Chapter 13 — Reproductive Health
Key Concepts Quick Recap
| Term | Definition |
|---|
| Reproductive health | Total well-being — physical, emotional, behavioural aspects of reproduction |
| Contraception | Prevention of pregnancy |
| STD/STI | Sexually transmitted disease/infection |
| Infertility | Inability to conceive after 1 year of unprotected intercourse |
| ART | Assisted Reproductive Technology (IVF, GIFT, ICSI, etc.) |
| MTP | Medical Termination of Pregnancy (legal abortion) |
| Amniocentesis | Prenatal diagnosis via amniotic fluid analysis |
| Vasectomy | Surgical cutting/tying of vas deferens in males |
| Tubectomy | Surgical cutting/tying of fallopian tubes in females |
| IVF | In Vitro Fertilisation — fertilisation outside the body |
I. Choose the Best Answer (MCQs)
1. Which contraceptive method has the highest effectiveness? (a) Condom (b) Oral contraceptive pills (c) Rhythm method (d) Tubectomy
Answer(d) Tubectomy Tubectomy (female sterilisation): bilateral ligation (cutting and tying) of fallopian tubes → permanently prevents eggs from reaching uterus. Effectiveness ~99.9%. Vasectomy (male) is equally effective. Oral pills: ~91-99% (if taken correctly). Condom: ~85-98%. Rhythm method: ~76-88% (least effective hormonal-free method).
2. The oral contraceptive pill works by: (a) Preventing fertilisation only (b) Inhibiting ovulation (c) Killing sperm (d) Preventing implantation only
Answer(b) Inhibiting ovulation Combined OCP (oestrogen + progesterone): inhibit GnRH from hypothalamus → suppress FSH and LH → no follicle development → no ovulation. Also thickens cervical mucus and alters endometrium. Emergency contraceptive pills (high-dose progesterone) taken within 72 hours of unprotected sex.
3. Copper-T works as a contraceptive primarily by: (a) Releasing hormones (b) Creating toxic environment for sperm and preventing implantation (c) Preventing fertilisation in the fallopian tube (d) Covering the cervix
Answer(b) Creating toxic environment for sperm and preventing implantation Copper-T (IUD): copper ions are spermicidal (toxic to sperm). Also alters uterine environment to prevent implantation. Non-hormonal, reversible, effective for 5-10 years. Ideal for women who cannot use hormonal methods.
4. Which of the following is a sexually transmitted disease caused by a virus? (a) Gonorrhoea (b) Syphilis (c) HIV/AIDS (d) Chlamydia
Answer(c) HIV/AIDS
Viral STDs also include: Herpes simplex virus (HSV), Human Papillomavirus (HPV → cervical cancer), Hepatitis B.
- HIV/AIDS: Caused by Human Immunodeficiency Virus → destroys CD4+ T cells → immunodeficiency.
- Gonorrhoea: caused by Neisseria gonorrhoeae (bacterium).
- Syphilis: Treponema pallidum (bacterium).
- Chlamydia: Chlamydia trachomatis (bacterium; most common STI globally).
5. The first test-tube baby was born in: (a) USA (b) India (c) UK (d) Australia
Answer(c) UK Louise Brown — world's first IVF baby — born July 25, 1978, in Oldham, UK. IVF was pioneered by Robert Edwards (Nobel Prize 2010) and Patrick Steptoe. In India, the first test-tube baby (Durga/Kanupriya Agarwal) was born in Kolkata in 1978 (just 67 days after Louise Brown).
6. Amniocentesis is used for: (a) Contraception (b) Prenatal sex determination and genetic diagnosis (c) Treatment of infertility (d) Prevention of STDs
Answer(b) Prenatal sex determination and genetic diagnosis Amniocentesis: sampling of amniotic fluid (10-16 weeks of pregnancy) → foetal cells analysed for chromosomal abnormalities (Down syndrome, Edwards syndrome, spina bifida), genetic disorders (cystic fibrosis, sickle cell disease). Note: Used for sex determination in India is banned under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994.
7. ICSI (Intracytoplasmic Sperm Injection) is used in cases of: (a) Blocked fallopian tubes (b) Severe male infertility (very few sperms) (c) Hormonal imbalance in females (d) Premature ovarian failure
Answer(b) Severe male infertility (very few sperms) ICSI: a single sperm is directly injected into the cytoplasm of an egg under a microscope. Used for: oligospermia (very few sperms), azoospermia (no sperms in ejaculate — surgically retrieved from testis), poor sperm motility. Part of Assisted Reproductive Technology (ART).
II. Short Answer Questions
Q1. Compare different methods of contraception.
Answer
| Method | Type | How it works | Effectiveness |
|---|
| Condom | Barrier | Physical barrier; prevents sperm reaching egg; also prevents STDs | 85-98% |
| OCP (oral pill) | Hormonal | Oestrogen + progesterone; suppresses ovulation | 91-99% |
| Copper-T | IUD | Copper toxic to sperm; prevents implantation | 99% |
| Vasectomy | Surgical | Vas deferens cut/tied; permanent | 99.9% |
| Tubectomy | Surgical | Fallopian tubes cut/tied; permanent | 99.9% |
| Rhythm method | Natural | Avoid sex during fertile days (day 8-17) | 76-88% |
| Lactational amenorrhoea | Natural | Breastfeeding suppresses ovulation | 98% (up to 6 months) |
| Emergency pill | Post-coital | High-dose progesterone; within 72 hours | 75-85% |
Q2. List the major sexually transmitted diseases and their causative agents.
Answer
| Disease | Causative agent | Type |
|---|
| HIV/AIDS | Human Immunodeficiency Virus (HIV) | Virus |
| Herpes genitalis | Herpes Simplex Virus-2 (HSV-2) | Virus |
| Genital warts/HPV | Human Papillomavirus (HPV) | Virus |
| Hepatitis B | Hepatitis B Virus | Virus |
| Gonorrhoea | Neisseria gonorrhoeae | Bacterium |
| Syphilis | Treponema pallidum | Bacterium |
| Chlamydia | Chlamydia trachomatis | Bacterium |
| Trichomoniasis | Trichomonas vaginalis | Protozoan |
Prevention of STDs:
- Abstinence or faithful partner.
- Use of condoms (only method that also prevents STD transmission).
- Avoid sharing needles.
- Voluntary testing and early treatment.
- HPV and Hepatitis B vaccines available.
Common Mistakes
- Saying OCP prevents fertilisation — OCPs primarily prevent OVULATION (no egg released).
- Confusing vasectomy (male, vas deferens) and tubectomy (female, fallopian tubes).
- Saying amniocentesis is used for contraception — it is a prenatal DIAGNOSTIC test.
- Forgetting condom is the ONLY contraceptive that prevents both pregnancy AND STDs.
Exam Checklist
- Most effective contraception: tubectomy/vasectomy (surgical sterilisation).
- OCP: inhibits ovulation (oestrogen + progesterone suppress LH/FSH).
- Copper-T: spermicidal + prevents implantation (non-hormonal IUD).
- Condom: only method preventing STDs AND pregnancy.
- IVF = in vitro fertilisation; ICSI = inject sperm into egg; GIFT = gamete intrafallopian transfer.
- Louise Brown: first IVF baby (1978, UK); Robert Edwards: Nobel Prize 2010.
- Amniocentesis: prenatal genetic diagnosis (not for sex determination in India — banned under PCPNDT Act).
