Biology Chapter 4 Reproductive Health

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2. Print Media (Newspapers).

(ii) 1 billion in May 2000.

Vasectomy and tubectomy
 


Fig. (a) Vasectomy in case of male      
Fig. (b) Tubectomy the case of female

1. Decline in death rate like maternal mortality rate (MMR) and infant mortality rate (IMR).

2. Increase in number of people in reproducible age.

3. Increase in birth rate and improved medical facilities which in turn increases the longevity of an individual.

(1) IVF-In Vitro Fertilization (Test tube babies). followed by where the sperm and ova are collected from the donors and the fertilized in a laboratory followed by ET-embryo transfer.

(2)The zygote or early embryo can be transferred by two methods: ZIFT-Zygote Intra Fallopian Transfer or IUT-Intra Uterine transfer

(3) In vivo fertilisation where fusion of gamete from donor takes place inside a female.

(4) GIFT-Gamete Intra Fallopian Transfer where ova is tranfered from fallopian tube of donor female to another female.

(5) ICSI-Intra Cytoplasmic Sperm Injection, AI-Artificial insemination and IUI-Intra uterine insemination where sperm from a donor is introduced into ovum, vagina and uterus of the female respectively.

1. Creating awareness about various reproduction related aspects.

2. Providing facilities and support for building up a reproductively healthy society.

1. increasing phagocytosis of sperms within the uterus.

2. suppressing sperm motility.

3. suppressing the fertilising capacity of the sperms.

3. making the uterus unsuitable for implantation.

4. making the cervix hostile to sperms.

The mechanisms of their action are :
i. They inhibit ovulation and implantation
ii. They alter the quality of cervical mucus to prevent or retard the  entry of sperms.

Saheli pills are advantageous as they are non-steroidal in nature , very effective (high contraceptive value) and has very few  side effects.

STDs can be prevented by taking the following measures - 

1. Avoiding  sex with unknown partners/multiple partners.

2. Using protection or condoms during coitus.

3. Consulting a qualified doctor in case of doubt  for early detection and treatment of the problem.

1. Increased awareness among the people about sex related aspects.

2. Rapid decline in death rate of the mother and the infant due to medically assisted deliveries and better post-natal care facilities.

3. Success of programmes like family planning and more and more couples having small families.

4. Better care and detection of STDs.

5. Improved medical facilities available for all the sex-related issues.

1. It will disrupt the normal functioning as gonads also secrete hormones, deficiency of which can pose problems and serious health issues.

2. It is an irreversible process which will lead to infertility forever. 

1. Avoidance of sex with multiple partners.

2. Avoidance of sex with unknown partners.

3. Complete abstinence from sex with infected individuals.

4. Use of condoms  and protection during sexual intercourse.

5.In case of doubt, one should consult a qualified doctor for early detection and treatment of the problem.

(b) All sexually transmitted diseases are completely curable if detected early and treated properly  except for hepatitis-B, genital herpes and HIV infections.

(c) Oral pills are very popular contraceptives among the educated urban women.

(d) In E.T. techniques embryos may be transferred to the fallopian tubes or uterus depending upon the number of blastomeres.

In the Test Tube Baby programmes,  ovum from the wife or a donor female and the sperms from the husband or a donor are collected and allowed to fuse under simulated conditions in the laboratory to form zygote; it is called In-vitro fertilisation (IVF). The zygote or early embryo is transferred into the uterus or fallopian tube for further development; this process is called Embryo Transfer (ET) and can be done in the following ways :

(i) The zygote or embryo upto eight blastomeres is transferred into the fallopian tube;this process is called Zygote Intra Fallopian Transfer (ZIFT).

(ii) Embryos with more than eight blastomeres are transferred into the uterus by the process called Intra Uterine Transfer (IUT).

Two methods of of birth control are 
1. Use of  oral contraceptives like pills that contain Progestogen or combination of Progestogen-estrogen which prevent ovulation and implantation.

2.. Sterilization procedures in which a small part of the gonads is surgically removed to prevent transport of gametes and thus prevent conception.

It can be of two types 

(a) Vasectomy. which is a sterilization procedure in male where a small part of the vas deferens is surgically  removed or tied up through a small incision on the scrotum.

