Reproductive Health | ISC Class 12 Biology Notes

This note covers reproductive well-being, family planning, population growth, prevention of pregnancy, care during pregnancy, sexually transmitted infections, difficulties in having children, and methods that assist reproduction.

What is reproductive health and how do health programmes promote it?

Definition: Reproductive health means total well-being in the physical, emotional, behavioural and social aspects of reproduction. It includes healthy reproductive organs and their normal functioning, together with well-being in relationships and reproductive behaviour.

Why does reproductive health extend beyond the body?

Physical health alone does not cover every aspect of reproduction. Accurate information, responsible behaviour, support during pregnancy and equal opportunities for girls and boys also matter. A reproductively healthy society therefore needs both education and accessible care.

Family planning helps couples plan the size of their families and the spacing of children. India was amongst the first countries to introduce national programmes for reproductive health. Its family planning programmes began in 1951 and were periodically assessed.

Reproductive and Child Health Care (RCH) programmes cover a wider range of reproductive needs. Their major tasks are creating awareness and providing facilities and support for a reproductively healthy society.

What services and information are needed?

• Education: Correct information about reproductive organs, adolescence (the transition towards adulthood), sexual health and hygienic practices helps counter myths and misconceptions.
• Maternal and child care: Care during pregnancy, medically assisted delivery, breastfeeding and post-natal care, meaning care after birth, support mothers and children.
• Medical assistance: Trained professionals and suitable facilities address menstrual problems, pregnancy-related difficulties, infections and difficulties in having children.
• Social awareness: Education about sexual abuse, sex-related crimes and equal opportunities for children supports responsible behaviour.

Parents, relatives, teachers, friends, print media and audio-visual media can spread reliable information. Programmes also require professional expertise, material support and improved techniques. Better awareness, more medically assisted deliveries and improved post-natal care are indicators of progress in reproductive health.

Why are population stabilisation and birth control needed?

Population explosion describes a rapid increase in population. Improved health facilities and living conditions can reduce deaths while more people survive to reproductive age. A rapid fall in death rates and an increase in people of reproductive age are probable reasons for rapid population growth.

Maternal mortality concerns deaths associated with pregnancy and childbirth; infant mortality concerns deaths among infants. Falling maternal and infant mortality contribute to the demographic changes associated with improved health care. These improvements need to be accompanied by awareness of family size.

How can government programmes help?

Rapid population growth could produce shortages of food, shelter and clothing even when production and living conditions improve. Government measures include promoting smaller families, publicising birth control methods and offering incentives to couples with small families.

Birth control involves regulating childbearing. Contraception means preventing conception or pregnancy. Contraceptive methods help people avoid an unwanted pregnancy or delay and space pregnancies. They also have a significant role in checking uncontrolled population growth.

What makes a contraceptive ideal?

An ideal contraceptive should be easy to use, readily available, effective and reversible, meaning its effect can be reversed when pregnancy is desired. It should have no or the least side-effects and should not interfere with sexual desire or the sexual act.

The principal groups are natural methods, physical barriers, devices placed inside the uterus, oral contraceptives, injections, implants and surgical methods. These methods act at different stages of reproduction. Their suitability must be considered with a qualified medical professional.

Note: Contraceptives are not regular requirements for maintaining reproductive health. Their particular purpose is to prevent, delay or space pregnancy; reproductive health also includes care, education and emotional and social well-being.

How do natural methods reduce the chance of conception?

Natural methods try to prevent the meeting of the ovum, the female reproductive cell, and sperm, the male reproductive cell. These cells are called gametes. Their fusion is fertilisation. Natural methods use timing or behaviour without contraceptive medicines or devices.

What are periodic abstinence and withdrawal?

Periodic abstinence means avoiding coitus, or sexual intercourse, during the fertile period. Ovulation is the release of an ovum from an ovary, an organ that produces ova and reproductive hormones. Ovulation could be expected between days 10 and 17 of the menstrual cycle, the recurring sequence of reproductive changes.

Chances of fertilisation are very high during this interval, so avoiding intercourse then could prevent conception. Menstruation is the discharge of blood and shed uterine lining when pregnancy does not occur. The uterus is the organ in which the embryo, the developing organism formed after fertilisation, develops.

Withdrawal, also called coitus interruptus, involves withdrawing the penis, the male external reproductive organ, from the vagina just before ejaculation. The vagina is the muscular passage opening to the exterior from the female reproductive tract. Ejaculation releases semen, the fluid containing sperm; avoiding its deposition prevents insemination.

What are the limits of lactational amenorrhoea?

Lactation means production and release of milk after childbirth, or parturition. Amenorrhoea means absence of menstruation. Lactational amenorrhoea is based on the absence of ovulation and the menstrual cycle during intense lactation after childbirth.

