Male reproductive system

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Male reproductive system (human)
Male anatomy 1.png
Male reproductive system
Details
Identifiers
Latin systema genitale masculinum
MeSH D005837
TA98 A09.0.00.002
TA2 3574
FMA 45664
Anatomical terminology

The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body, and within the pelvis.

Contents

The main male sex organs are the penis and the scrotum, which contains the testicles that produce semen and sperm, which, as part of sexual intercourse, fertilize an ovum in the female's body; the fertilized ovum (zygote) develops into a fetus, which is later born as an infant.

The corresponding system in females is the female reproductive system.

External genitalia

External male genitalia; a human penis and scrotum Flaccid penis cropped.jpg
External male genitalia; a human penis and scrotum

Penis

The penis is an intromittent organ with a long shaft, an enlarged bulbous-shaped tip called the glans and its foreskin for protection. Inside the penis is the urethra, which is used to ejaculate semen and to excrete urine. Both substances exit through the meatus.

When the male becomes sexually aroused, erection occurs because sinuses within the erectile tissues of the penis (corpora cavernosa and corpus spongiosum) become filled with blood. The arteries of the penis are dilated while the veins are compressed so that blood flows into the erectile cartilage under pressure. The penis is supplied by the pudendal artery.

Scrotum

The scrotum is a sac of skin that hangs behind the penis. It holds and protects the testicles. It also contains numerous nerves and blood vessels. During times of lower temperatures, the cremaster muscle contracts and pulls the scrotum closer to the body, while the dartos fascia gives it a wrinkled appearance; when the temperature increases, the cremaster and dartos fascia relax to bring down the scrotum away from the body and remove the wrinkles respectively.

The scrotum remains connected with the abdomen or pelvic cavity through the inguinal canal. (The spermatic cord, formed from spermatic artery, vein and nerve bound together with connective tissue passes into the testis through inguinal canal.)

Internal genitalia

Cross-section of the human male reproductive system, showing the structure around the scrotum Sobo 1906 490.png
Cross-section of the human male reproductive system, showing the structure around the scrotum
Image showing innervation and blood supply of the human external male genitalia Sobo 1909 571.png
Image showing innervation and blood supply of the human external male genitalia

Testicles

The testicles are two gonads that produce sperm by meiotic division of germ cells within the seminiferous tubules, [1] and synthesize and secrete androgens that regulate the male reproductive functions. The site of production of androgens is the Leydig cells that are located in the interstitium between seminiferous tubules. [1]

Epididymides

The epididymis is a long whitish mass of tightly coiled tube. The sperm that are produced in the seminiferous tubules flow into the epididymis. During passage via the epididymis, the sperm undergo maturation and are concentrated by the action of ion channels located on the apical membrane of the epididymis. [2]

Vasa deferentia

The vas deferens, which is also known as the sperm duct, is a thin tube approximately 30 centimetres (0.98 ft) long that starts from the epididymis to the pelvic cavity. It carries the spermatozoa from the epididymis to the ejaculatory duct.

Accessory glands

Three accessory glands provide fluids that lubricate the duct system and nourish the sperm cells.

Development

The embryonic and prenatal development of the male reproductive system is the process whereby the reproductive organs grow, mature and are established. It begins with a single fertilized egg and culminates 38 weeks later with the birth of a male child. It is a part of the stages of sexual differentiation. The development of the male reproductive system coincides with the urinary system. Their development can also be described together as the development of the urinary and reproductive organs.

Sexual determination

Human karyotype, showing 22 homologous autosomal chromosome pairs, both the female (XX) and male (XY) versions of the two sex chromosomes, as well as the mitochondrial genome (at bottom left). Further information: Karyotype Human karyotype with bands and sub-bands.png
Human karyotype, showing 22 homologous autosomal chromosome pairs, both the female (XX) and male (XY) versions of the two sex chromosomes, as well as the mitochondrial genome (at bottom left).