(b) Tubectomy. which is a sterlisation process in  women where a part of  of fallopian tube is cut and tied off through a small incision in the abdomen or through vagina.

Family planning is the programme launched by the Indian Government in the year 1951 to build a reproductively heathy society and keep a check on population.

The various ways of Family Planning are

1. Restrict the family to two children .

2. There should be spacing between the birth of two children so as to ensure good health of mother and child.

3.Late marriage for young persons.

4. Increase in the sources of recreation so as to divert the attention from sex.

5. Use of contraceptives and  sterlisation methods.

Population Education - which means to educate the masses about the evils of population explosion and make them aware of the various measures that can keep a check on the growing population and help maintain a healthy society.

Use of Contraceptives methods like Natural/Traditional, Barrier, IUDs or intra Uterine Devices, Oral contraceptives, Injectables, Implants and Surgical methods.

(i) Birth or Natality rate. It is generally expressed as number of births per 1,000 individuals of a population per year. 

(ii) Death or Mortality rate. It is opposite of natality rate. It is commonly expressed as the number of deaths per 1,000 individuals of a population per year.

(iii) Fertility Rate. It is the number of live births per unit time per unit number of fertile females.

1. Avoiding of sex with unknown or multiple partners.

2. Use of protection like condoms during sexual intercourse.

Reproductive health is the total well-being in all aspects of reproduction. The aspects which should be given special attention in the present scenarios are:

(1) Counselling and creating awareness among people, especially the youth, about various aspects of reproductive health, such as sexually transmitted diseases, available contraceptive methods, case of pregnant mothers, adolescence, etc.

(2) Providing support and better facilities such as medical assistance to people during pregnancy, abortions, contraceptives, infertility, etc. for building a reproductively healthy society.

Tips: -

The following are explanations of incorrect statements:
(a) Abortions can be spontaneous due to injury, infection or improper nutrition or care.
(b) The abnormalities or defects can be in either male or female.
(c) Complete lactation is a natural method of contraception but it is limited till lactation period, which continues till six months after parturition only. Chances of failure is very high.
(d) Yes. Creating awareness about sex related aspects provides necessary information about reproductive health.

The ART procedure used to help the couple is ZIFT, that is, zygote intrafallopian transfer. In this method, the sperm is collected from the donor male and the ovum from donor female. The sperm and the ovum are fused in the laboratory and developed till 8-cell stage. The 8 cell zygote is then transferred into the fallopian tubes of the mother for further development.

MOET – Multiple Ovulation Embryo Transfer is a method in which a cow is administered hormones with FSH (follicular stimulating hormone) like activity. These hormones induce follicular maturation and superovulation in which the cow produces 6–8 eggs per cycle instead of one egg. The cow is mated with an elite bull or artificially inseminated and the fertilized eggs at 8-32 stage is recovered non-surgically and transferred to a surrogate mother.

Reproductive health is the total well-being in all aspects which  includes the physical, emotional, behavioural and social well-being of an individual. Therefore, there is an urgent need to educate and discuss topics related to the reproductive health.
Following are the topics about reproductive health that should be discussed with the students:

i. Sexually transmitted diseases, such as AIDS and Gonorrhoea, are transferred from one individual to another through sexual contact. Therefore, making the students aware about these diseases will help to prevent their spread.  

ii. Lack of knowledge about the reproductive status may lead to unwanted pregnancies. Hence, it is necessary to create awareness among people, especially the youth.

iii. Learning about one's sexuality at a proper age may help the students to know about the different changes happening in their body; thereby, leading to a better mental and physical state of health.

iv. Counselling and creating awareness about reproductive health also help to curb the problems of infertility, birth control, mortality, etc.

There is a statutory ban on amniocentesis because it leads to increase in the number of female foeticide.
Amniocentesis is the technique which is used for sex-determination of the foetus based on the chromosomal pattern in the amniotic fluid surrounding the developing embryo. The ban on the technique is a correct measure because many couples tend to abort the baby if they find the baby to be a girl which increases the number of female foeticides. The ban helps to prevent the misuse of the method and keep a check on it.

