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NEET Biology: Reproduction · Chapter 3

Reproductive Health

What to remember

  • Reproductive health means total well-being in all aspects of reproduction: physical, emotional, behavioural and social. It is not only the absence of disease.
  • Contraceptive methods: natural (periodic abstinence, coitus interruptus, lactational amenorrhea), barrier (condoms, diaphragms, cervical caps, vaults), IUDs, oral pills, injectables and implants, emergency contraception and surgical sterilisation (vasectomy, tubectomy).
  • Medical termination of pregnancy (MTP) is legal in India and is safest in the first trimester. Sexually transmitted infections (STIs) are prevented by safe sexual behaviour and condoms.
  • Assisted reproductive technologies: IVF with ZIFT or IUT, GIFT, ICSI and artificial insemination (IUI). In ZIFT the zygote or an embryo of up to 8 blastomeres goes into the fallopian tube. In IUT an embryo of more than 8 blastomeres goes into the uterus.

Meaning of reproductive health

The World Health Organization (WHO) defines reproductive health as a total well-being in all aspects of reproduction: physical, emotional, behavioural and social. A society with people having physically and functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex-related aspects might be called reproductively healthy.

Problems and strategies

India was among the first countries in the world to initiate family planning programmes, in 1951. The programmes were improved over the years and are now covered under the wider Reproductive and Child Health Care (RCH) programmes. These programmes create awareness about reproduction-related aspects and provide facilities and support for building a reproductively healthy society.

StrategyPurpose
Sex education in schoolsGives correct information about reproductive organs, adolescence, safe and hygienic sexual practices, STIs and AIDS, and removes myths and misconceptions
Awareness through audio-visual and print media, and by government and non-government agenciesInforms people about reproduction, birth control and STIs
Medical facilitiesProvide care of pregnant and lactating mothers, post-natal care of mother and child, and care of the new-born
Statutory ban on amniocentesisPrevents sex-determination tests that can lead to female foeticide
Research on new contraceptivesDevelops better and safer methods

Amniocentesis is a foetal sex-determination test based on the chromosomal pattern in the amniotic fluid. It is banned for sex determination, although it is allowed for detecting genetic disorders.

Good reproductive health also includes a sound infrastructure, detection of STIs, and timely help for problems such as infertility. Awareness of problems of a growing population is also a part of this effort.

Population stabilisation and birth control

Rapid growth of the population needs control. Contraception is used to prevent unwanted pregnancy. An ideal contraceptive should be user-friendly, easily available, effective, and reversible, with no or least side effects. It should also not interfere with the sexual drive, desire or the sexual act.

A rapidly growing population puts pressure on food, housing and health services. The main steps to reduce population growth are to motivate smaller families by using slogans or advertisements, to educate couples about the use of contraceptives, and to raise the marriageable age. Government agencies also provide incentives to couples with small families. These steps help to keep the population stable, which is called population stabilisation. Contraceptive methods are of many kinds: natural, barrier, intra-uterine devices, oral, injectable and implants, and surgical.

Natural or traditional methods. These try to prevent the ovum and sperm from meeting.

MethodHow it works
Periodic abstinenceThe couple avoids or abstains from coitus from day 10 to 17 of the menstrual cycle, because ovulation is expected in this period (the fertile period)
Withdrawal (coitus interruptus)The male withdraws the penis from the vagina just before ejaculation, so semen is not deposited in the vagina
Lactational amenorrheaAbsence of menstruation during intense lactation after parturition; ovulation and cycles do not occur. It is effective as a method only up to about six months after delivery

These methods have no side effects, but their chances of failure are higher.

Barrier methods. These prevent the sperm from physically meeting the ovum.

  • Condoms: thin rubber/latex sheaths worn on the penis (male) or in the vagina and cervix (female). They also protect against STIs, including AIDS. Condoms are disposable and can be self-use. An example brand name in India is Nirodh.
  • Diaphragms, cervical caps and vaults: reusable rubber barriers that cover the cervix in the female reproductive tract. They also block the entry of sperm through the cervix.