Sexual identity is determined at fertilization when the genetic sex of the zygote has been initialized by a sperm cell containing either an X or Y chromosome. If this sperm cell contains an X chromosome it will coincide with the X chromosome of the ovum and a female child will develop. A sperm cell carrying a Y chromosome results in an XY combination, and a male child will develop. [3]

Genetic sex determines whether the gonads will be testes or ovaries. In the developing embryo if the testes are developed, it will produce and secrete male sex hormones during late embryonic development and cause the secondary sex organs of the male to develop. [4]

Other embryonic reproductive structures

The structures are masculinized by secretions of the testes:

The prostate gland derives from the urogenital sinus, and the other embryonic structures differentiate into the external genitalia. In the absence of testicular secretions, the female genitalia are formed. [7]

External structures

At six weeks post-conception, the differentiation of the external genitalia in the male and female has not taken place. At eight weeks, a distinct phallus is present during the indifferent stage. By the 10th-12th week, the genitalia are distinctly male or female being and derived from their homologous structures. At 16 weeks post-conception, the genitalia are formed and distinct. [8] [9]

The masculinization of the embryonic reproductive structures occurs as a result of testosterone secreted by the embryonic testes. Testosterone, however, is not the active agent within these organs. Once inside the target cells, testosterone is converted by means of an enzyme called 5α-reductase into the dihydrotestosterone (DHT). DHT mediates the androgen effect in these organs. [10]

Testes

At nine weeks, male differentiation of the gonads and the testes is well underway. Internal changes include the formation of the tubular seminar Chris tubules in the rete testis from the primary sex cord. Developing on the outside surface of each testis is a Phibro muscular cord called the gubernaculum. This structure attaches to the inferior portion of the testis and extends to the labial sacral fold of the same side at the same time, a portion of the embryonic mesonephric duct adjacent to the testis becomes attached and convoluted informs the epididymis. Another portion of the mesonephric duct becomes the ductus deferens. [10]

The seminal vesicles form from lateral outgrowths of the caudal and of each mesonephric duct the prostate gland arises from an Indo dermal outgrowth of the urogenital sinus the bulbourethral glands develop from outgrowths in the membrane-like portion of the urethra. [10]

The descent of the testes to its final location at the anterior abdominal wall, followed by the development of the gubernaculum, which subsequently pulls and translocates the testis down into the developing scrotum. Ultimately, the passageway closes behind the testis. A failure in this process can cause indirect inguinal hernia or an infantile hydrocoele. [11] The testes descend into the scrotal sac between the sixth and 10th week. Descent does not occur until about the 28th week when compared to when canals form and the abdominal wall provides openings from the pelvic cavity to the scrotal sac. The process by which a testis descends is not well understood but it seems to be associated with the shortening of the gubernaculum. This is attached to the testis and extends through the inguinal canal to the wall of the scrotum as a testis. It carries with it the ductus deference, which are testicular vessels and nerves, a portion of the abdominal muscle, and lymph vessels. All of the structures remain attached to the testis and form what is known as the spermatic cord. By the time the testis is in the scrotal sac, the gubernaculum is no more than a remnant of scar like tissue. [10]

External genitalia

The external genitalia of the male is distinct from those of the female by the end of the ninth week. Prior to that, the genital tubercle in both sexes is a phallus. The urethral groove forms on the ventral surface of the phallus early in development during the differentiation of the external genitalia. This is caused by the androgens produced and secreted by the testes. Androgen induced development causes the elongation and differentiation of the phallus into a penis, a fusion of the urogenital folds surrounding the urethral groove along the ventral surface of the penis, and a midline closure of the labioscrotal folds. This closure forms the wall of the scrotum the external genitalia. The external genitalia are completely formed by the end of the 12th week. [10] [12]

At birth, the development of the prepubertal male reproductive system is completed. During the second trimester of pregnancy, testosterone secretion in the male declines so that at birth the testes are inactive. [13] Gonadotropin secretion is low until the beginning of puberty. [14]

Summary

Chart of the generalized male reproductive system embryionic Generalized male reproductive system embryonic development.png
Chart of the generalized male reproductive system embryionic

The genetic sex is determined by whether a Y bearing or next bearing sperm fertilizes the open; the presence or absence of a Y chromosome in turn determines whether the gonads of the embryo will be testes or ovaries; and the presence or absence of testes, finally, determines whether the sex accessory organs and external genitalia will be male or female. This sequence is understandable in light of the fact that both male and female embryos develop within the maternal environment - high in estrogen secreted by the mother's ovaries and the placenta. If estrogen determined the gender, all embryos would become feminized. [10]

Puberty

During puberty, increased gonadotropin secretion stimulates a rise in sex steroids creation from the testes. The increased secretion of testosterone from the testes during puberty causes the male secondary sexual characteristics to be manifested. [15]

Male secondary sex characteristics include:

Secondary development includes the increased activity of the eccrine sweat glands and sebaceous glands along with the darkening of the skin in the scrotal region. [14]

