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
The corpus luteum is formed from the ruptured ovarian follicle after ovulation and functions as a temporary endocrine gland, primarily secreting progesterone (5–20 ng/mL mid-luteal) and smaller amounts of estrogen. It maintains the endometrium in preparation for implantation. If fertilization and implantation do not occur, the absence of human chorionic gonadotropin (hCG) causes the corpus luteum to degenerate around day 24–26 of a typical 28-day cycle. It then becomes a fibrous scar tissue called the corpus albicans, leading to a drop in progesterone and estrogen levels, and triggering menstruation.
Rationale for correct answer
B. If fertilization does not occur, the corpus luteum degenerates due to lack of hCG support and transforms into the corpus albicans. This structural regression leads to hormonal withdrawal and menstruation.
Rationale for incorrect answers
A. Progesterone secretion continues only if fertilization occurs and hCG is produced by the trophoblast. Without hCG, the corpus luteum involutes and stops secreting hormones.
C. The corpus luteum forms after ovulation; it does not trigger it. Ovulation is triggered by the LH surge prior to corpus luteum formation.
D. The corpus luteum secretes some estrogen, but its primary function is progesterone production. After degeneration, it no longer produces either hormone in significant amounts.
Take home points
- The corpus luteum regresses into the corpus albicans without fertilization.
- Hormonal support from hCG is necessary to sustain the corpus luteum.
- Progesterone levels drop, triggering menstruation.
- The corpus luteum does not cause ovulation; it follows it.
Correct Answer is ["A","B"]
Explanation
The ovaries are the primary source of estrogen and progesterone during the menstrual cycle. These steroid hormones regulate endometrial development, ovulation, and feedback control of the hypothalamic-pituitary axis. Estrogen is mainly secreted by granulosa cells of developing follicles during the follicular phase, reaching peak levels of 200–300 pg/mL pre-ovulation. Progesterone is produced by the corpus luteum in the luteal phase, with mid-luteal levels of 5–20 ng/mL, stabilizing the endometrium for implantation.
Rationale for correct answers
A. Estrogen is produced by ovarian granulosa cells during follicular development. It promotes endometrial proliferation and regulates FSH and LH secretion via feedback.
B. Progesterone is secreted by the corpus luteum after ovulation. It prepares and maintains the endometrium for implantation and inhibits GnRH, FSH, and LH secretion to prevent further ovulation.
Rationale for incorrect answers
C. FSH is secreted by the anterior pituitary, not the ovaries. It stimulates follicular growth in the ovaries and estrogen production.
D. LH is also secreted by the anterior pituitary, not the ovaries. It triggers ovulation and supports the corpus luteum.
E. GnRH is secreted by the hypothalamus, not the ovaries. It regulates the release of FSH and LH from the pituitary.
Take home points
- The ovaries produce estrogen (follicular phase) and progesterone (luteal phase).
- FSH and LH come from the anterior pituitary, not the ovaries.
- GnRH originates in the hypothalamus and regulates pituitary hormones.
- Ovarian hormones regulate endometrial changes and provide feedback control.
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