Two hormones that are constituents of contraceptive pills are
i. Progesterone
ii. Estrogen.
They have a high and effective contraceptive value as they inhibit ovulation and implantation as well as after the quality of cervical mucus to prevent / retard entry of sperm and have very few side effects . 
Saheli - is an example of non-steroidal pill. 

(a) In India the female partner is often blamed for the couple being childless because our society is a male dominating society so nobody blames the male. Lack of education, awareness is the another reason. People are not aware about scientific reasons for infertility.
Two values that we can promote to check this social evil are:
i. People should be given proper education about all this. They should be made to understand that both the male and the female can have problems. 
ii. They should be made aware of the causes for infertility and the ways how to overcome it.
(b) The reasons responsible for the cause of infertility are -: 
i. Physical
ii. Congenital etc. 
(c) Artificial insemination is a technique that can help the couple to have a child where the problem is with male partner. In this technique, semen collected either from husband or a healthy donor is artificially introduced into vagina or uterus of the female. 

(a) Providing sex education is one of the best ways to create a reproductively healthy society. Sex education helps in achieving this goal by:
1. Providing proper knowledge to curious adolescents and preventing them from being misguided and preventing them from believing myths about sex-related aspects.
2. Creating awareness about sexually transmitted diseases and ways to prevent them.
3. Providing proper information about reproductive organs and various adolescents and related changes.
4. Proper information about safe and hygienic sexual practices.

(b) Two indicators of a reproductively healthy society are as follows:

1. In a reproductively healthy society, there is no emphasis on the selection of a particular sex. Hence, the ratio of male and female individuals is maintained.

2.The members of the society have physically andf functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex related aspects.

Lactational amenorrhea method is a natural method of birth control. In this breastfeeding delays the onset of menstruation in new mothers. Breastfeeding halts the release of hormone that triggers ovulation. Is is based on the fact that ovulation does not occur during the period of intense lactation following parturition. 

MTP or induced abortion is termination of pregnancy due to certain medical reasons. Government of India legalised MTP in 1971 with strict conditions to avoid its misuse. 

Parents feel embarrassed as : -
(a) Indian Society is not that broad minded and parents feel shy talking openly regarding these matters to their children due to which their children go astray sometimes. But parents should consider that at adolescence parents should behave like friends to their child. So that child could also share his problems with parents. Parents should give right information about the reproductive aspects, sexual practices, adolescence changes to their children so that their children will never be misleaded.
(b) By an example of male honey bee and orchid ophyrys flower, it is evident that sexual attraction is a natural phenomenon, the honey bee is attracted to a ophrys flower and assumes its one petal as its female partner & pseudo copulates with it. So it is a natural phenomenon & parents should talk regarding this matter to their children.

C.

Vasectomy blocks the gamete transport and does not affect spermatogenesis.

C.

It can be used for detection of cleft palate

Cleft palate is a developmental abnormality which may occur in the developing foetus and so it can be detected by sonography and not amniocentesis. 

D.

Jaundice

Amniocentesis is a foetal sex determination test based on the chromosomal pattern in the amniotic fluid surrounding the developing embryo. Jaundice is a condition not based on chromosomal pattern It is a disease related to liver dysfunctions.

C.

artificial introduction of sperms of the healthy donor into the vagina

infertility due to the inability of the male to inseminate the female or due to very low sperm counts n the ejaculates can correct by artificial insemination.

B.

Gamete intra fallopian transfer

The full form of GIFT is 'Gamete Intra Fallopian Transfer'.
The method is used in females who cannot produce ova but can provide suitable environment for fertilization and further development of embryo in the oviducts. In such cases, ovum from the donar female is surgically removed and is then introduced into the Fallopian tube of such females. Such women then accept sperms from her husband during copulation. 

B.

Implantation of embryo at site other than uterus

Ectopic pregnancy develops when an embryo implants somewhere other than the uterus, such as in one of Fallopian tube. It is also known as eccyesis or tubal pregnancy. 

C.

Tubectomy

The process of cutting and ligating both the oviducts or fallopian tubes of female is called tubectomy. It is very reliable method of birth control, the approximate failure rate of which is less than 1%

D.

