. The mature eggs of horses and humans are approximately the same size—somewhat less than microns. In seasonally breeding oviparous fishes and amphibians, all eggs are usually in the same stage of development, and the ovary grows to a mature state quite rapidly as a result of growth of the eggs, which frequently number more than 1,, Such ovaries distend the body wall when mature; following spawning, the ovaries shrink rapidly to inconspicuous bodies consisting mainly of oogonia, immature oocytes, and a few stromal cells.

In reptiles and birds, ovarian weight also is high in proportion to body weight during egg-laying seasons. The weight of the ovary of the starling, for example, may increase from eight milligrams in early winter to 1, milligrams immediately before ovulation.

The mature eggs of reptiles and birds are unique in that they are suspended from the ovary by a short stalk pedicle. The stalk contains a cortex with additional oocytes in various stages of development and extensions of vessels and nerves. Full growth of the follicle in reptiles and birds requires only a few days or weeks nine days in the domestic hen.

In mammals, the ratio of ovarian weight to body weight varies insignificantly throughout the reproductive life of the female, and follicles in many stages of development are constantly present.

Vertebrate eggs are almost universally shed into the coelom or into a subdivision thereof, from which they enter the female reproductive tract. Even in those teleosts in which the eggs are shed into an ovarian cavity, the latter is often of coelomic origin. In many mammals a membranous sac of peritoneum, the ovarian bursa, traps part of the coelom in a chamber along with the ovary.

The bursal cavity periovarian space may be broadly open to the main coelom, completely closed off from the coelom, or in communication with the coelom by a narrow, slitlike passage. The bursa, moderately developed in lower primates and catarrhines Old World monkeys , is poorly developed in man. In horses, one edge of the ovary contains a long groove ovulation fossa into which all eggs are shed; the groove is found in a cleftlike ovarian bursa.

The ovarian bursa increases the probability that all ovulated eggs will enter the oviduct. The process of ovulation has been described for all vertebrate classes. Elasmobranchs, reptiles, and birds have massively yolked eggs. As ovulation approaches, the fimbria i. An egg that is nearly free of the ovary is grasped and partially encompassed by the fimbria; when the egg is freed, the fimbria draw the egg into the funnel.

At this time, the egg has little shape and is partly squirted and partly flows into the oviduct; never completely free in the coelom, its chances of not entering the oviduct are small.

In the case of moderately or poorly yolked eggs cilia help to sweep the eggs into the ostium, or opening, of the oviduct. During ovulation in Japanese rice fish, Oryzias latipes , a tiny papilla, or fingerlike process, develops on the surface of a bulging mature follicle in the centre stigma of the follicle.

The follicle becomes thin at the stigma, an aperture appears, and the egg rolls out. In rabbits this process differs only in detail. During the final 20 minutes before ovulation in rabbits, some of the tiny blood vessels surrounding the stigma rupture, and a small pool of blood forms under the apex of the cone-shaped papilla. The follicular wall shortly gives way at the apex, and follicular fluid oozes from the opening, followed soon after by the egg.

The ovulated mammalian egg typically is surrounded by a layer of columnar follicular cells, the corona radiata; but it is naked in some insectivores and some marsupials. Following ovulation in all vertebrates, the ovary may become smaller, become modified for maintenance of pregnancy , or proceed to form additional eggs. The process of ovulation in vertebrates has been documented, but the immediate causes remain to be clarified. It is almost certain that an ovulatory hormone is secreted by the pituitary gland i.

It is highly probable that breakdown of very small fibres that bind the follicular cells together may occur at the stigma, weakening the follicular wall at that location. Hormones from the ovary and other sources may play a role, as may neurohormones, which are hormones released at nerve endings. Rhythmic contractions of the entire ovary occur at ovulation in many vertebrates and have been described in rabbits.

The role of mechanical pressure within the follicle, however, is not understood. Ovulation in most mammals spontaneous ovulators occurs cyclically as a result of the spontaneous release of the ovulatory hormone. In a few mammals reflex ovulators the stimulus of copulation is essential for release of the ovulatory hormone.

Striking postovulatory changes take place in the follicles of mammals and, to lesser degrees, of lower vertebrates. Blood vessels from the theca interna invade the ovulated follicles; the granulosa cells divide, enlarge, accumulate fats, and obliterate any remnants of the collapsed antra. Thereafter, they are known as lutein cells. Theca interna cells undergo changes identical to those of the granulosa cells.