Spermicidal creams, jellies and foams are often used along with these barriers to increase their contraceptive efficiency.

Intra-uterine devices (IUDs). These are inserted by a doctor or a nurse into the uterus through the vagina. They are ideal for females who want to delay pregnancy or space children.

TypeExamplesAction
Non-medicatedLippes loopMechanical, increases phagocytosis of sperms
Copper releasingCuT, Cu7, Multiload 375Copper ions suppress sperm motility and the fertilising capacity of sperms
Hormone releasingProgestasert, LNG-20Make the uterus unsuitable for implantation and the cervix hostile to sperms

Oral contraceptives (pills). These contain progestogens or a progestogen–estrogen combination. They are used by females in the form of tablets. The pills are taken daily for 21 days, starting preferably within the first five days of the menstrual cycle. After a gap of 7 days (during which menstruation occurs), the pills are taken again in the same pattern. They inhibit ovulation and implantation, and alter the quality of cervical mucus so that sperm entry is retarded. Saheli is a non-steroidal pill. It is taken once a week, was developed at the Central Drug Research Institute (CDRI), Lucknow, and has few side effects and high contraceptive value.

Injectables and implants. Progestogens alone, or in combination with estrogen, can also be used as injections or as implants under the skin. Their mode of action is similar to that of the pills, and they have a much longer-lasting effect.

Emergency contraception. Administration of progestogens or progestogen–estrogen combinations, or the use of IUDs, within 72 hours of coitus has been found to be very effective as emergency contraception. It can be used to avoid possible pregnancy after unprotected coitus or rape.

Surgical methods (sterilisation). These are advised for the male or the female partner as a terminal method to prevent any more pregnancies. They are highly effective but their reversibility is very poor.

MethodPartnerProcedure
VasectomyMaleA small incision is made on the scrotum and the vas deferens is cut and tied
TubectomyFemaleA small incision is made in the abdomen or through the vagina and the fallopian tubes are cut and tied

Medical termination of pregnancy (MTP)

Intentional or voluntary termination of pregnancy before full term is called MTP, or induced abortion. MTPs are used to get rid of unwanted pregnancies due to casual unprotected intercourse or failure of a contraceptive used during coitus. They are also necessary in cases where continuation of the pregnancy could be harmful or even fatal to the mother or the foetus, or both.

The Government of India legalised MTP in 1971 with strict conditions to avoid its misuse, and the Act was amended later. MTP is considered relatively safe during the first trimester, up to 12 weeks of pregnancy. Second-trimester abortions are much more risky. The legal conditions are meant to prevent female foeticide.

Sexually transmitted infections (STIs)

Infections or diseases that are transmitted through sexual intercourse are collectively called sexually transmitted infections (STIs), or venereal diseases (VD), or reproductive tract infections (RTI).

Examples
Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and HIV leading to AIDS

Hepatitis-B and HIV can also spread by sharing of injection needles, surgical instruments and blood transfusion, and from an infected mother to the foetus. Except for hepatitis-B, genital herpes and HIV infections, the other diseases are completely curable if detected early and treated properly.

Early symptoms are minor: itching, fluid discharge, slight pain and swelling in the genital region. Often these are not noticed, especially in females. Complications include pelvic inflammatory diseases (PID), abortions, stillbirths, ectopic pregnancies, infertility, and cancer of the reproductive tract.

STIs are a serious public health concern because many infected persons show no early signs and can pass the infection on without knowing it. Infection can also pass from an infected mother to the new-born in some cases. Persons in the age group of 15–24 years are reported to have a high incidence of these infections.

Prevention.

  • Avoid sex with unknown partners or multiple partners.
  • Always use condoms during coitus.
  • In case of doubt, consult a qualified doctor for early detection and complete treatment of the disease.

Infertility and assisted reproductive technologies

Infertility is the inability to conceive or produce children in spite of unprotected sexual cohabitation. The causes may be physical, congenital, diseases, drugs, immunological or even psychological. Specialised health care units (infertility clinics) help couples with infertility by using certain special techniques called assisted reproductive technologies (ART).