Zygote intra fallopian transfer (ZIFT)

The test-tube baby programme employs the technique of in vitro fertilisation (IVF) and zygote intrafallopian transfer (ZIFT) technique. ZIFT is a method used to treat infertility, in which an egg fertilized in vitro (outside the body) is placed into a woman's fallopian tube (oviduct). It is an assisted reproductive procedure similar to IVF and embryo transfer, the difference being that zygote or proembryo is transferred into the fallopian tube, instead of the uterus. Because the fertilized egg (zygote) is directly transferred into the tubes, the procedure is also referred to as tubal embryo transfer.

A.

Small part of the Fallopian tube is removed or tied up

Tubectomy is a type of sterilisation. During this procedure for female's Fallopian tubes are tied up and blocked to restrict entry of sperms reaching the ovary in females permanent birth control.

B.

LNG - 20

LNG - 20 is a hormone-releasing IUD, that makes the uterus unstable for implantation and cervix hostiling to sperm intera uterine devices are plastic or metal objects which are inserted by the doctors into the uterus through the vagina. 
These are available as.
Non-medicated IUDS (i.e., lippes loop)
Copper-releasing IUDS (e.g., multi-load 375)
Hormone-releasing (e.g.,prgestaert).
Cervical caps and vaults are made up of rubber, and are inserted into the female reproductive tract to cover the cervix before coitus. They prevent conception.

A.

Surgical removal of uterus is Hysterectomy. It is complete or partial removal of uterus or uterine body, rendering the patient unable to bear children. 
Surgical removal of prostate gland is called prostatectomy. Vasectomy is the surgical process of tiging up a portion of vas deferens, as a method of contraception.
Mammectomy is the removal of mammary glands.

D.

Encephalitis

Sexually Transmitted Diseases (STDs) or venereal disease includes syphillis (T. pallidum), AIDS (HIV) and trichomoniasis (T. vaginalis)! Transmission of STDs occurs through direct contact with blood, body fluids etc.
Encephalitis is an acute inflammation of brain caused by bacterial, viral or other pathogens. No direct transmission through body fluids is essential as its is not as STD.

A.

Twelve weeks

Intentional or voluntary termination of pregnancy before full term is called medical termination of pregnancy (MTP) or induced abortion. MTPs are considered relatively safe during the first trimester, i.e., upto 12 weeks of pregnancy. Second trimseter abortions are much more risker. 

C.

IUDs (Intra Uterine Devices)

At present, the most widely accepted method of contraception in India is IUDs (Intra Uterine Devices). These devices are effective and popular. These devices are inserted by doctors and expert nurses in the uterus through the vagina.

C.

With 15 days of sexual contact with an infected person

HIV enters into T -lymphocytes replicates and produces progeny viruses. The progeny viruses released in the blood other helper T-lymphocytes.This is repeated leading to a progressive decrease in the body of the infected person. During this period, the person suffers from bouts of fever, diarrhoea and weight loss. The person starts suffering from an infection.

A.

who cannot produce an ovum

The technique called gamete intra-fallopian transfer (GIFT) is a transfer of an ovum collected from a donor into the fallopian tube of another female. This technique is recommended for those females who can not produce an ovum but can provide a suitable environment for fertilisation and further development.

A.

Secretions of acrosome helps one sperm enter cytoplasm of ovum through zona pellucida

The process of fusion of a sperm with an ovum is called fertilisation. During fertilization, a sperm comes in contact with the zona pellucida layer of the ovum and induces changes in the membrane that blocks the entry of additional sperms. Thus, it ensures that only one sperm can fertilise an ovum. The secretions of the acrosome help the sperm enter into the cytoplasm of the ovum through the zona pellucida and the plasma membrane.

A.

14^th day

Rapid secretion of LH leading to its maximum level during the mid- cycle, i.e about the 14th day of menstrual cycle, popularly called LH surge induces rupture of Graafian follicle and thereby the release of ovum (ovulation).

A.

make uterus unsuitable for implantation

Intra- uterine device (IUD) is a small device made up pf copper, plastic or stainless steel. It is inserted into the uterus by a doctor and left in in place. It prevents implantation. iIt can be left in place for long periods. It may cause bleeding and discomfort. IUD may come out. 

