CHSE Odisha Class 12 Biology Solutions Chapter 4 Reproductive Health

Odisha State Board CHSE Odisha Class 12 Biology Solutions Chapter 4 Reproductive Health Textbook Questions and Answers.

CHSE Odisha 12th Class Biology Chapter 4 Question Answer Reproductive Health

Reproductive Health Class 12 Questions and Answers CHSE Odisha

Very Short Answer Type Questions

Choose the correct options

Question 1.
The method of directly injecting a sperm into an ovum is assisted by reproductive technology called
(a) GIFT
(b) ZIFT
(c) ICSI
(d) ET
Answer:
(c) ICSI

Question 2.
Intensely lactating mothers do not generally conceive due to the
(a) suppression of gonadotropins
(b) hypersecretion of gonadotropins
(c) suppression of gametic transport
(d) suppression of fertilisation
Answer:
(a) suppression of gonadotropins

Question 3.
Which is not a spacing method of family planning?
(a) Natural method
(b) Terminal method
(c) Chemical method
(d) Hormonal method
Answer:
(b) Terminal method

Question 4.
Intrauterine Devices (IUDs) are not made up of
(a) plastic
(b) metal
(c) rubber
(d) Both (a) and (b)
Answer:
(c) rubber

Question 5.
Creams, jelly and foam tablets are chemical contraceptions of which method of birth control?
(a) IUD
(b) Chemical method
(c) Hormonal method
(d) Natural method
Answer:
(b) Chemical method

Question 6.
Which is not a constituent of chemical method?
(a) Lactic acid
(b) Boric acid
(c) Malic acid
(d) Citric acid
Answer:
(c) Malic acid

Question 7.
Which is not a method of tubectomy?
(a) Conventional transabdominal surgery
(b) Conventional laprotomy
(c) Implants
(d) Milaparatomy
Answer:
(c) Implants

Question 8.
In which type of pill, both oestrogen and progestin are present in nearly the same amount?
(a) Monophasic combined
(b) Multiphasic combined
(c) Mini
(d) Antiprogesteron
Answer:
(b) Multiphasic combined

Question 9.
Which is not a type of Intrauterine Device (IUD)?
(a) Vaginal vault
(b) Loops
(c) Spirals
(d) Ts
Answer:
(a) Vaginal vault

Question 10.
Which is not a common type of Sexually Transmitted Disease (STD)?
(a) Genital warts
(b) Syphilis
(c) Cancer
(d) Gonorrhoea
Answer:
(c) Cancer

Question 11.
Which is a fertility treatment for men?
(a) Intrauterine insemination
(b) Erectile dysfunction
(c) Assisted hatching
(d) In vitro fertilisation
Answer:
(a) Intrauterine insemination

Question 12.
Emergency contraceptives are effective if used within
(a) 72 hours of coitus
(b) 72 hours of ovulation
(c) 72 hours of menstruation
(d) 72 hours of implantation
Answer:
(a) 72 hours of coitus .

Question 13.
The correct surgical procedure as contraceptive method is
(a) ovariectomy
(b) hysterectomy
(c) vasectomy
(d) castration
Answer:
(c) vasectomy

Fill in the blanks

Question 1.
The scientific study of human population is called ……………..
Answer:
demography

Question 2.
In India, the sex ratio of 1:1 is found in ………….
Answer:
Kerala

Question 3.
The common brand provided by family welfare services is …………
Answer:
NIRODH

Question 4.
Fern shield is otherwisely known as female ……………
Answer:
condom

Question 5.
Loops and bows are the type of …………….
Answer:
IUDs

Question 6.
Cooper-T has a local ……….. effect.
Answer:
antifertility.

Question 7.
Sponge (Today) is a foam suppository or tablet containing ………….. as spermicides.
Answer:
nonoxynot-9

Question 8.
The example of chemical contraceptive in the form of cream is ……………
Answer:
delfem

Question 9.
An antiprogesterone pill ………… is a single pill treatment for oral contraceptive.
Answer:
mifepristone

Question 10.
The sterilisation procedure in males is called ……….. and in females is called …………. .
Answer:
vasectomy, tubectomy

Question 11.
………. and ……….. are combined injectable contraceptives.
Answer:
Cyclofem, mesigna

Question 12.
Human …………… infection is a known cause of cancer of the cervix.
Answer:
papilloma virus

Question 13.
The method of preserving sperm in frozen condition is called ……………. .
Answer:
sperm banking or semen cryopreservation

Question 14.
The monthly release of eggs is called …………. .
Answer:
ovulation

Question 15.
The ejaculatory duct obstruction in males is confirmed by ………….. .
Answer:
ultrasound test

Question 16.
Fertility treatment with donor eggs is usually done using ………….. .
Answer:
IVF

Express in one or two word(s)

Question 1.
In which state of India, the sex ratio is favourable for females?
Answer:
Kerala

Question 2.
Which device provides protection against sexually transmitted diseases including AIDS?
Answer:
Condom

Question 3.
Which device prevents the entry of sperms into the uterus?
Answer:
Cervical caps

Question 4.
Which toxic substance is released by local antifertility effect of copper-T?
Answer:
Cytokines

Question 5.
What activities are caused due to hormone releasing lUDs?
Answer:
Hormone releasing IUDs result in the prevention of maturation of ovum, so that no ovulation occurs in females.