TechniqueProcedure
IVF (in vitro fertilisation)Ova from the wife or a donor female and sperms from the husband or a donor male are collected and induced to form a zygote under simulated conditions in the laboratory (the "test tube baby" programme)
ZIFT (zygote intra-fallopian transfer)The zygote or early embryo (up to 8 blastomeres) is transferred into the fallopian tube
IUT (intra-uterine transfer)An embryo with more than 8 blastomeres is transferred into the uterus
GIFT (gamete intra-fallopian transfer)An ovum collected from a donor is transferred into the fallopian tube of another female who cannot produce ova but can provide a suitable environment for fertilisation and development
ICSI (intra-cytoplasmic sperm injection)A sperm is directly injected into the ovum in the laboratory to form an embryo
Artificial insemination (AI)Semen from the husband or a healthy donor is artificially introduced into the vagina or into the uterus (IUI, intra-uterine insemination) of the female. It helps when the male cannot inseminate or has a low sperm count

The group of methods can be read as a simple sequence. Gametes are collected from the husband or donors. Fertilisation is done in the laboratory in IVF and ICSI, or inside the female tract in GIFT and artificial insemination. Then the zygote or embryo is placed in the fallopian tube (ZIFT) or the uterus (IUT). The choice of method depends on the cause of infertility. For example, ICSI is useful when sperms cannot penetrate the ovum, and artificial insemination is used when the male partner cannot inseminate or has a low sperm count.

In IVF, the embryo formed is transferred into the female genital tract to complete its further development. In ZIFT and IUT the embryo comes from laboratory fertilisation, while in GIFT the fertilisation takes place inside the body. These methods require a lot of expertise and are expensive. Emotional, religious and social issues may arise, and couples may also consider adoption.

NEET traps

  • 1. ZIFT vs IUT: ZIFT puts the zygote or an embryo of up to 8 blastomeres in the fallopian tube. IUT puts an embryo of more than 8 blastomeres in the uterus.
  • 2. ZIFT vs GIFT: ZIFT transfers a zygote or early embryo. GIFT transfers a gamete (ovum) and fertilisation is inside the body.
  • 3. ICSI vs IUI: ICSI injects one sperm into one ovum in the laboratory. IUI places semen in the uterus.
  • 4. Vasectomy vs tubectomy: vasectomy cuts the vas deferens (male). Tubectomy cuts the fallopian tubes (female).
  • 5. CuT vs Progestasert: CuT releases copper. Progestasert (and LNG-20) release hormones.
  • 6. Lippes loop vs CuT: Lippes loop is non-medicated. CuT, Cu7 and Multiload 375 release copper.
  • 7. Saheli vs usual pills: Saheli is non-steroidal and taken weekly. The usual pills are hormonal and taken daily for 21 days.
  • 8. Periodic abstinence vs lactational amenorrhea: the first avoids coitus around day 10–17. The second depends on absence of cycles during intense lactation (up to about six months).
  • 9. Barrier methods and STIs: condoms protect against STIs, but IUDs and pills do not.
  • 10. Curable vs incurable STIs: hepatitis-B, genital herpes and HIV are not completely curable, while gonorrhoea and syphilis are.

One-liners

  • 1. The WHO defines reproductive health as total well-being in physical, emotional, behavioural and social aspects of reproduction.
  • 2. India started family planning programmes in 1951.
  • 3. RCH stands for Reproductive and Child Health Care.
  • 4. Amniocentesis for sex determination is banned by law.
  • 5. The fertile period in a cycle is about days 10 to 17.
  • 6. Lactational amenorrhea works as contraception for up to about six months after delivery.
  • 7. Condoms are the only listed contraceptive that also protect against STIs, including AIDS.
  • 8. Lippes loop is a non-medicated IUD.
  • 9. Cu7, CuT and Multiload 375 release copper ions.
  • 10. Progestasert and LNG-20 are hormone-releasing IUDs.
  • 11. Oral pills are taken for 21 days, then there is a gap of 7 days.
  • 12. Saheli is a once-a-week non-steroidal pill developed at CDRI, Lucknow.
  • 13. Emergency contraception should be used within 72 hours of coitus.
  • 14. MTP is relatively safe in the first trimester (up to 12 weeks).
  • 15. Test tube baby programme is IVF followed by embryo transfer.