B.

the release of oxytocin from pituitary

Oxytocin (childbirth hormone) secreted by neurohypophysis of pituitary gland stimulates contraction of uterus muscles, including labour pain for child birth, when secretion of progesterone hormone declines, making the end of pregnancy. As the sensory impulse of increasing labour pain reaches hypothalamus, more and more oxytocin is released from posterior pituitary under a positive feedback regulation childbirth, it dilates the cervix (vaginal stretching).

B.

A = Vas deferens,
B = Seminal vesicle
C = Prostrate 
D = Bulbourethral gland.

C.

Development of corpus - luteum - Secretory phase and increased secretion of progesterone

In secretory phase during ovulation, the follicle breaks and collapses under the continuous influence of Luteinizing Hormone (LH). It begins to enlarge and forms a yellowish structure, called the corpus luteum. The corpus luteum plays an important role in the preparation of the endometrium for the implantation of the fertilised egg by secreting oestrogens and progesterone.

B.

Bile pigements passed through bile juice

The stools, which the infant passes out is quite yellowish due to bile pigments passed through bile juice.

A.

The contraceptive pills hormones either in combination or progesterone only that primarily prevent the release of the egg. It is convenient and highly effective, significant non- contraceptive health benefits such as protection against ovarian and endometrial cancers.
A condom is thin rubber sheath for penis that collects semen. It is easy to use effective and inexpensive.
vasectomy is the cutting and tying off ductus deferens. so that sperm cannot enter the ejaculate. 
Copper -T is a small device placed in the uterus that prevents fertilisation or implantation.

C.

A, C

The most used contraceptive product in the united states is the birth control pill. Many combination birth control pills (marketed under various names including ovral, tetragynon and triphasil) are also being used for post-coital contraception. Mifepristone is an antihormone that when taken during the first seven weak of pregnancy in conjunction with a tiny amount of prostaglandin to stimulate uterine contraction induces miscarriage by blocking progesterone's quieting effect on the uterus. 

B.

The menstrual fluid can easily clot

During normal menstruation, approximately 40 mL of blood and an additional 35 mL of serous fluid are lost. The menstrual fluid is normally non-clotting because a fibrinolysin is released along with the necrotic endometrial material.
The cause of menopause is burning out of the ovaries. At about age 45 only a few primordial follicles remain to be stimulated by FSH and LH. The oestrogen production falls below a critical value and the gonadotropic hormones (FSH and LH)  are produced regularly from the pituitary so, a there level increase in body.

A.

a-b-c-d
(ii)-(iii)-(iv)-(i)

C.

Artificial Insemination

A.

They suppress sperm motility and fertilising capacity of sperms

A.

blocks estrogen receptors in the uterus, preventing eggs from getting implanted.

Saheli is the world's first non-steroidal, oral pills. It can be only taken once a week. It contains centchroman and its functioning is based upon selective Estrogen Receptor modulation.

B.

FSH

Follicle Stimulating Hormone (FSH) is produced by basophilic cells of adenohypophysis of the pituitary gland. In females, this hormone is responsible for the growth of ovarian follicles up to ovulation, while in males, its functions are the development of seminiferous tubules and maintenance of spermatogenesis.

C.

Gamete Intra Fallopian Transfer

Gamete Intra Fallopian Transfer (GIFT) is an Assisted Reproductive Technology (ART). In this technique, eggs are removed from the woman and placed in one of the Fallopian tubes, along with the man's sperm. This allows fertilisation to take place inside the woman's body. Therefore, this variation is actually an in vivo fertilisation, not an in vitro fertilisation.

A.

Trichomonas vaginalis – Leishmaniasis

Trichomonas Vaginalis is a flagellate found in the vagina of female (humans) causing vaginalis. It leads to burning sensation, itching and frothy vaginal discharge.

B.

Mesoderm

Gonads are derived from the mesodermal germinal ridges of the embryo which contain mesodermal epithelium and large spherical primitive germs cells.

C.

Desidua capsularis

Desidua parietalis is the part of the endometrium between chorion and stratum basalis of the uterus.

Desidua parietalis is the part of the endometrium not involved in the implantation.

Decidua umbilicus no such structure exists in the endometrium.

A.

Injectible contraceptive

Depo-Provera injections contain the active ingredient medroxyprogesterone acetate, which is a synthetic form of the naturally occurring female sex hormone progesterone.