Clinical significance

Chromosomal abnormalities

Sex chromosomes in XO sex determination Critique of the Theory of Evolution Fig 060.svg
Sex chromosomes in XO sex determination
YChromShowingSRY2 YChromShowingSRY2.png
YChromShowingSRY2

Chromosomal abnormalities can occur during fertilization impacting the development of the male reproductive system. The genotype of the male consists of a Y chromosome paired with an X chromosome. Female sex is determined by the absence of a Y chromosome. Some individuals are male who have the XX male syndrome and androgen insensitivity syndrome. This occurs when one X chromosome contains a segment of the Y chromosome, which was inserted into the X chromosome of the father's sperm. Rarely females are born with the XY genotype. They are found to be missing the same portion of the Y chromosome as was inserted into the chromosome of XX males. The gene for sexual differentiation in humans, called the testis determining factor (TDF), [20] [ non-primary source needed ] is located on the short arm of the Y chromosome. [21] [22] The presence or absence of the Y chromosome determines whether the embryo will have testes or ovaries. An abnormal number of sex chromosomes (aneuploidy) can occur. This includes Turner's syndrome - a single X chromosome is present, [23] Klinefelter's syndrome - two X chromosomes and a Y chromosome are present, XYY syndrome and XXYY syndrome. Other less common chromosomal arrangements include: triple X syndrome, 48, XXXX, and 49, XXXXX. [24] [4]

A.--Diagram of the primitive urogenital organs, from 'Diagrams to show the development of male and female generative organs from a common type' * w, w. Right and left Wolffian ducts. Gray1110-1.png
A.—Diagram of the primitive urogenital organs, from 'Diagrams to show the development of male and female generative organs from a common type'
* w, w. Right and left Wolffian ducts.

The observable, visual differences become apparent between male or the female reproductive organs are not seen initially. Maturation continues as the medial aspect of each mesonephros grows to form the genital ridge. The genital ridge continues to grow behind the developing peritoneal membrane. By week six, string-like cell congregations called primitive sex cords form within the enlarging genital ridge. Externally, a swelling called the genital tubercle appears above the cloacal membrane. [4]

The mesoderm extends to the midventral line. Mesoderm-mid.png
The mesoderm extends to the midventral line.

External distinctions are not observed even by the eighth week of pre-embryonic development. This is the indifferent stage during which the gonads are relatively large and have an outer cortex of primitive sex cords and an inner medulla. [4]

Specialized primordial germ cells are forming and migrating from the yolk sac to the embryonic gonads during week eight and nine. These are the spermatogonia in the developing male. Before seven weeks after fertilization, the gonads have the potential to become either testes or ovaries. Reproductive sex organs for both male and female are derived from the same embryonic tissues and are considered homologous tissues or organs. [4]

Testosterone Testosteron.svg
Testosterone

After the testes have differentiated, male sex hormones, called androgens, are secreted from interstitial cells (cells of Leydig). The major androgens secreted by these cells is testosterone and secretion begins 8 to 10 weeks after conception. Testosterone secretion reaches a peak at 12 to 14 weeks, and declines to very low levels by the end of the second trimester (about 21 weeks). Levels are the barely detectable 4–6 months of age postnatal. [25] [26] High levels of testosterone will not appear again until the time of puberty. [7] [27]

Internal accessory sex organs to develop and most of these are derived from two systems of embryonic ducts. Male accessory organs are derived from mesonephric (wolfian) ducts. The developing tubules within the testes secretes a polypeptide Müllerian inhibition factor (MIF). MIF causes the regression of the paramesonephritic ducts 60 days after fertilization. Testosterone secretion by the interstitial cells of the testes then causes the growth and development of the mesonephric ducts into male secondary sex organs. [7] The Müllerian ducts atrophy, but traces of their anterior ends are represented by the appendices testis (hydatids of Morgagni of the male), while their terminal fused portions form the utriculus on the floor of the prostatic urethra. This is due to the production of anti-Müllerian hormone by the Sertoli cells of the testes. [28]

See also

Related Research Articles

<span class="mw-page-title-main">Sex organ</span> Biological part involved in sexual reproduction

A sex organ, also known as a reproductive organ, is a part of an organism that is involved in sexual reproduction. Sex organs constitute the primary sex characteristics of an organism. Sex organs are responsible for producing and transporting gametes, as well as facilitating fertilization and supporting the development and birth of offspring. Sex organs are found in many species of animals and plants, with their features varying depending on the species.