Practice questions

  1. Reproductive health, as defined by the WHO, means

    1. total well-being in the physical, emotional, behavioural and social aspects of reproduction
    2. only the absence of reproductive diseases
    3. the ability to conceive within one year
    4. the use of contraceptives by all couples
    Answer

    A. total well-being in the physical, emotional, behavioural and social aspects of reproduction

    Reproductive health covers complete well-being, not just absence of disease.

  2. India started its family planning programmes in the year

    1. 1921
    2. 1951
    3. 1991
    4. 1971
    Answer

    B. 1951

    India was among the first countries to start such programmes, in 1951.

  3. Periodic abstinence is based on avoiding coitus during the fertile period, which is about days

    1. 1 to 5 of the menstrual cycle
    2. 3 to 8 of the menstrual cycle
    3. 20 to 28 of the menstrual cycle
    4. 10 to 17 of the menstrual cycle
    Answer

    D. 10 to 17 of the menstrual cycle

    Ovulation is expected around days 10 to 17.

  4. The Lippes loop is a

    1. barrier method that covers the cervix
    2. hormone-releasing intra-uterine device
    3. non-medicated intra-uterine device
    4. copper-releasing intra-uterine device
    Answer

    C. non-medicated intra-uterine device

    Lippes loop is non-medicated; CuT, Cu7 and Multiload 375 release copper.

  5. CuT acts mainly by releasing

    1. estrogen that thickens the endometrium
    2. copper ions that suppress sperm motility
    3. progestogen that inhibits ovulation
    4. spermicide that blocks the cervix
    Answer

    B. copper ions that suppress sperm motility

    Copper ions reduce sperm motility and fertilising capacity.

  6. Saheli, developed at CDRI Lucknow, is

    1. a copper-releasing IUD
    2. an injectable implant
    3. a non-steroidal oral pill taken once a week
    4. a steroidal pill taken for 21 days
    Answer

    C. a non-steroidal oral pill taken once a week

    Saheli is non-steroidal, weekly and has few side effects.

  7. Emergency contraception is effective if used within

    1. 7 days of coitus
    2. 1 month of coitus
    3. 72 hours of coitus
    4. 6 hours of coitus only
    Answer

    C. 72 hours of coitus

    Progestogens, progestogen-estrogen combinations or IUDs work within 72 hours.

  8. In vasectomy, which structure is cut and tied?

    1. Vas deferens
    2. Fallopian tube
    3. Epididymis
    4. Urethra
    Answer

    A. Vas deferens

    Vasectomy is male sterilisation by cutting and tying the vas deferens.

  9. Which contraceptive also protects against sexually transmitted infections?

    1. Oral pill
    2. Copper-T
    3. Lippes loop
    4. Condom
    Answer

    D. Condom

    Condoms are barriers that reduce transmission of STIs including AIDS.

  10. The usual oral contraceptive pill schedule is

    1. one pill daily for 28 days starting at day 14
    2. one pill daily for 21 days, starting within the first five days of the cycle
    3. one pill weekly for 21 weeks
    4. one pill daily for 7 days after day 14
    Answer

    B. one pill daily for 21 days, starting within the first five days of the cycle

    After the 21 days there is a 7-day gap during which menstruation occurs.

  11. MTP is considered relatively safe during

    1. any stage of pregnancy
    2. the second trimester
    3. the third trimester
    4. the first trimester (up to 12 weeks)
    Answer

    D. the first trimester (up to 12 weeks)

    Second-trimester abortions are much more risky.

  12. Which of the following STIs is not completely curable?

    1. Hepatitis-B
    2. Syphilis
    3. Chlamydiasis
    4. Gonorrhoea
    Answer

    A. Hepatitis-B

    Hepatitis-B, genital herpes and HIV infection are not completely curable.

