Which of the following are changes that occur in the uterine endometrium during the secretory phase? Select all that apply.
Endometrial glands become tortuous
Secretion of glycogen and mucus into the lumen
Endometrium becomes edematous and highly vascular
The functional layer is shed
Spiral arteries become less prominent
Correct Answer : A,B,C
Secretory phase of the menstrual cycle The secretory phase follows ovulation and is driven by progesterone from the corpus luteum, transforming the proliferative endometrium into a receptive environment for implantation. The endometrial glands become tortuous and begin secreting glycogen, while stromal edema and increased vascularity aid embryo nourishment. Spiral arteries elongate and become more coiled, and normal endometrial thickness during this phase ranges from 7–14 mm. Progesterone levels peak around 5–20 ng/mL in the mid-luteal phase.
Rationale for correct answers
A. Endometrial glands become tortuous due to progesterone influence, increasing their secretory capacity in preparation for embryo implantation.
B. Glycogen and mucus are secreted into the lumen to create a nutrient-rich medium essential for the survival and implantation of the embryo.
C. Progesterone enhances vascular permeability and stromal edema, making the endometrium highly vascular and edematous to support embryo development.
Rationale for incorrect answers
D. Shedding of the functional layer occurs during menstruation, not the secretory phase. Menstrual shedding begins only if fertilization does not take place, leading to corpus luteum regression and progesterone withdrawal.
E. Spiral arteries become more prominent and coiled during the secretory phase to support increased blood flow. Less prominence is incorrect; their hypertrophy is critical for placental development if implantation occurs.
Take home points
- Secretory phase is progesterone-dominant and follows ovulation.
- Tortuous glands and glycogen secretion prepare the endometrium for implantation.
- Spiral arteries elongate and coil for enhanced perfusion.
- Functional layer shedding occurs only in menstruation, not in the secretory phase.
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Related Questions
Correct Answer is B
Explanation
Corpus luteum
The corpus luteum is a temporary endocrine structure formed from the ruptured Graafian follicle after ovulation. It secretes high levels of progesterone, moderate estrogen, and minimal inhibin A to maintain the luteal phase of the menstrual cycle. Progesterone levels peak around day 21 of a 28-day cycle and range from 5–20 ng/mL in the mid-luteal phase. Its main role is to stabilize the endometrial lining for potential implantation and to inhibit GnRH, FSH, and LH via negative feedback. If fertilization does not occur, it regresses into the corpus albicans, causing a drop in hormones and onset of menstruation.
Rationale for correct answer
B. The corpus luteum secretes progesterone during the luteal phase to maintain the endometrium for possible implantation. It forms after ovulation and is hormonally dependent on LH for function.
Rationale for incorrect answers
A. Estrogen is secreted mainly by the dominant follicle during the follicular phase, not by the corpus luteum. The follicular phase precedes ovulation, and the corpus luteum forms after ovulation.
C. The ovum is released by the ruptured follicle due to the LH surge, not by the corpus luteum. The corpus luteum forms after ovulation and plays no direct role in ovum release.
D. GnRH is secreted by the hypothalamus and regulated by sex steroid feedback. The corpus luteum does not stimulate GnRH; in fact, progesterone from the corpus luteum inhibits it.
Take home points
- The corpus luteum secretes progesterone to maintain the endometrium.
- It forms after ovulation from the ruptured follicle.
- It does not release the ovum; that happens before it forms.
- Its hormones inhibit GnRH, FSH, and LH to prevent further ovulation.
Correct Answer is ["B","C","E"]
Explanation
Progesterone in the menstrual cycle Progesterone is a steroid hormone produced by the corpus luteum after ovulation during the luteal phase. Its primary role is to prepare the endometrium for implantation. Progesterone maintains the uterine lining, inhibits uterine contractions, and increases basal body temperature. Normal serum progesterone levels vary across the cycle: follicular phase <1 ng/mL, luteal phase 5–20 ng/mL, postmenopausal <0.5 ng/mL. It is also critical in modulating immune tolerance during early pregnancy.
Rationale for correct answers
B. Progesterone converts the endometrium from the proliferative to the secretory phase, enhancing glandular secretion and stromal edema to support implantation.
C. It inhibits myometrial contractions by reducing prostaglandin synthesis and promoting uterine quiescence during the luteal phase, preventing embryo expulsion.
E. Progesterone increases basal body temperature typically by 0.3–0.5°C due to its thermogenic effect on the hypothalamic temperature-regulating center.
Rationale for incorrect answers
A. Endometrial proliferation occurs during the follicular phase and is mediated primarily by estradiol. Progesterone opposes proliferation and promotes secretory transformation.
D. Ovulation is triggered by a surge in luteinizing hormone (LH), not progesterone. Progesterone secretion rises only after ovulation has occurred.
Take home points
- Progesterone maintains a secretory endometrium essential for embryo implantation.
- It inhibits uterine contractility by downregulating prostaglandins.
- Progesterone elevation correlates with the post-ovulatory rise in body temperature.
- Estradiol governs the proliferative phase; LH surge triggers ovulation.
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