Question 6.
The chemical method of birth control absorbs, what?
Answer:
Sperms

Question 7.
STDs can be considered as self-invited diseases. Comment.
Answer:
STDs can be self-invited if unprotected sexual intercourse is done with an infected person. Therefore, unprotected sex should be avoided.

Question 8.
Mention the primary aim of the ‘Assisted Reproductive Technology’ (ART) programme .
Answer:
The primary aim of ‘Assisted Reproductive Technology’ (ART) is to cure infertility by successful conception and giving birth to healthy babies.

Question 9.
What is the significance of progesterone – oestrogen combination as a contraceptive, method?
Answer:
The combination of oestrogen and progesterone as contraceptive method inhibits the ovulation. Hence, no egg is made available for pregnancy.

Question 10.
Males whose testes fail to descend to the scrotum are generally infertile, why?
Answer:
Scrotum provides optimum temperature for sperm . production. If testes fail to descend to scrotum, sperms are not formed due to high body temperature.

Question 11.
Name the process of bringing eligible couples under family planning measures.
Answer:
Couple protection.

Short Answer Type Questions

Question 1.
Mention the different barrier methods of family planning.
Answer:
The common barrier methods are condoms, diaphragm, fern shield, cervical cap and vault cap. These are mechanical devices which prevent the release of sperms into the vagina and hence, their passage into the uterus.

Question 2.
What are the different types of IUDs?
Answer:
IUDs are of three types- copper releasing, hormone and non-medicated IUDs.

• Copper releasing IUDs has local antifertility effect by releasing the toxic cytokines.
• Hormone releasing IUDs suppress endometrial changes which cause an ovulation.
• Inert IUDs are made up of polyethylene, impregnated with barium sulphate, their exact mechanism is not clear.

Question 3.
Why copper-T are to be replaced every 3-5 years?
Answer:
Copper-T are to be replaced every 3-5 years when copper release slows down due to calcium deposition.

Question 4.
What changes occur in the endometrium due to inert IUD contraception?
Answer:
Inert IUDs histologically and biochemically change the endometrium, which have gametotoxic and spermicidal effects.

Question 5.
What are the hormone releasing IUDs?
Answer:
Hormone releasing IUDs are contraceptive devices which release small quantities of hormones to suppress endometrial changes and cervical mucous, cause an ovulation and insufficient luteal activity. Hormone releasing IUDs are of three types

• Oral contraceptives
• Non-oral contraceptives
• Emergency contraceptives

Question 6.
What are the different types of hormonal methods of family planning?
Answer:
Hormonal methods of family planning involve the use of oral contraceptives, hormone releasing IUDs, implants, injectable contraceptives and emergency contraceptives.

Question 7.
What are the morning after pills of oral contraceptive?
Answer:
The drugs used in emergency contraception are called morning after pills. They include noral, norgynon and ovidon. An antiprogesterone pill (mifepristone) is a single pill treatment.

Question 8.
Mention the different natural methods of birth control.
Answer:
Natural methods of birth control include

• Safe period or Rhythm method Avoiding sexual intercourse upto 48 hours of an ovulation prevents conception.
• Coitus interruptus Withdrawal of penis before ejaculation.
• Lactational amenorrhea Period of intense breast feeding prevents ovulation and hence, pregnancy.

Question 9.
What are the different ways of tubectomy?
Answer:
Tubectomy is performed by conventional transabdominal surgery, conventional laparoscopy and milaparotomy.

Question 10.
What are the different diseases, which show no symptoms?
Answer:
STDs like chlamydia, genital herpes and gonorrhoea may be present, but express no symptoms, especially in women.

Question 11.
What are the STDs in women, which show no symptoms?
Answer:
STDs like chlamydia, genital herpes and gonorrhoea may be present, but express no symptoms, especially in women.

Question 12.
What is ‘ectopic pregnancy’ ?
Or The pregnancy that occurs outside the uterus is called pregnancy.
Answer:
Ectopic (tubular) pregnancy is a complication of pregnancy in which the embryo attaches outside the uterus.