A.

Progesterone

Use of Contraceptive pills is a widespread form of birth control. Contraceptive pills contain oestrogen and progesterone. The production of the pituitary hormones FSH and LH in the normal sexual cycle of a female is shut down by these hormones. In the absence of FSH, the ovarian follicles do not ripen and ovulation does not occur in the absence of LH.

D.

both (b) and (c)

Oral contraceptive pills inhibit ovulation and implantation. They have to be taken daily for 21 days starting within the first five days of menstrual cycle. After a gap of 7 days, it has to be repeated.

B.

Serratia - Drug addiction

Serratia marcescens is considered a harmful human pathogen which has been known to cause urinary tract infections, wound infections, and pneumonia. Serratia bacteria also have many antibiotic resistance properties which may become important if the incidence of Serratia infections dramatically increases.

B.

If both assertion and reason are true but reason is not the correct explanation of assertion

Amniocentesis is a foetal sex determination and disorder test based on the chromosomal pattern in the amniotic fluid surrounding the developing embryo. It withdraws a sample of the amniotic fluid surrounding the embryo in the uterus by piercing the amniotic sac through the abdominal wall. Amniotic fluid drawn from the uterus contains cells from the embryo (mostly shed from the skin). Cell cultures enable chromosome patterns to be studied so that prenatal diagnosis of chromosomal abnormalities (such as Down's syndrome) can be made. Metabolic errors and other diseases such as spina bifida, can also be diagnosed prenatally from the biochemistry of the cells.

D.

underdeveloped limbs.

Even a single dose of thalidomide can cause severe birth defects or fetal death, thalomid (a form of thalidomide) must not be used during pregnancy. Pregnancy must be ruled out 24 hours before starting therapy with thalidomide. Women must be monitored for pregnancy while using thalomid because it can give rise to underdeveloped limbs in fetus.

D.

sonography

Sonography is a technique to visualise the structures beneath the skin. A transducer is used to recieve soundwave and signals to the skin. The transducer contains the crystals of lead zirconate that convert electric current into sound waves. It also acts as a reciever and converts the echoes into electrical signals which are processed and displayed on the screen of a monitor to show 2-D image.

A.

biotic potential

Chapman (1928) proposed the term biotic potential to designate maximum reproductive power. He defined it as the inherent power of an organism to reproduce, to survive, ie, to increase in number. But there is a natural check called environmental resistance.

A.

oestrogen and progesterone

Oral contraceptive pills contain a combination of female sex hormones oestrogen and progesterone. These pills prevent the development of eggs and ovulation by inhibiting the secretion of FSH.

B.

by abstaining from coitus from day 10-17 of the menstrual cycle

One of the legal method of birth control is periodic in which couple abstain from coitus from day 10 to 17 of the menstrual cycle. Abortion by taking medicine is not a legal method. A day break coitus may increase the changes of contraception.

D.

Jaundice

Amniocentesis is a foetal sex determination test based on the chromosomal pattern in the amniotic fluid surrounding the developing embryo. Jaundice is a condition not based on chromosomal pattern. It is a disease related to liver dysfunctions.

C.

artificial introduction of sperms ofa healthy donor into the vagina

Infertility due to inability of the male to inseminate the female or due to very low sperm counts in the ejaculates can be corrected by artificial insemination. Ova from the wife/donor (female) and sperms from the husband/donor (male) are callected and are induced to form zygote under simulated conditions in the laboratory and is known as test-tube baby programme. Introduction of sperms of healthy donor directly into the ovary is called Intra Cytoplasmic Sperm Injection (ICSI).

D.

Test tube baby grows following uterine fertilisation

In the test tube procedure, the fertilisation takes place in vitro (i.e., outside the body and not in the uterus. It grows upto 4-8 cell stage inside the test tube followed by the embryo transplant inside the uterus with the intention to establish pregnancy.

C.

collection of sperms from the testis surgically

Testicular Sperm Aspiration (TESA) involves making a small incision in the testis and examining the tubules for the presence ofsperm. It is recommended to men who are azospermic, due to the congenital absence of the vas deferens or non-reconstructed vasectomy.

C.

A - 3; B - 1; C - 4; D - 2