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Introduction
1. Anatomy
2. Microbiology
3. Physiology
3.1 Nervous system and special senses
3.2 Cardiovascular system
3.3 Respiratory system
3.4 Gastrointestinal system
3.5 Renal and urinary system
3.6 Endocrine system
3.7 Reproductive system
3.7.1 Fundamentals
3.7.2 Menopause
3.7.3 Additional information
4. Pathology
5. Pharmacology
6. Immunology
7. Biochemistry
8. Cell and molecular biology
9. Biostatistics and epidemiology
10. Genetics
11. Behavioral science
Wrapping up
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3.7.3 Additional information
Achievable USMLE/1
3. Physiology
3.7. Reproductive system

Additional information

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  1. AMH (anti-müllerian hormone) role in women: AMH is a glycoprotein hormone secreted by granulosa cells in the ovary. It belongs to the transforming growth factor β (TGF-β) family of growth and differentiation factors. AMH inhibits primordial follicle recruitment and reduces the responsiveness of growing follicles to follicle-stimulating hormone (FSH). Clinically, AMH is used as a marker of ovarian reserve, which is useful in infertility treatment such as IVF. AMH levels are increased in women with PCOS. In premenopausal women, serum AMH levels decrease with age.

Tanner stages in males and females

Stage Males Females Pubic hair (both sexes)
1 Prepubertal Prepubertal. No breast tissue None
2 Testes enlarge (4 ml); scrotum larger, reddened, and skin coarser Areolar enlargement with breast bud Few darker hairs along labia or at base of penis
3 Penis enlarges, initially in length. Continued growth of testes and scrotum Enlargement of breast and areola as single mound Curly pigmented hairs across pubes
4 Penis grows in length and breadth; continued growth of testes and scrotum that becomes pigmented Projection of areola above breast as double mound Small adult configuration, covers triangular area overlying the pubic region
5 Testis, scrotum and penis adult size Adult; papilla projects out of areola that is part of breast contour Adult configuration with spread onto inner thighs

AMH (anti-müllerian hormone) in women

  • Secreted by ovarian granulosa cells; member of TGF-β family
  • Inhibits primordial follicle recruitment; decreases follicle sensitivity to FSH
  • Clinical uses:
    • Marker of ovarian reserve (infertility/IVF)
    • Increased in PCOS
    • Declines with age in premenopausal women

Tanner stages in males and females

  • Stage 1: Prepubertal; no breast/testicular development; no pubic hair
  • Stage 2:
    • Males: Testes enlarge, scrotum changes
    • Females: Breast bud, areolar enlargement
    • Pubic hair: Sparse, darker, at base/labia
  • Stage 3:
    • Males: Penis lengthens, further testes/scrotum growth
    • Females: Breast and areola enlarge as single mound
    • Pubic hair: Curly, pigmented, across pubes
  • Stage 4:
    • Males: Penis grows in length/breadth, pigmented scrotum
    • Females: Areola projects as double mound
    • Pubic hair: Adult-like, covers pubic triangle
  • Stage 5:
    • Males: Adult genitalia
    • Females: Adult breast contour, papilla projects
    • Pubic hair: Adult pattern, spreads to inner thighs

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Additional information

  1. AMH (anti-müllerian hormone) role in women: AMH is a glycoprotein hormone secreted by granulosa cells in the ovary. It belongs to the transforming growth factor β (TGF-β) family of growth and differentiation factors. AMH inhibits primordial follicle recruitment and reduces the responsiveness of growing follicles to follicle-stimulating hormone (FSH). Clinically, AMH is used as a marker of ovarian reserve, which is useful in infertility treatment such as IVF. AMH levels are increased in women with PCOS. In premenopausal women, serum AMH levels decrease with age.

Tanner stages in males and females

Stage Males Females Pubic hair (both sexes)
1 Prepubertal Prepubertal. No breast tissue None
2 Testes enlarge (4 ml); scrotum larger, reddened, and skin coarser Areolar enlargement with breast bud Few darker hairs along labia or at base of penis
3 Penis enlarges, initially in length. Continued growth of testes and scrotum Enlargement of breast and areola as single mound Curly pigmented hairs across pubes
4 Penis grows in length and breadth; continued growth of testes and scrotum that becomes pigmented Projection of areola above breast as double mound Small adult configuration, covers triangular area overlying the pubic region
5 Testis, scrotum and penis adult size Adult; papilla projects out of areola that is part of breast contour Adult configuration with spread onto inner thighs
Key points

AMH (anti-müllerian hormone) in women

  • Secreted by ovarian granulosa cells; member of TGF-β family
  • Inhibits primordial follicle recruitment; decreases follicle sensitivity to FSH
  • Clinical uses:
    • Marker of ovarian reserve (infertility/IVF)
    • Increased in PCOS
    • Declines with age in premenopausal women

Tanner stages in males and females

  • Stage 1: Prepubertal; no breast/testicular development; no pubic hair
  • Stage 2:
    • Males: Testes enlarge, scrotum changes
    • Females: Breast bud, areolar enlargement
    • Pubic hair: Sparse, darker, at base/labia
  • Stage 3:
    • Males: Penis lengthens, further testes/scrotum growth
    • Females: Breast and areola enlarge as single mound
    • Pubic hair: Curly, pigmented, across pubes
  • Stage 4:
    • Males: Penis grows in length/breadth, pigmented scrotum
    • Females: Areola projects as double mound
    • Pubic hair: Adult-like, covers pubic triangle
  • Stage 5:
    • Males: Adult genitalia
    • Females: Adult breast contour, papilla projects
    • Pubic hair: Adult pattern, spreads to inner thighs