Question 13.
Name the different types of semen problems.
Answer:
Abnormal semen is responsible for male infertility in more than 75% cases. The following semen problems are possible

• Low sperm count (oligospermia) Sperm count should be 20 million sperms/mL3 of semen. If the count is under 10 million, there is a low sperm concentration.
• No sperm When the man ejaculates, there is no sperm in the semen.
• Low sperm motility The sperm cannot swim as effectively as it should.
• Abnormal sperm Sometimes the sperms have unusual structures, making these more difficult to swim towards the egg and fertilise it.

Differentiate between two words in the following pairs of words

Question 1.
Vasectomy and Tubectomy
Answer:
Differences between vasectomy and tubectomy are as follows

Vasectomy	Tubectomy
It is a sterilisation method of contraception in males.	It is a sterilisation method of contraception in females.
In this method, a small part of the vas deferens is removed or tied up through a small incision on the scrotum.	In this method, a small part of Fallopian tube is removed or tied up through a small incision in the abdomen/vagina.
Man’s body continues to produce sperms, they are simply reabsorbed back into body and not ejaculated.	This keeps egg away from the uterus, site of its fertilisation.

Question 2.
Spacing method and Terminal method
Answer:
Differences between spacing and terminal method are as follows

Spacing method	Terminal method
It is a temporary method.	It is a permanent method.
Birth of children can be planned later in life.	Birth of children cannot be planned after this procedure.
It may use physical barriers, hormones, chemicals, etc., to induce contraception.	It is a surgical procedure to block the passage of sperms and ova.
It includes use of condoms, pills, rhythm method, etc.	It includes methods like vasectomy and tubectomy.

Question 3.
Chemical and Natural methods of birth control.
Answer:
Differences between chemical and natural method of birth control are as follows

Chemical method of birth control	Natural method of birth control
In this, chemicals are used to kill spermatozoa.	It works on the principle of avoiding the chances of sperm meeting an ovum.
Spermicides like creams, foams, jellies which contain lactic acid, citric acid, zinc, sulphate, etc. are used.	They include various methods like periodic abstinence, coitus interrupts or withdrawal and lactational amenorrhea.
In this, chemicals are introduced into the vagina before coitus.	No such chemicals are introduced into the vagina before coitus.

Question 4.
Safe period and Unsafe period.
Answer:
Differences between safe and unsafe period are as follows

Safe period	Unsafe period
Period of monthly cycle minus ± 2 days of ovulation.	Period upto 48 hours after ovulation.
Pregnancy does not occur.	Pregnancy chances are higher during this period,
Body temperature is raised around 1°F above average.	Body temperature dips below average.
Cervical mucous is thick.	Cervical mucous is slippery to allow easy passage of sperm.

Question 5.
Conventional vasectomy and Non-scalpel vasectomy.
Answer:
Differences between conventional and non-scalpel vasectomy are as follows

Conventional vasectomy	Non-scalpel vasectomy
Incision is made on scrotum’s skin with the help of scalpel over the area of vas deferens.	Instead of scalpel, dissecting forceps and ringed forceps are used.
As vas deferens is exposed and cut, the two ends are separated and tied.	The skin is punctured, vas deferens is taken out. It is occulated, followed by ligation of ends.
A gap of 1 -4 cm must be maintained.	A gap of 1 -2 cm is maintained.

Long Answer Type Questions

Question 1.
Discuss the mode of action and advantages / disadvantages of hormonal contraceptives.
Answer:
Hormonal Methods
These are hormones possessing contraceptive properties, usually employed on women for suppressing ovulation. Hormonal methods are of three types-oral contraceptives (oral pills), non-oral hormonal contraceptives and emergency contraceptives.
(i) Oral contraceptives These are the preparations of hormones either progestin or progestin-oestrogen combinations in the form of pills (tablets), used by the females.
These oral contraceptives act in four ways
(a) Inhibition of ovulation.
(b) Alternation in the uterine endometrium to make it unsuitable for implantation.
(c) Modification in cervical mucus secretion to impair the ability of transportation of sperm.
(d) Inhibition of motility and secretory activity of Fallopian tubes.

Oral pills are of following types
1. Pill (combined) It contains the female sex hormones oestrogen and progesterone. Oestrogen prevents development of eggs and ovulation by inhibiting secretion of FSH. Progesterone inhibits LH production; acts on cervical mucous to prevent penetration of sperm. They can also prevent the blastocyst implantation, e.g. Mala-D Mala-L. One pill taken orally each day during first 3 weeks of cycle. After 4 weeks, menstruation starts and the pill is taker) again.