<span class="mw-page-title-main">Testicle</span> Internal organ in the male reproductive system

A testicle or testis is the male gonad in all bilaterians, including humans. It is homologous to the female ovary. The functions of the testicles are to produce both sperm and androgens, primarily testosterone. Testosterone release is controlled by the anterior pituitary luteinizing hormone, whereas sperm production is controlled both by the anterior pituitary follicle-stimulating hormone and gonadal testosterone.

<span class="mw-page-title-main">Gonad</span> Gland that produces sex cells

A gonad, sex gland, or reproductive gland is a mixed gland that produces the gametes and sex hormones of an organism. Female reproductive cells are egg cells, and male reproductive cells are sperm. The male gonad, the testicle, produces sperm in the form of spermatozoa. The female gonad, the ovary, produces egg cells. Both of these gametes are haploid cells. Some hermaphroditic animals have a type of gonad called an ovotestis.

<span class="mw-page-title-main">Androgen</span> Any steroid hormone that promotes male characteristics

An androgen is any natural or synthetic steroid hormone that regulates the development and maintenance of male characteristics in vertebrates by binding to androgen receptors. This includes the embryological development of the primary male sex organs, and the development of male secondary sex characteristics at puberty. Androgens are synthesized in the testes, the ovaries, and the adrenal glands.

<span class="mw-page-title-main">Mesonephric duct</span> Paired organ in mammals

The mesonephric duct, also known as the Wolffian duct, archinephric duct, Leydig's duct or nephric duct, is a paired organ that develops in the early stages of embryonic development in humans and other mammals. It is an important structure that plays a critical role in the formation of male reproductive organs. The duct is named after Caspar Friedrich Wolff, a German physiologist and embryologist who first described it in 1759.

<span class="mw-page-title-main">Spermatogenesis</span> Production of sperm

Spermatogenesis is the process by which haploid spermatozoa develop from germ cells in the seminiferous tubules of the testicle. This process starts with the mitotic division of the stem cells located close to the basement membrane of the tubules. These cells are called spermatogonial stem cells. The mitotic division of these produces two types of cells. Type A cells replenish the stem cells, and type B cells differentiate into primary spermatocytes. The primary spermatocyte divides meiotically into two secondary spermatocytes; each secondary spermatocyte divides into two equal haploid spermatids by Meiosis II. The spermatids are transformed into spermatozoa (sperm) by the process of spermiogenesis. These develop into mature spermatozoa, also known as sperm cells. Thus, the primary spermatocyte gives rise to two cells, the secondary spermatocytes, and the two secondary spermatocytes by their subdivision produce four spermatozoa and four haploid cells.

<span class="mw-page-title-main">Female reproductive system</span> Reproductive system of human females

The female reproductive system is made up of the internal and external sex organs that function in the reproduction of new offspring. The human female reproductive system is immature at birth and develops to maturity at puberty to be able to produce gametes, and to carry a fetus to full term. The internal sex organs are the vagina, uterus, fallopian tubes, and ovaries. The female reproductive tract includes the vagina, uterus, and fallopian tubes and is prone to infections. The vagina allows for sexual intercourse and childbirth, and is connected to the uterus at the cervix. The uterus or womb accommodates the embryo, which develops into the fetus. The uterus also produces secretions, which help the transit of sperm to the fallopian tubes, where sperm fertilize ova produced by the ovaries. The external sex organs are also known as the genitals and these are the organs of the vulva including the labia, clitoris, and vaginal opening.

<span class="mw-page-title-main">Paramesonephric duct</span> Paired ducts in the embryo in the primitive urogenital structures

The paramesonephric ducts are paired ducts of the embryo in the female reproductive system that run down the lateral sides of the genital ridge and terminate at the sinus tubercle in the primitive urogenital sinus. In the female, they will develop to form the fallopian tubes, uterus, cervix, and the upper one-third of the vagina.

<span class="mw-page-title-main">Persistent Müllerian duct syndrome</span> Medical condition

Persistent Müllerian duct syndrome (PMDS) is the presence of Müllerian duct derivatives in what would be considered a genetically and otherwise physically normal male animal by typical human based standards. In humans, PMDS typically is due to an autosomal recessive congenital disorder and is considered by some to be a form of pseudohermaphroditism due to the presence of Müllerian derivatives.

The development of the urinary system begins during prenatal development, and relates to the development of the urogenital system – both the organs of the urinary system and the sex organs of the reproductive system. The development continues as a part of sexual differentiation.

Reproductive biology includes both sexual and asexual reproduction.

