Dr: Azza Zaki

Fertilization
 Definition:
 It is the fusion of
the male &
female gametes
(union of a sperm
and an ovum) to
form zygote.
 Normal site:
 Ampulla or lateral
third of the
uterine
(fallopian) tube.
 Time:
 Within 24 hours
from ovulation. Dr: Azza Zaki
Dr: Azza Zaki
Steps of fertilization:
1-Transport of gametes:
 Ovum: during ovulation
the fimbriated end of
the uterine tube
becomes closely
applied to the ovary.
 Sweeping action of
tubal fimbriae carries
the oocyte into the
uterine tube.
 The oocyte then passes
into the ampulla of the
tube by beating of the
cilia and peristaltic
contraction.
 Sperm: of the 200-300
millions sperms
deposited in the
vagina, only 300-500 Dr: Azza Zaki
reach the site of
 Ii. Sperm Conditioning
Sperms deposited in the female genital tract must undergo two
changes before they can fertilize an ovum:
1. Capacitation:
 Sperms cannot fertilize oocytes when they are newly
ejaculated.
 The process of capacitation takes 5-7 hours.

 Capacitated sperms are more active.

 Location: capacitation occurs in the uterus and oviducts.

 The acrosomal reaction cannot occur until capacitation has

occurred.
 The glycoprotein coat removed from the cell membrane
covering the acrosomal cap.
Dr: Azza Zaki
2. Acrosome reaction:
 Fusion occurs between the
outer acrosomal membrane
and the cell membrane of
the corona radiata with the
release of acrosomal
enzymes (acrosin).
a) Hyaluronidase results in
digestion of the corona
radiata.
b) Trypsin-like substance & During fertilization, the sperm
zona lysin lead to must penetrate:
penetration of the zona A-the corona radiata.
pellucida. B-the zona pellucida.
C.the oocyte cell membrane.
Dr: Azza Zaki
 Phases of
fertilization:
 Phase 1:
penetration of corona
radiata:
 many sperms
penetrate the corona
radiata with the aid of
acrosomal enzymes
(hyaluronidase)
 Phase 2:
penetration of zona
pellucida:
 Only one sperm
penetrates the zona
and once the sperm isDr: Azza Zaki
 Phase 3: fusion of the oocyte and sperm
cell membranes.
 After fertilization, as soon as the sperm has
entered the oocyte: a) the oocyte finishes its
2nd meiotic division & forms the female
pronucleus; b) the zona pellucida becomes
impermeable to other sperms;& c) The head
of the sperm separates from the tail, swells
& forms the male pronucleus.
 The female pronucleus
comes into close contact
with male pronucleus.
 The nuclear membranes

of the 2 pronuclei
disappear and their
chromosomes become
around the equator
thus the zygote is Dr: Azza Zaki
 Results Of Fertilization
 Restoration of the diploid number of
chromosome (46).
 Determination of the sex of the embryo. An X-
carrying sperm produces a female embryo, and
a Y- carrying sperm produces a male embryo.
 Completion of the 2nd maturation (meiotic)
division with formation of the mature ovum and
2nd polar body.
 Initiation of cleavage or cell division of the
zygote .
 The zona & cortical reactions occur to prevent
fertilization of the same ovum by more than one
sperm.
Dr: Azza Zaki
 In- Vitro Fertilization
 A method of treatment of
(IVF)
infertility, if there is occlusion of
fallopian tube.
 The female is given gonadotropin
to stimulate multiple ovulations.
 The ova are collected with
aspirator during laparoscopy &
are put in a glass plate.
 Sperms collected from the
husband are added immediately.
 After fertilization, the eggs are
monitored to 8- cell stage then
placed in the uterus to develop to
term.
Dr: Azza Zaki
CLEAVAGE
 Definition:
 Is a series of
mitotic
divisions of
the zygote
results in an
increase in
cells number
without
increase in
total size.
 Site:
 uterine tube.