2. Saheli (non-steroidal pill) Selectively, it is a non-hormonal pill that contains centchroman. It acts by inhibiting oestrogen activity. It was developed by Central Drug Research Institute (CDRI), Lucknow. It is taken twice a week for 3 months.

3. Mini pill or Progestin Only Pill (POP) It contains progestin, a synthetic progesterone only. Ovulation may occur, but cervical mucous is thickened, preventing entry of sperms. Must be taken within 3 hours of same time every day, but newer generation have the relaxations of 12 hours.

(ii) Non-oral Contraceptives
These are categorised as of following two types ,
1. Injectables hormone injections (Depo-Provera) are progestin derivative preparations.
They are convenient and highly effective with no side effects. These injectables inhibit the release of hormone to prevent ovulation.
For example, Depot-Medroxy Progesterone Acetate (DMPA) with dose of 150 mg every 3 months or 300 mg for 6 months and Norethisternone Enanthate (NET EN) with dose 200 mg every 2 months.
Cyclofem and mesigna are combined injectable – contraceptives that contain progestin and oestrodiol.

2. Implant (Norplant) is a new method of ‘ contraception, which is inserted under the skin inside upper arm or forearm through a small incision.
Though, these act similarly to oral contraceptives by blocking ovulation and thickening the cervical mucous, to prevent sperm transport, their effective periods are longer. One implant is effective for about five years.
Implanon is a single rod-like device (40 mm x 2mm). It is implanted through a wide bored needle. It contains about 60mg of 3-keto desogestrel and remains functional for three years. Norplant is progestin device contains six small permeable capsules (34 mm x 2.4 mm). Each capsule comprises of 36 mg levonorgestrel.
Norplant is effective for 5 years.

3. Emergency contraceptives (Morning-After Pills) These are the most common form of kits which consist of high dose of birth control pills.
These, if taken within 72 hours of coitus have been very effective as emergency contraceptives as they could avoid possible pregnancy due to rape or casual unprotected intercourse. Their side effects are menstrual irregulation, vomiting, etc., e.g. I-pill, pill-72, unwanted-72, mifepristone (antiprogesterone pill), norigynon, ovidon and ovral. Oral pills are taken two tablets at begining and two tablets in later 12 hours give result to prevent implantation.

Question 2.
What are advantages of natural methods of contraceptive over artificial methods?
Answer:
Natural methods of contraceptives are safe and they do not pose any threat in future. But, these methods are not reliable. In contrast, artificial methods leads to many complications like abdominal pain, hair less or unwanted facial hair, infection in reproductive tract (due to IUDs), hormonal imbalance, etc. Natural methods are easy and safe to use, but do not demand any cost and also does not interfere with the sexual drive of humans.

Natural/Traditional Methods:
These methods are based on the principle of avoiding chances of sperms and ovum meeting.
Some of them are as follows
1. Periodic abstinence (or Rhythm method) It is a method in which couples avoid coitus (intercourse) from 10 to 17th days of the menstrual cycle, because ovulation can occur mosdy during this time (it is called the fertile period). Thus, by abstaining from coitus during this period, conception could be prevented. This method is also known as rhythm period or safeperiod.

2. Coitus interruptus or Withdrawal In this method, the male partner withdraws his penis from the vagina just before ejaculation so as to avoid insemination.

3. Lactational amenorrhea (Absence of menstruation) From ancient times, women have extended breast feeding so, as to avoid a new pregnancy.
It refers to the absence of menstruation during the period of intense lactation following parturition. Because ovulation does not occur in this period, the chances of conception are almost nil. This method is reliable for a maximum period of six months following delivery. Side effects are almost nil, but chances of failure of this method are high.

Question 3.
Why are the assisted reproductive techniques practised to help infertile couples? Describe any three techniques.
Answer:
Due to certain issues both men and women suffer from infertility. Some women are also unable to conceive normally. There are several methods that are practiced under Assisted Reproductive Technologies to help such women to conceive.

1. Intrauterine Insemination (IUI):
A fine catheter is inserted through the cervix, into the uterus to place a sperm sample directly into the uterus. This procedure may be done when ovulation occurs.
The woman may be administered a low dose of Luteinizing Hormone (LH) before the practice to initiate ovulation. This method is also applicable in men having low sperm count and severe erectite dysfunction.

2. Donation of Sperms or Eggs:
If partners are unable to produce eggs or sperms then they can receive eggs or sperms from a donor. The egg is fertilised in vitro and transplanted into the uterus of pseudopregnant woman.

3. Gamete Intra Fallopian Transfer (GIFT):
The ovum collected from donor is transferred to the Fallopian tube of another female, who cannot produce ova, but can provide a suitable environment for fertilisation and further development.
This is termed as Gamete Intra Fallopian Transfer (GIFT). This technique was first attempted by Steptoe and Edwards and later led by Lichardo Ascho.