<span class="mw-page-title-main">Human reproductive system</span> Organs involved in reproduction

The human reproductive system includes the male reproductive system which functions to produce and deposit sperm; and the female reproductive system which functions to produce egg cells, and to protect and nourish the fetus until birth. Humans have a high level of sexual differentiation. In addition to differences in nearly every reproductive organ, there are numerous differences in typical secondary sex characteristics.

<span class="mw-page-title-main">Sex cords</span> Structures that develop from the genital ridges that further differentiate based on an embryos sex

Sex cords are embryonic structures which eventually will give rise (differentiate) to the adult gonads. They are formed from the genital ridges - which will develop into the gonads - in the first 2 months of gestation which depending on the sex of the embryo will give rise to male or female sex cords. These epithelial cells penetrate and invade the underlying mesenchyme to form the primitive sex cords. This occurs shortly before and during the arrival of the primordial germ cells (PGCs) to the paired genital ridges. If there is a Y chromosome present, testicular cords will develop via the Sry gene : repressing the female sex cord genes and activating the male. If there is no Y chromosome present the opposite will occur, developing ovarian cords. Prior to giving rise to sex cords, both XX and XY embryos have Müllerian ducts and Wolffian ducts. One of these structures will be repressed to induce the other to further differentiate into the external genitalia.

<span class="mw-page-title-main">Gonadal dysgenesis</span> Congenital disorder of the reproductive system

Gonadal dysgenesis is classified as any congenital developmental disorder of the reproductive system in humans. It is atypical development of gonads in an embryo. One type of gonadal dysgenesis is the development of functionless, fibrous tissue, termed streak gonads, instead of reproductive tissue. Streak gonads are a form of aplasia, resulting in hormonal failure that manifests as sexual infantism and infertility, with no initiation of puberty and secondary sex characteristics.

<span class="mw-page-title-main">Sexual differentiation in humans</span> Process of development of sex differences in humans

Sexual differentiation in humans is the process of development of sex differences in humans. It is defined as the development of phenotypic structures consequent to the action of hormones produced following gonadal determination. Sexual differentiation includes development of different genitalia and the internal genital tracts and body hair plays a role in sex identification.

The development of the reproductive system is the part of embryonic growth that results in the sex organs and contributes to sexual differentiation. Due to its large overlap with development of the urinary system, the two systems are typically described together as the genitourinary system.

<span class="mw-page-title-main">Scrotum</span> Sac of skin that protects the testicles

In most terrestrial mammals, the scrotum or scrotal sac is a part of the external male genitalia located at the base of the penis. It consists of a sac of skin containing the external spermatic fascia, testicles, epididymides, and vasa deferentia. The scrotum will usually tighten during penile erection and when exposed to cold temperatures.

The reproductive system of an organism, also known as the genital system, is the biological system made up of all the anatomical organs involved in sexual reproduction. Many non-living substances such as fluids, hormones, and pheromones are also important accessories to the reproductive system. Unlike most organ systems, the sexes of differentiated species often have significant differences. These differences allow for a combination of genetic material between two individuals, which allows for the possibility of greater genetic fitness of the offspring.

The epididymis, which is a tube that connects a testicle to a vas deferens in the male reproductive system, evolved by retention of the mesonephric duct during regression and replacement of the mesonephros with the metanephric kidney. Similarly, during embryological involution of the paired mesonephric kidneys, each mesonephric duct is retained to become the epididymis, vas deferens, seminal vesicle and ejaculatory duct. In reptiles and birds both the testes and excurrent ducts occur in an intra-abdominal location (testicond). Primitive mammals, such as the monotremes (prototheria), also are testicond. Marsupial (metatheria) and placental (eutheria) mammals exhibit differing degrees of testicular descent into an extra-abdominal scrotum. In scrotal mammals the epididymis is attached to the testes in an extra-abdominal position where the cauda epididymis extends beyond the lowest extremity of the testis. Hence, the cauda epididymis is exposed to the coolest of temperatures compared to all other reproductive structures.

Heterocrine glands are the glands which function as both exocrine gland and endocrine gland. These glands exhibit a unique and diverse secretory function encompassing the release of proteins and non-proteinaceous compounds, endocrine and exocrine secretions into both the bloodstream and ducts respectively, thereby bridging the realms of internal and external communication within the body. This duality allows them to serve crucial roles in regulating various physiological processes and maintaining homeostasis. These include the gonads, pancreas and salivary glands.