As long as the mother breastfeeds fully, the chances of conception are almost nil. This method has been reported effective only up to a maximum of six months following childbirth. It must not be described as guaranteed protection whenever a mother breastfeeds.

Because natural methods use no medicines or devices, side-effects are almost nil. However, chances of failure are also high. The distinction between few side-effects and dependable pregnancy prevention is essential when comparing methods.

How do barriers and spermicidal agents prevent fertilisation?

Barrier methods physically prevent sperm and ovum from meeting. Male and female condoms provide barriers, while diaphragms, cervical caps and vaults cover the cervix, the lower narrow part of the uterus opening into the vagina.

How do condoms differ from cervical barriers?

Condoms are thin rubber or latex sheaths. The male condom covers the penis, while the female condom covers the vagina and cervix. They are used before intercourse to prevent ejaculated semen from entering the female reproductive tract.

Both male and female condoms are disposable and can be self-inserted, allowing privacy. Nirodh is a male condom brand. Condoms also help protect against sexually transmitted infections (STIs), infections passed through sexual intercourse. This additional benefit is distinct from pregnancy prevention.

Diaphragms, cervical caps and vaults are rubber barriers inserted into the female reproductive tract. They block sperm entry through the cervix and are reusable. Spermicidal agents, substances that kill sperm, are usually used as creams, jellies or foams with these barriers to increase contraceptive efficiency.

Table: How barrier methods compare

Part (a) is a drawing of an elongated male condom with a rolled rim. Part (b) is a photograph of a transparent female condom with a ring visible at each end.

See Fig. 3.1 in your NCERT textbook

How do intrauterine devices act inside the uterus?

An intrauterine device (IUD) is a contraceptive device inserted into the uterus through the vagina by a doctor or expert nurse. The term intrauterine means within the uterus. These devices are suitable for women wishing to delay pregnancy or space children.

What are the main types?

The three types are non-medicated, copper-releasing and hormone-releasing devices. Hormones are chemical messengers that regulate body functions. The names in the table identify particular devices; their numbers are parts of the device names, not dosage instructions.

How do the mechanisms differ?

Phagocytosis is the engulfment of material by cells. IUDs increase phagocytosis of sperm within the uterus. Copper-releasing devices add an effect on sperm motility, meaning movement, and on their capacity to fertilise the ovum.

Cu is the chemical symbol for copper. Copper ions are electrically charged copper particles. CuT is also called Copper T. Do not interpret the presence of copper as a hormone: copper-releasing and hormone-releasing IUDs are distinct types.

Implantation is attachment and embedding of the developing embryo in the uterine lining. Hormone-releasing IUDs make the uterus unsuitable for implantation and the cervix hostile to sperm, in addition to the general IUD effect.

The photograph shows a T-shaped device with a horizontal upper arm, a vertical stem and two thin threads extending downwards. Its caption identifies it as Copper T (CuT).

See Fig. 3.2 in your NCERT textbook

How do oral pills, injections and implants work?

Oral contraceptives are contraceptive preparations taken by mouth. Hormonal pills contain small doses of progestogens, substances with progesterone-like activity, either alone or combined with oestrogen. Progesterone and oestrogen are hormones involved in regulating female reproduction.

Which reproductive events do hormonal methods affect?

These pills inhibit ovulation and implantation. They also alter cervical mucus, the secretion at the cervix, to prevent or retard sperm entry. The effects therefore involve release of the ovum, conditions for implantation and passage of sperm.

The cyclic pill pattern involves a daily course followed by an interval. The timing is part of the contraceptive method and should not be confused with the weekly pattern of Saheli.

1. Start the pill course preferably within the first five days of the menstrual cycle.
2. Take the pills daily for a period of 21 days.
3. Leave a gap of seven days, during which menstruation occurs.
4. Repeat the same pattern while pregnancy prevention is desired, with qualified medical guidance on selection and use.

Saheli is a non-steroidal oral contraceptive, meaning it does not use a steroid preparation. Developed at the Central Drug Research Institute in Lucknow, it is taken once a week and has very few side-effects and high contraceptive value.

How do injections, implants and emergency methods compare?

Progestogens alone or with oestrogen can be given as injections or implants, preparations placed under the skin. Their action resembles that of pills, but their effective periods are much longer. The route and duration differ even when the contraceptive mechanisms are similar.

Emergency contraception aims to prevent a possible pregnancy after unprotected intercourse. Administration of progestogens, progestogen-oestrogen combinations or IUDs within 72 hours of intercourse has been found very effective. This is different from terminating an established pregnancy.

Hormonal pills are very effective with lesser side-effects; this does not mean side-effects are impossible. Selecting and using a contraceptive should always involve a qualified medical professional.