4. Assisted Hatching
It improves the possibilites of the implantation of embryo on the wall of uterus. In this method, an opening or small hole is created on the outer membrane of embryo, i.e. zona pellucida by an expert practitioner. This opening enables the embryo to leave its shell and get implanted into the uterine lining. This method is also useful in unsuccessful IVF [In Vitro Fertilisation) procedures or when the female is unable to produce good quality of eggs, i. e. at the age of above 35 years.

5. Electrical or Vibratory Simulation to Induce Ejaculation:
Men who are unable to ejaculate naturally are provided with the electrical or vibratory simulations.

6. Surgical Sperm Aspiration:
In this method, the semen is removed from the male reproductive tract (vas deferens or epididymis) of a person’ who himself cannot ejaculate during coitus. This procecjure is done through minor surgery.

7. In Vitro Fertilisation (IVF):
It is a technique in which fertilisation occurs outside the female body. It is followed by the embryo transfer in which embryo is placed inside the uterus. This method is also called as test tube baby technique because sperms are placed with unfertilised eggs in petridish for fertilisation. Donated sperms or eggs can be used in this purpose. IVF techinque can also be employed in gestational surrogacy.
In this case, fertilised egg is implanted in the uterus of surrogate mother.

Surrogacy is banned in few countries because it is unethical to build business on women’s reproductive capabilites. The practice of surrogacy is expensive too. Thus, these two obstacels has opened a new area of tourism, i.e. fertility tourism in those countries where surrogacy is comparatively cheaper.

Question 4.
Give an account of Medical Termination of Pregnancy (MTP).
Answer:
Medical Termination of Pregnancy (MTP):
Intentional or voluntary termination (abortion) of pregnancy before full term or before the foetus becomes viable is called Medical Termination of Pregnancy (MTP). Nearly 45-50 million MTPs are performed in a year all over the world which accounts to 1/5th of the total number of conceived pregnancies in a year.

Government of India legalised MTP in 1971 with some strict conditions to avoid its misuse, especially to check indiscriminate and illegal female foeticides, which are reported to be high in India.

Misoprostol (a prostaglandin) combined with mifepristone (antiprogesterone) is an effective combination to terminate pregnancy. Vacuum aspiration and surgical procedure are also used for medical termination of pregnancy.

Question 5.
Discuss the spacing method and intrauterine devices of family planning.
Answer:
Intrauterine Devices (IUDs) or Intrauterine Contraceptive Devices (IUCDs)
They are made up of plastic, metal or combination of both. They are called loops, spirals, rings, bows or shields. These devices contain either copper or progesterone and are inserted by doctors in the uterus through vagina. These are a form of long reversible contraceptive method.

They may be categorised as
1. Copper releasing IUDs They are commonly called copper-Ts having ionised copper. It slowly diffuses at the rate of around 50 mg/day. It has a local antifertility effect by bringing about the release of toxic cytokines.
The device is to replaced every 3-5 years when copper release slows down due to calcium deposition, e.g. Cu-T, Cu-7, Multiload 375 and paragard.
2. Hormone releasing IUDs, e.g. Progestasert, LNG-20, Mirena are some of the well-known hormone releasing IUDs.
3. Non-medicated or Inert IUDs These are made up – of polyethylene, barium sulphate impregnated or stainless steel.

IUDs prevent contraception in the following ways

• By increasing phagocytosis of sperms within the uterus.
• By suppressing the sperm motility and fertilising ability of sperms by releasing Cu ions.
• The hormone releasing IUDs make the uterus unsuitable for implantation.
• IUDs are also suppress endometrial changes and cervical mucus, cause an ovulation and insufficient luteal activity.
• IUDs are ideal contraceptives for females who want to maintain space among children and/or delay pregnancy. It is one of most widely accepted methods of contraception in India.

Chemical Methods:
Spermicides available in the form of creams (e.g. delfem) jellies (e.g. perception, volpar) and foam tablets (e.g. aerosol foam, chlorimin-T or contab) are usually used along with the above stated barrier methods to increase their contraceptive efficiency.

Placed in vagina to cover lining of vagina and cervix. Effective for about 1 hour. These are applied at the surface of vagina before intercourse. These contain spermicides (that kill spermatozoa) such as lactic acid, citric acid, boric acid, zinc sulphate and potassium permanganate. These can be used by anyone who is not allergic to these spermicides.

Now-a-days Sponge is a foam suppository or tablet containing nonoxyneet-9 as a spermicide. Fitted over cervix upto 24 hours before intercourse. It should be left in place atleast 6 hours after intercourse.