Dr: Azza Zaki

 Stages Of Cleavage
 The zygote divides by mitosis into two-
cell stage. Each cell is named blastomere.
 Repeated mitosis giving 4 cells, 8 cells&
so on until a Morula of 12-16
compacted cells is formed after 3 days
after fertilization & enters the uterus. The
morula is differentiated into an inner cell
mass & an outer cell mass.
 Blastocyst stage: fluid from the uterine
cavity accumulates between the
blastomeres dividing them into 2 groups,
one group of cells in the center (inner
cell mass) which will give the embryo so
it is called (embryoblast)& 2nd group of
cells at the periphery, forming the wall of
blastocyst (outer cellDr:mass)
Azza Zaki which will
 Blastocyst
Consists of: Inner cell mass: 1-embryoblast : large cells on
the embryonic pole of the blastocyst. These cells form the
embryo (embryo proper)
 2-Outer cell mass: trophoblast : small cells forming the
wall of blastocyst. They forms the foetal membranes and
placenta.3-Blastocoele: a cavity.
 The zona pellucida has disappeared, allowing implantation
to begin.

Dr: Azza Zaki

Dr: Azza Zaki
Dr: Azza Zaki
 Implantation
Definition:
It is the
embedding of
the blastocyst
into the
compact layer
of the
endometrium.
Time:
It begins
about the 6th
day after
fertilization.
It is completed
by the 11th or
Events during the first week of human
12th day.
development
 Steps
 On the 5th day after fertilization, the zona
pellucida disappears. The blastocyst increases
rapidly in size.
 On the 6th day, the trophoblast cells covering
the embryonic pole adhere to the endometrium
& starts to proliferate rapidly.

Dr: Azza Zaki

 It differentiates into
2 layers:
 an inner cytotrophoblast
 an outer

syncytiotrophoblast
(cells lose its cell
boundaries)
- It extends finger-like processes,
which secrete proteolytic
enzymes that erode the
endometrium, creating a hole
through which the blastocyst
is gradually buried in the
endometrium.
Dr: Azza Zaki
3. By the 9th -10th day, the
hole in the endometrium
is closed by a fibrin plug.
The endometrium
regenerates by the 12th
day.
Normal site of implantation:
Posterior wall of the upper
part of the uterus near the
fundus, in the midline.
 Time: from 7th to 12th

day after fertilization.

Dr: Azza Zaki

 Intrauterine
Implantation
The normal site of implantation is the posterior wall of uterus near
the fundus.

Dr: Azza Zaki

 Uterus At Time Of
Implantation
 The endometrium is in the secretory phase.
The endometrium is in the secretory phase.

Dr: Azza Zaki

 The decidua
It is the
endometrium after
implantation.
After implantation
the decidua
becomes
differentiated into:

Decidua basalis:
under the site of
implantation.
Decidua capsularis:
Dr: Azza Zaki
Ectopic pregnancy( abnormal site of
implantation)

Dr: Azza Zaki

 Abnormal Site of Implantation
1.Intra- uterine:
Placenta praevia:
Implantation in the
lower uterine segment
(cervix).
 3 types: lateral,
marginal and central.
Cause severe bleeding
before delivery.
2. Extra-uterine:
(Ectopic pregnancy):
Outside the uterus:
 Tubal
 ovarian
 abdominal.
Dr: Azza Zaki
 Cervical pregnancy
(Placenta
Implantation in the lower
Previa)
uterine segment (cervix).
 Types of placenta previa:
 Placenta previa centralis: the
placenta
completely covers the
internal os.
 Placenta previa marginalis: the
margin of the
placenta reaches the internal
os.
 Placenta previa lateralis: the
margin of the placenta
does not reach the internal
Dr: Azza Zaki os.
 Ectopic Implantation
The most common site of ectopic pregnancy is
tubal pregnancy.

Dr: Azza Zaki

Dr: Azza Zaki
a) Tubal pregnancy (95%):
Implantation in the
fallopian tube causing its
rupture.
 It usually ruptures leading
to pain that is commonly
confused with appendicitis
if on the right side.
 Rupture usually occurs in
the 2nd month causing
internal haemorrhage
which endanger life of the
mother.
b) Ovarian pregnancy
c) Abdominal pregnancy:
Implantation in the
peritoneal cavity (Douglas
pouch or mesentery.

Dr: Azza Zaki

Dr: Azza Zaki