The result in mammals is the formation of solid masses called corpora lutea , recognizable as prominent reddish-yellow bulges on the ovary. Corpora lutea produce the hormone progesterone , which is essential for the maintenance of pregnancy.

The conversion of postovulatory follicles into structures more or less resembling mammalian corpora lutea has been demonstrated in numerous viviparous reptiles, amphibians, and elasmobranchs; in certain other fishes, including cyclostomes; and in some oviparous amphibians and reptiles. In birds, the postovulatory follicle shrinks, and identifiable corpora lutea do not develop, although some granulosa cells accumulate lipids of unknown significance.

The female reproductive tract consists of a pair of tubes gonoducts extending from anterior, funnel-like openings ostia to the cloaca, except as noted below.

The gonoducts are specialized along their length for secretion of substances added to the eggs; for transport, storage, nutrition, and expulsion of eggs or the products of conception; and, in species with internal fertilization, for receipt, transport, storage, and nutrition of inseminated sperm. The predominately muscular tracts are lined by a secretory epithelium and ciliated over at least part of their length. Fusion of the caudal tail ends of the paired ducts may occur.

Gonoducts are absent in cyclostomes and a few gnathostome fishes that have abdominal pores. A few vertebrates have only one functional gonoduct. Gonoducts in lungfishes and amphibians are coiled muscular tubes that are ciliated over most of their length. Only occasionally do they unite caudally in a genital papilla before opening into the cloaca. During breeding seasons their diameter increases severalfold because of the highly active secretory epithelium. Between breeding seasons they are small.

In some anurans frogs, toads , such as Rana , the lower end of each gonoduct is expanded to form an ovisac, in which ovulated eggs are stored until spawning; the tube between the ostium funnel-like opening and ovisac is the oviduct.

In viviparous amphibians the young develop in the ovisac. Women also showed improvements in testosterone, cholesterol and TG levels. NAC was also shown to improve oocyte and embryo quality in Iranian women undergoing intracytoplasmic sperm injection. Overall, NAC is well tolerated but can cause gastrointestinal adverse effects including nausea, abdominal pain, vomiting, constipation, and diarrhea, particularly when used in high doses.

The therapeutic dosage of NAC to improve insulin levels based on the published studies is 1. If you are overweight, you may benefit from the higher end of the dose range. As with any nutrition supplement, it is important to discuss use with your physician before taking. A comparison between the effects of metformin and N-acetyl cysteine NAC on some metabolic and endocrine characteristics of women with polycystic ovary syndrome. The adjuvant effect of metformin and N-acetylcysteine to clomiphene citrate in induction of ovulation in patients with Polycystic Ovary Syndrome.

N-acetylcysteine for polycystic ovary syndrome: N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: N-acetyl-cysteine treatment improves insulin sensitivity in women with polycystic ovary syndrome.

N-acetyl cysteine plus clomiphene citrate versus metformin and clomiphene citrate in treatment of clomiphene-resistant polycystic ovary syndrome: J Womens Health Larchmt. Epub Oct Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. I have been taking mg a day — 2x mg capsules. Unfortunately I can only find one range of vitamins in South Africa which manufactures NAC — and they only make them in mg capsules.

Do you think I should increase dose to mg? I have noticed better agility — maybe assisting in reducing inflammation. I am excited to see what long term befits will be and will keep you posted. Please send your thoughts on dosage. If you are having good results with the dosage you are taking now you can stick with that. Heavier people need more in general.

I have been using mg NAC twice a day for about a month now. I have had some astounding results. My facial hair growth which was increasing steadily and spreading down towards my neck has almost stopped.

If I miss a dose, I have immense sugar and carb cravings which tells me that the NAC really does help lower insulin levels thereby banishing those cravings.

I am now looking to add Chromium and ALA to my regimen. Previous to this, I have used fasting as a means to restore my period, but subsequent bouts of overeating have resulted in gaining back the 40 lbs that I lost and now I am back to my PCOS state.

For those with hirsutism… please try NAC. Thanks for the article!! I started taking mg 3x a day for ten days so far. After day 3 I got my period, which I had not gotten since november it is June. I have hypothyroidism and PCOS. I take Levothyroxine 50mcg in the morning for hypothyroidism. Diane is the brand name of a contraceptive pill.

It contains Cyproterone Acetate 2mg and Ethinyl Estradiol 0. I just want to make sure it does not interfere with the contraceptive pill.

Accessory glands