Hormonal Methods:
These are hormones possessing contraceptive properties, usually employed on women for suppressing ovulation. Hormonal methods are of three types-oral contraceptives (oral pills), non-oral hormonal contraceptives and emergency contraceptives.
(i) Oral contraceptives These are the preparations of hormones either progestin or progestin-oestrogen combinations in the form of pills (tablets), used by the females.

These oral contraceptives act in four ways

• Inhibition of ovulation.
• Alternation in the uterine endometrium to make it unsuitable for implantation.
• Modification in cervical mucus secretion to impair the ability of transportation of sperm.
• Inhibition of motility and secretory activity of Fallopian tubes.

Oral pills are of following types
(a) Pill (combined) It contains the female sex hormones oestrogen and progesterone. Oestrogen prevents development of eggs and ovulation by inhibiting secretion of FSH. Progesterone inhibits LH production; acts on cervical mucous to prevent penetration of sperm. They can also prevent the blastocyst implantation, e.g. Mala-D Mala-L. One pill taken orally each day during first 3 weeks of cycle. After 4 weeks, menstruation starts and the pill is taker) again.

(b) Saheli (non-steroidal pill) Selectively, it is a non-hormonal pill that contains centchroman. It acts by inhibiting oestrogen activity. It was developed by Central Drug Research Institute (CDRI), Lucknow. It is taken twice a week for 3 months.

(c) Mini pill or Progestin Only Pill (POP) It contains progestin, a synthetic progesterone only. Ovulation may occur, but cervical mucous is thickened, preventing entry of sperms. Must be taken within 3 hours of same time every day, but newer generation have the relaxations of 12 hours.

(ii) Non-oral Contraceptives
These are categorised as of following two types
(a) Injectables hormone injections (Depo-Provera) are progestin derivative preparations.
They are convenient and highly effective with no side effects. These injectables inhibit the release of hormone to prevent ovulation.
For example, Depot-Medroxy Progesterone Acetate (DMPA) with dose of 150 mg every 3 months or 300 mg for 6 months and Norethisternone Enanthate (NET EN) with dose 200 mg every 2 months.
Cyclofem and mesigna are combined injectable-contraceptives that contain progestin and oestrodiol.

(b) Implant (Norplant) is a new method of contraception, which is inserted under the skin inside upper arm or forearm through a small incision.
Though, these act similarly to oral contraceptives by blocking ovulation and thickening the cervical mucous, to prevent sperm transport, their effective periods are longer. One implant is effective for about five years.

Implanon is a single rod-like device (40 mm x 2mm). It is implanted through a wide bored needle. It contains about 60mg of 3-keto desogestrel and remains functional for three years. Norplant is progestin device contains six small permeable capsules (34 mm x 2.4 mm). Each capsule comprises of 36 mg levonorgestrel.
Norplant is effective for 5 years.

(iii) Emergency contraceptives (Morning-After Pills) These are the most common form of kits which consist of high dose of birth control pills.

These, if taken within 72 hours of coitus have been very effective as emergency contraceptives as they could avoid possible pregnancy due to rape or casual unprotected intercourse. Their side effects are menstrual irregulation, vomiting, etc., e.g. I-pill, pill-72, unwanted-72, mifepristone (antiprogesterone pill), norigynon, ovidon and ovral. Oral pills are taken two tablets at begining and two tablets in later 12 hours give result to prevent implantation.

Natural/Traditional Methods:
These methods are based on the principle of avoiding chances of sperms and ovum meeting.
Some of them are as follows
(i) Periodic abstinence (or Rhythm method) It is a method in which couples avoid coitus (intercourse) from 10 to 17th days of the menstrual cycle, because ovulation can occur mosdy during this time (it is called the fertile period). Thus, by abstaining from coitus during this period, conception could be prevented. This method is also known as rhythm period or safeperiod.

(ii) Coitus interruptus or Withdrawal In this method, the male partner withdraws his penis from the vagina just before ejaculation so as to avoid insemination.

(iii) Lactational amenorrhea (Absence of menstruation) From ancient times, women have extended breast feeding so, as to avoid a new pregnancy.

It refers to the absence of menstruation during the period of intense lactation following parturition. Because ovulation does not occur in this period, the chances of conception are almost nil. This method is reliable for a maximum period of six months following delivery. Side effects are almost nil, but chances of failure of this method are high.

Medical Termination of Pregnancy (MTP):
Intentional or voluntary termination (abortion) of pregnancy before full term or before the foetus becomes viable is called Medical Termination of Pregnancy (MTP). Nearly 45-50 million MTPs are performed in a year all over the world which accounts to 1/5th of the total number of conceived pregnancies in a year.