References

  1. 1 2 Sharma S, Hanukoglu A, Hanukoglu I (2018). "Localization of epithelial sodium channel (ENaC) and CFTR in the germinal epithelium of the testis, Sertoli cells, and spermatozoa". Journal of Molecular Histology. 49 (2): 195–208. doi:10.1007/s10735-018-9759-2. PMID   29453757. S2CID   3761720.
  2. ↑ Sharma S, Hanukoglu I (2019). "Mapping the sites of localization of epithelial sodium channel (ENaC) and CFTR in segments of the mammalian epididymis". Journal of Molecular Histology. 50 (2): 141–154. doi:10.1007/s10735-019-09813-3. PMID   30659401. S2CID   58026884.
  3. ↑ Fauci et al. 2008, pp. 2339–2346.
  4. 1 2 3 4 5 Van de Graaff & Fox 1989, p. 927.
  5. ↑ "Differentiation of the urogenital sinus in males". www.embryology.ch.
  6. ↑ "The external genitalia, indifferent stage". Human Embryology: Organogenesis. Retrieved 2015-03-03.
  7. 1 2 3 Van de Graaff & Fox 1989, p. 928.
  8. ↑ Van de Graaff & Fox 1989, p. 929.
  9. ↑ "Differentiated stage of the male genitalia". Human Embryology Organogenesis. Retrieved 2015-03-03.
  10. 1 2 3 4 5 6 Van de Graaff & Fox 1989, p. 932.
  11. ↑ "Hydroceles and Inguinal Hernia: Symptoms, Diagnosis & Treatment - Urology Care Foundation". www.urologyhealth.org. Retrieved 2024-04-17.
  12. ↑ "Embryo Images Online". syllabus.med.unc.edu.
  13. ↑ Van de Graaff & Fox 1989, p. 933.
  14. 1 2 Van de Graaff & Fox 1989, p. 934.
  15. ↑ Van de Graaff & Fox 1989, p. 933-4.
  16. ↑ Pack PE (2016). CliffsNotes AP Biology (5th ed.). Houghton Mifflin Harcourt. p. 219. ISBN   978-0544784178.
  17. 1 2 3 4 5 6 Bjorklund DF, Blasi CH (2011). Child and Adolescent Development: An Integrated Approach. Cengage Learning. pp. 152–153. ISBN   978-1133168379.
  18. 1 2 "Help is here!". www.hartnell.edu. Archived from the original on February 8, 2009.
  19. ↑ "Secondary Characteristics". hu-berlin.de. Archived from the original on 2011-09-27.
  20. ↑ Sinclair, Andrew H.; et al. (19 July 1990). "A gene from the human sex-determining region encodes a protein with homology to a conserved DNA-binding motif". Nature. 346 (6281): 240–244. Bibcode:1990Natur.346..240S. doi:10.1038/346240a0. PMID   1695712. S2CID   4364032.
  21. ↑ Rediscovering Biology, Unit 11 - Biology of Sex and Gender, Expert interview transcripts,Link Archived 2018-07-28 at the Wayback Machine
  22. ↑ Schoenwolf, Gary C. (2009). "Development of the Urogenital system". Larsen's human embryology (4th ed.). Philadelphia: Churchill Livingstone/Elsevier. pp. 307–9. ISBN   9780443068119.
  23. ↑ FORD, CE; JONES, KW; POLANI, PE; DE ALMEIDA, JC; BRIGGS, JH (Apr 4, 1959). "A sex-chromosome anomaly in a case of gonadal dysgenesis (Turner's syndrome)". Lancet. 1 (7075): 711–3. doi:10.1016/S0140-6736(59)91893-8. PMID   13642858.
  24. ↑ Fauci et al. 2008.
  25. ↑ Forest MG, Cathiard AM, Bertrand JA (July 1973). "Evidence of testicular activity in early infancy". J. Clin. Endocrinol. Metab. 37 (1): 148–51. doi:10.1210/jcem-37-1-148. PMID   4715291.
  26. ↑ Corbier P, Edwards DA, Roffi J (1992). "The neonatal testosterone surge: a comparative study". Arch Int Physiol Biochim Biophys. 100 (2): 127–31. doi:10.3109/13813459209035274. PMID   1379488.
  27. ↑ Swaab DF, Garcia-Falgueras A (2009). "Sexual differentiation of the human brain in relation to gender identity and sexual orientation". Funct. Neurol. 24 (1): 17–28. PMID   19403051.
  28. ↑ Wilson, Danielle; Bordoni, Bruno (2024), "Embryology, Mullerian Ducts (Paramesonephric Ducts)", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   32491659 , retrieved 2024-04-18

Bibliography

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