  13. In ZIFT, what is transferred into the fallopian tube?

    1. A zygote or an early embryo of up to 8 blastomeres
    2. An embryo with more than 8 blastomeres
    3. Only sperms
    4. Semen from a donor
    Answer

    A. A zygote or an early embryo of up to 8 blastomeres

    Embryos with more than 8 blastomeres are transferred into the uterus (IUT).

  14. Lactational amenorrhea is effective as a contraceptive method for up to about

    1. the whole duration of lactation
    2. one month after delivery
    3. six months after delivery
    4. two years after delivery
    Answer

    C. six months after delivery

    It works only during intense lactation, up to about six months.

  15. Which of the following is NOT a sexually transmitted infection?

    1. Genital herpes
    2. Malaria
    3. Trichomoniasis
    4. Gonorrhoea
    Answer

    B. Malaria

    Malaria is a vector-borne infection; the others are STIs.

  16. Given below are two statements: Statement I: In coitus interruptus the male withdraws the penis before ejaculation. Statement II: Periodic abstinence involves avoiding coitus around days 10 to 17 of the cycle. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    A. Both Statement I and Statement II are correct

    Both describe natural methods correctly.

  17. Given below are two statements: Statement I: Condoms protect against sexually transmitted infections. Statement II: Copper-releasing IUDs protect against sexually transmitted infections. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    C. Statement I is correct but Statement II is incorrect

    IUDs do not give protection against STIs.

  18. Given below are two statements: Statement I: Vasectomy involves cutting and tying the fallopian tubes. Statement II: Tubectomy involves cutting and tying the vas deferens. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    B. Both Statement I and Statement II are incorrect

    The two terms are interchanged: vasectomy is the vas deferens, tubectomy is the fallopian tubes.

  19. Given below are two statements: Statement I: Hormone-releasing IUDs make the uterus unsuitable for implantation. Statement II: Non-medicated IUDs release hormones. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    C. Statement I is correct but Statement II is incorrect

    Non-medicated IUDs such as the Lippes loop release nothing.

  20. Which of the following statements are correct? 1. ZIFT transfers a zygote or early embryo into the fallopian tube. 2. IUT transfers an embryo with more than 8 blastomeres into the uterus. 3. GIFT transfers an embryo into the uterus.

    1. 1 and 3 only
    2. 1 and 2 only
    3. 2 and 3 only
    4. 1, 2 and 3
    Answer

    B. 1 and 2 only

    GIFT transfers a gamete (ovum) into the fallopian tube.

  21. Given below are two statements: Statement I: Saheli is a steroidal pill taken daily. Statement II: Oral pills alter the quality of cervical mucus so that sperm entry is retarded. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    D. Statement I is incorrect but Statement II is correct

    Saheli is non-steroidal and weekly; pills do change cervical mucus.

  22. Given below are two statements: Statement I: Amniocentesis for sex determination is banned by law. Statement II: Amniocentesis cannot be used for detecting genetic disorders under any circumstance. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    C. Statement I is correct but Statement II is incorrect

    It is banned for sex determination but may be used to detect genetic disorders.

  23. Given below are two statements: Statement I: MTP is safest during the second trimester. Statement II: MTP was legalised in India in 1971. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    D. Statement I is incorrect but Statement II is correct

    The first trimester is the safer period.

  24. Which of the following statements are correct? 1. Hepatitis-B can spread by sharing injection needles. 2. HIV can pass from an infected mother to the foetus. 3. Gonorrhoea is curable if detected early and treated properly.

    1. 1 and 2 only
    2. 2 and 3 only
    3. 1 and 3 only
    4. 1, 2 and 3
    Answer

    D. 1, 2 and 3

    All three statements are correct.

  25. Given below are two statements: Statement I: Emergency contraception can be used within 72 hours of unprotected coitus. Statement II: Emergency contraception may use progestogen-estrogen combinations or IUDs. Choose the correct answer.