Government of India legalised MTP in 1971 with some strict conditions to avoid its misuse, especially to check indiscriminate and illegal female foeticides, which are reported to be high in India.

Misoprostol (a prostaglandin) combined with mifepristone (antiprogesterone) is an effective combination to terminate pregnancy. Vacuum aspiration and surgical procedure are also used for medical termination of pregnancy.

Question 6.
Give an account of risk factors of infertility.
Answer:
Some Risk Factors of Infertility
These are as follows

1. Age A woman’s fertility starts to drop when she is above 32 years old or more. A 50 year old man is less fertile than a man in his 20 year (male fertility begins to drop after the age of 40).
2. Smoking It significantly increases the risk of infertility in both men and women. It may also undermine the effects of fertility treatment. When a pregnant woman smokes she develops a higher risk of miscarriage.
3. Alcohol consumption A woman’s pregnancy can be seriously affected by alcohol consumption. Alcohol abuse may lower’ male fertility. Moderate alcohol consumption ‘has not been shown to lower fertility in most men, but is thought to lower fertility in men who already have a low sperm count.
4. Obese or Overweight In developed countries, overweight (obesity) and a sedentary lifestyle are the principal causes of female and male infertility. An overweight man may suffer from lower sperms count or form abnormal sperms.
5. Eating disorders Women who are in the category of serious underweight may have fertility problems.
6. Being vegetarian If a person is on a strict vegetarian diet, he/she must make sure that intake of iron, folic acid, zinc and vitamin-B12 should be adequate in a diet, fertility may be affected.
7. Overexercise A woman who exercises for more than seven hours every week may have ovulation problems.
8. Sedentary life-style Leading a sedentary life-style may increase the chance of lower fertility in both men and women.
9. Sexually Transmitted Infections (STls) Chlamydia can damage the Fallopian tubes and influences man’s scrotum. Some other STls may also cause infertility.
10. Exposure to some chemicals Some pesticides, herbicides, heavy metals (lead) and solvents may cause fertility problems in both men and women.
11. Mental stress Studies indicate that ovulation and sperms production may be affected by mental- stress. If a partner is stressed, than the frequency of sexual intercourse decreases, resulting in a lower chance of conception.

Question 7.
Describe the various causes of infertility in women.
Answer:
Causes of Infertility in Women
(i) Ovulation disorders Problems with ovulation are the • common causes of infertility in women. Ovulation is the monthly release of an egg. Some women never release eggs, while some do not release eggs during regular cycles.

Ovulation disorders can be due to

1. Premature ovarian failure The ovaries stop functioning properly before 40 years of age.
2. PCOS (Polycystic Ovary Syndrome) The ovaries function abnormally. Such women have abnormally high levels of androgens. About 5% to 10% of women in the reproductive age range are affected by this syndrome.
3. Hyperprolactinemia If the prolactin is high to those women who are not pregnant or not in breast feeding period, then they may effect of an ovulation and infertility.
4. Poor egg quality Eggs that are damaged or develop genetic abnormality cannot sustain a pregnancy. Older women are at a higher risk.

(ii) Problems in the uterus or Fallopian tubes The egg travels from the ovary to the uterus (womb) through the Fallopian tube, where the fertilisation of the egg takes place. If there is something wrong in the uterus or the Fallopian tubes the woman may not be able to conceive naturally.
This may be due to

1. Surgery Pelvic surgery may sometimes cause damage to the Fallopian tubes. Cervical surgery may sometimes cause shortening of the cervix. The cervix is the neck of the uterus.
2. Submucosal fibroids Benign or non-cancerous tumours found in the muscular wall of the uterus, occurr in 30-40% of women in the child bearing age. They may interfere with implantation. They may also block the Fallopian tube preventing sperm from fertilising the egg. Large submucosal uterine fibroids make the uterus cavity bigger, increasing the distance the sperm has to travel.
3. Endometriosis Cells that are normally found within the lining of the uterus start growing elsewhere in the body.
4. Previous sterilisation treatment If a woman has her Fallopian tubes blocked, it is possible to reverse the process. But, the chances of becoming fertile again are low.

(iii) Medications Some drugs can affect the fertility of a woman. These include

1. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) Women who take aspirin or ibuprofen in a long term may find it harder to conceive.
2. Chemotherapy Some medications used in chemotherapy can result in ovarian failure. In some cases, this side effect of chemotherapy may be permanent.
3. Radiotherapy If radiation therapy is aimed near the woman’s reproductive organs, there is a higher risk of fertility problems.
4. Illegal drugs Some women who take marijuana or cocaine may have fertility problems.

