 FOLDER 23.1 Clinical Correlation: Polycystic Ovarian Disease
TATATATATA FIGURE F23.1.1 • Polycystic ovarian disease. This photo-micrograph shows a section through the cortex of the ovary from an individual with polycystic ovarian disease. Note the unusually thick tunica albuginea (TA) that overlies numerous follicles. The thickness of the tunica albuginea prevents ovulation of the mature (Graafian) follicles. Note that one of the follicles has developed to the primary follicle stage. 45.
The collapsed follicle undergoes reorganization into the corpus luteum after ovulation.
At ovulation, the follicular wall, composed of the remaining granulosa and thecal cells, is thrown into deep folds as the follicle collapses and is transformed into the corpus luteum (yellow body), or luteal gland (Fig. 23.10a and Plate 94, page 876). At first, bleeding from the capillaries in the theca interna into the follicular lumen leads to formation of the corpus hemorrhagicum with a central clot. Connective tissue from the stroma then invades the former follicular cavity. Cells of the granulosa and theca interna layers then differentiate into granulosa luteal and theca luteal cells in the process called luteinization. These luteal cells undergo dramatic morphologic changes, increasing in size and filling with lipid droplets (Fig. 23.10b). A lipid-soluble pigment, lipochrome, in the cytoplasm of the cells gives them a yellow appearance in fresh preparations. At the ultrastructural level, the cells demonstrate features associated with steroid-secreting cells, namely, abundant sER and mitochondria with tubular cristae (Fig. 23.11).
Two types of luteal cells are identified:  Granulosa lutein cells are large (about 30 m in diame ter), centrally located cells derived from the granulosa cells. Theca lutein cells are smaller (about 15 m), more deeply staining, and peripherally located cells derived from the cells of the theca interna layer (Plate 94, page 876)
As the corpus luteum begins to form, blood and lymphatic vessels from the theca interna rapidly grow into the granulosa layer. A rich vascular network is established within the corpus luteum. This highly vascularized structure located in the cortex of the ovary secretes progesterone and estrogens. These hormones stimulate the growth and secretory activity of the lining of the uterus, the endometrium, to prepare it for the implantation of the developing zygote in the event that fertilization occurs.
The corpus luteum of menstruation is formed in the absence of fertilization.
If fertilization and implantation do not occur, the corpus luteum remains active only for 14 days; in this case it is called the corpus luteum of menstruation. In the absence of formation of centrosome of spermatozoon unpacked nucleus of spermatozoon formation of second polar body human chorionic gonadotropin (hCG) and other luteotropins, the rate of secretion of progestogens and estrogens declines, and the corpus luteum begins to degenerate about 10 to 12 days after ovulation.
The corpus luteum degenerates and undergoes a slow involution after pregnancy or menstruation. The cells become loaded with lipid, decrease in size, and undergo autolysis. A white scar, the corpus albicans, is formed as intercellular hyaline material accumulates among the degenerating cells of the former corpus luteum (Fig. 23.12). The corpus albicans sinks deeper into the ovarian cortex as it slowly disappears over a period of several months.
During capacitation, the mature spermatozoa acquire the ability to fertilize the oocyte.