    1. Both Statement I and Statement II are correct
    2. Both Statement I and Statement II are incorrect
    3. Statement I is correct but Statement II is incorrect
    4. Statement I is incorrect but Statement II is correct
    Answer

    A. Both Statement I and Statement II are correct

    Both statements are correct.

  26. Assertion (A): Condoms help to prevent sexually transmitted infections. Reason (R): Condoms act as a barrier that prevents contact with genital secretions.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    A. Both A and R are true and R is the correct explanation of A

    The barrier prevents exchange of body fluids.

  27. Assertion (A): Copper-releasing IUDs prevent fertilisation by suppressing sperm motility. Reason (R): Copper-releasing IUDs inhibit ovulation.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    C. A is true but R is false

    They act on sperm; ovulation is not inhibited.

  28. Assertion (A): Saheli has few side effects. Reason (R): Saheli is taken once a week.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    B. Both A and R are true but R is not the correct explanation of A

    Both are true, but the weekly schedule is not the reason for few side effects (it is non-steroidal).

  29. Assertion (A): Vasectomy is easily reversible. Reason (R): In vasectomy the vas deferens is cut and tied.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    D. A is false but R is true

    Surgical methods are terminal with very poor reversibility.

  30. Assertion (A): Amniocentesis for sex determination is banned. Reason (R): Such testing could lead to female foeticide.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    A. Both A and R are true and R is the correct explanation of A

    The ban aims to prevent misuse for female foeticide.

  31. Assertion (A): Lactational amenorrhea can be relied on for about six months after delivery. Reason (R): Ovulation is not suppressed during lactation.

    1. Both A and R are true and R is the correct explanation of A
    2. Both A and R are true but R is not the correct explanation of A
    3. A is true but R is false
    4. A is false but R is true
    Answer

    C. A is true but R is false

    The method works because ovulation and cycles are suppressed during intense lactation.

  32. Match List I with List II. List I: a. Lippes loop b. Multiload 375 c. Progestasert d. Saheli List II: i. Non-medicated IUD ii. Copper-releasing IUD iii. Hormone-releasing IUD iv. Non-steroidal weekly pill

    1. a-iv, b-ii, c-iii, d-i
    2. a-i, b-iii, c-ii, d-iv
    3. a-ii, b-i, c-iii, d-iv
    4. a-i, b-ii, c-iii, d-iv
    Answer

    D. a-i, b-ii, c-iii, d-iv

    Lippes-non-medicated, Multiload 375-copper, Progestasert-hormone, Saheli-weekly pill.

  33. Match List I with List II. List I: a. Vasectomy b. Tubectomy c. IUI d. ICSI List II: i. Sperm injected into the ovum ii. Semen introduced into the uterus iii. Fallopian tubes cut and tied iv. Vas deferens cut and tied

    1. a-iv, b-iii, c-i, d-ii
    2. a-iv, b-iii, c-ii, d-i
    3. a-ii, b-iii, c-iv, d-i
    4. a-iii, b-iv, c-ii, d-i
    Answer

    B. a-iv, b-iii, c-ii, d-i

    Vasectomy-iv, tubectomy-iii, IUI-ii, ICSI-i.

  34. Match List I with List II. List I: a. IVF b. ZIFT c. IUT d. GIFT List II: i. Ovum from a donor transferred into the fallopian tube ii. Embryo of more than 8 blastomeres transferred into the uterus iii. Fertilisation in the laboratory (test tube baby) iv. Zygote or embryo of up to 8 blastomeres into the fallopian tube

    1. a-iii, b-iv, c-ii, d-i
    2. a-i, b-iv, c-ii, d-iii
    3. a-iii, b-ii, c-iv, d-i
    4. a-iv, b-iii, c-ii, d-i
    Answer

    A. a-iii, b-iv, c-ii, d-i

    IVF-iii, ZIFT-iv, IUT-ii, GIFT-i.