Question 8.
What is Sexually Transmitted Diseases (STDs)? Give an account of the prevention and treatment of STDs.
Answer:
Sexually Transmitted Diseases (STDs) are the diseases that are mainly passed from one person to another during sexual intercourse. They are also known as Venereal Diseases (VDs) or Reproductive Tract Infections (RTls). These can be prevented by avoiding unprotected sexual intercourse.

Prevention and Treatment It is much easier to prevent STDs than treating. The only way to completely prevent STDs is to abstain from all types of sexual contact. If some one is going to have intercourse, the best way to reduce the chance of getting an STD is by using a condom. People who are in the habit of having frequent sexual contract should get regular gynaecological or male genital examinations.

There are two benefits from this. First, these examinations give the doctor an opportunity to teach people about the consequences of contracting STDs and the methods of protecting themselves. Secondly, regular examinations give a better opportunity for an effective treatment, while the infections are in their earliest.

The visiting person needs to disclose all facts about his / her sexual contact to the physician without fear, so that the physician decides on a course of action. Consequently, the physician will prescribe an investigation and then an effective treatment schedule.
If the person feels embarassed to visit a physician, with whom he/she is familiar, he/she may seek the assistance of experts by calling STD hotline operated by some national organisations.

The experts will advice in respect of the STD clinics undertaking the investigation and treatment. In doing so a confidentiality about the identity of the person in question is maintained.

Not all infections in the genitalia are caused by STDs. Sometimes, people may express symptoms that are . similar to those of STDs, although they have never had sex. For example, in girls, a yeast infection is sometimes confused with an STD. Males may worry about bumps on the penis that turn out to be pimples or irritated hair follicles. It is therefore, important to visit a physician to solve many of the above mentioned problems.

Question 9.
How infertility in men and women can be diagnosed by tests?
Answer:
Tests for Females:

1. General physical examination is cross examination of female patient by the gynaecologist about her medical history, menstrual cycle and sexual habits. The gynaecologist may also examine some other gynaecological habits.
2. Blood test is analysis of the blood sample to check the female hormone levels and also ovulation period in women.
3. Hysterosalpingography is radio-opaque fluid which when injected into the woman’s uterus appears on the X-ray film. X-rays are taken to know about blockages in the uterus and Fallopian tubes.This is followed by a surgery to rectify the problem.
4. Ovarian reserve testing is done to find out of effectiveness of the eggs after ovulation.
5. Pelvic ultrasound is the sonography of the pelvic region of the female to know about the normal structures of the ovary, uterus and Fallopian tube.
6. Thyroid function test checks the fertility of women due to thyroid malfunctions. According to National Health Service (UK), between 1.3% and 5.1% of women are suffering thyroid disease. This test is undertaken and used to correct it by medication.

Tests for Males

1. General physical examination is done by the andrologist (physician specialised in male reproduction) when he knows about the patient medical history, medications and sexual habits. The physician is also examine of his genitals. The testicles are also checked for lumps or deformities, while the shape and structure of penis are examined for any abnormality.
2. Semen analysis is the analysis of semen, sperm count, motility, colour, quality and infections in a laboratory.
3. Blood analysis is analysis of testosterone and other male hormone concentrations in blood.
4. Ultrasound test is used to detect any ejaculatory duct obstruction, retrograde ejaculation or other abnormal functioning.
5. Chlamydia test is used to dignose chlamydia in man.

Question 10.
Describe the treatment options for infertility in men and women.
Answer:
Treatment for Infertility:
The treatment of infertility depends on many factors
including age, medical issues, personal choice, etc., of patient.

Fertility Treatment for Women:
1. Ovulation disorders It can be treated by drugs including Clomifene, Metformin, Bromocriptine, HMG, FSH, Human chorionic gonadotropins, GnRH, etc.

2. Surgical Procedure for Women
(a) Fallopian tube surgery If the Fallopian tubes are blocked or scarred, surgery may repair them and make them easier for eggs to pass through them.
(b) Laparoscopic surgery A small incision is made in the woman’s abdomen. Laparoscope is inserted through the incision. In endometriosis, laparoscopy removes implants and scar tissue restoring fertility.

Fertility Treatment for Men:

• Erectile dysfunction or Premature ejaculation Medication and/or some behaviour approaches can help men to improve general sexual problems and fertility.
• Blockage of the ejaculatory duct In case of blockage sperms are extracted direcdy from the testicles and injected into an egg in vitro in the laboratory condition.
• Retrograde ejaculation Sperms are directly taken from the bladder for injecting into an egg in vitro.
• Surgery for epididymal blockage If the epididymis is blocked, it can be surgically repaired and sperms can be ejaculated properly.