  35. Match List I with List II. List I: a. Periodic abstinence b. Coitus interruptus c. Lactational amenorrhea d. Condom List II: i. Absence of cycles after delivery ii. Barrier worn on the penis iii. Avoiding coitus around days 10 to 17 iv. Withdrawal before ejaculation

    1. a-iv, b-iii, c-i, d-ii
    2. a-iii, b-i, c-iv, d-ii
    3. a-i, b-iv, c-iii, d-ii
    4. a-iii, b-iv, c-i, d-ii
    Answer

    D. a-iii, b-iv, c-i, d-ii

    Periodic abstinence-iii, withdrawal-iv, lactational amenorrhea-i, condom-ii.

  36. Match List I with List II. List I: a. Emergency contraception b. MTP safe period c. Lactational amenorrhea d. Oral pill course List II: i. Up to 12 weeks ii. 21 days iii. Within 72 hours iv. Up to about six months

    1. a-ii, b-i, c-iv, d-iii
    2. a-iii, b-i, c-iv, d-ii
    3. a-iii, b-iv, c-i, d-ii
    4. a-i, b-iii, c-iv, d-ii
    Answer

    B. a-iii, b-i, c-iv, d-ii

    Emergency contraception-72 hours, MTP-12 weeks, lactational amenorrhea-six months, pill-21 days.

  37. Match List I with List II. List I: a. Copper IUD b. Hormonal IUD c. Oral pill d. Diaphragm List II: i. Blocks the cervix ii. Suppresses sperm motility iii. Makes the cervix hostile to sperms and the uterus unsuitable for implantation iv. Inhibits ovulation

    1. a-ii, b-iv, c-iii, d-i
    2. a-i, b-iii, c-iv, d-ii
    3. a-ii, b-iii, c-iv, d-i
    4. a-iii, b-ii, c-iv, d-i
    Answer

    C. a-ii, b-iii, c-iv, d-i

    Copper IUD-ii, hormonal IUD-iii, oral pill-iv, diaphragm-i.

  38. A couple wants to space their children. They prefer a long-acting, reversible method placed in the uterus by a doctor. The most suitable option is

    1. a copper-releasing IUD
    2. a condom
    3. vasectomy
    4. tubectomy
    Answer

    A. a copper-releasing IUD

    IUDs are ideal for delaying pregnancy or spacing children and are inserted by doctors or nurses.

  39. A woman has a regular 28-day cycle with ovulation about day 14. For periodic abstinence the couple should avoid coitus approximately on days

    1. 1 to 5
    2. 20 to 28
    3. 24 to 28
    4. 10 to 17
    Answer

    D. 10 to 17

    The fertile period is about days 10 to 17.

  40. A couple has infertility because the sperms cannot penetrate the ovum. Which technique is most suitable?

    1. Tubectomy
    2. ICSI
    3. GIFT
    4. Periodic abstinence
    Answer

    B. ICSI

    In ICSI a single sperm is injected directly into the ovum.

  41. A woman cannot produce ova but can provide a suitable environment for fertilisation and development. A donor ovum is placed in her fallopian tube. This technique is

    1. GIFT
    2. ZIFT
    3. IUI
    4. IUT
    Answer

    A. GIFT

    GIFT transfers a gamete from a donor into the fallopian tube.

  42. A woman had unprotected coitus 24 hours ago and wants to avoid pregnancy. Which option is suitable?

    1. Lactational amenorrhea method
    2. Periodic abstinence from now
    3. Emergency contraception within 72 hours
    4. Vasectomy of the partner
    Answer

    C. Emergency contraception within 72 hours

    Progestogens or an IUD within 72 hours can prevent pregnancy.

  43. A couple wants to prevent both pregnancy and sexually transmitted infections. The most suitable single method is

    1. Copper-T
    2. an oral pill
    3. an injectable implant
    4. a condom
    Answer

    D. a condom

    Only barrier methods like condoms also protect against STIs.

  44. In an IVF programme an embryo with 16 blastomeres is formed. It should be transferred into the

    1. fallopian tube
    2. uterus
    3. vagina
    4. ovary
    Answer

    B. uterus

    Embryos with more than 8 blastomeres are transferred into the uterus (IUT).

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