How do vasectomy and tubectomy prevent pregnancy?

Sterilisation refers to surgical contraception that blocks gamete transport. It is generally advised as a terminal method when no more pregnancies are desired. The male procedure is vasectomy and the female procedure is tubectomy.

Which ducts are interrupted?

In vasectomy, a small part of the vas deferens, the duct carrying sperm from the testis towards the urethra, is removed or tied. The testis is the sperm-producing organ; the urethra is the passage through which semen leaves the male body.

The operation uses a small incision in the scrotum, the pouch containing the testes. An incision is a surgical cut. Interrupting the duct prevents sperm transport. Vasectomy should not be described as removal of the testes or prevention of sperm formation.

In tubectomy, a small part of the fallopian tube, or oviduct, is removed or tied. This tube connects the region near the ovary to the uterus and transports the ovum. Access is through a small incision in the abdomen or through the vagina.

How effective and reversible are these procedures?

Both techniques are highly effective, but their reversibility is very poor. This qualification explains why they are generally considered terminal methods. They differ from methods intended simply to postpone a pregnancy or space successive children.

The shared principle is blockage of transport, while the duct and site of surgery differ. Contraceptive action must therefore be explained in terms of preventing the gametes from meeting, rather than destroying or removing the reproductive organs.

The male drawing labels the vas deferens as “tied and cut” on the sperm-carrying ducts. The female drawing has arrows to the interrupted fallopian tubes, labelled “Fallopian tubes tied and cut”. The uterus and ovaries remain drawn.

See Fig. 3.4 in your NCERT textbook

What are medical termination of pregnancy and amniocentesis?

Medical termination of pregnancy (MTP), or induced abortion, is the intentional or voluntary termination of pregnancy before full term. It ends a pregnancy, whereas contraception aims to prevent pregnancy. An abortion can also occur spontaneously, without intentional intervention.

Why might MTP be considered?

Reasons include an unwanted pregnancy after unprotected intercourse, failure of a contraceptive or rape. In certain cases, continuing pregnancy could harm or even be fatal to the mother, the foetus or both. A foetus is the developing offspring at a later stage of pregnancy.

MTP is considered relatively safe during the first trimester, the first three months, up to 12 weeks of pregnancy. Second-trimester abortions are much riskier. “Relatively safe” does not mean risk-free, and procedures performed by unqualified people can be dangerous or fatal.

Counselling about avoiding unprotected intercourse, awareness of unsafe abortion risks and better health facilities are measures for improving reproductive care. Decisions concerning pregnancy require qualified medical care.

What can amniocentesis reveal?

Amniocentesis involves sampling amniotic fluid, the fluid surrounding the developing foetus, to examine foetal cells and dissolved substances. It can help detect certain genetic disorders, conditions caused by abnormalities in inherited material or chromosomes, the structures carrying genetic information.

1. A sample of amniotic fluid surrounding the developing foetus is obtained.
2. Foetal cells present in the sample are examined.
3. Dissolved substances in the fluid are also analysed.
4. The findings are assessed for the presence of certain genetic disorders and information about foetal survival.

Examples include Down syndrome, a chromosomal disorder; haemophilia, an inherited defect in blood clotting; and sickle-cell anaemia, an inherited disorder affecting haemoglobin, the oxygen-carrying pigment of red blood cells.

Using amniocentesis for foetal sex determination is prohibited, whether or not an abortion follows. Female foeticide, the intentional destruction of a female foetus, is also prohibited. Its diagnostic purpose must be distinguished from this misuse. The ability to detect certain disorders does not mean it detects every possible disorder.

Which sexually transmitted infections and symptoms should be recognised?

Sexually transmitted diseases (STDs) are diseases passed through sexual intercourse; the term STI also includes infection that may produce no noticeable symptoms. The named examples include bacterial, viral and protozoan infections. A protozoan is a single-celled animal-like organism.

What causes each infection?

Immunity is the body's ability to resist disease-causing agents. Immune defence refers to this protection. A pathogen is a disease-causing organism or agent. Disease names and pathogen names are different: for example, gonorrhoea is the disease, while Neisseria gonorrhoeae is its bacterial cause. A symptom is a change or discomfort associated with disease.

Table: Comparison of the named sexually transmitted infections

Why can infections remain unnoticed?

Early symptoms of most STIs are minor: itching, fluid discharge, slight pain or swelling in the genital region. Infected females may often be asymptomatic, meaning without noticeable symptoms, so infection may remain undetected for a long time.

Minor symptoms and social stigma can discourage timely diagnosis and treatment. Absence of obvious symptoms is therefore not proof that a person is free of infection. Recognition of possible symptoms should lead to qualified assessment, not identification by appearance alone.

AIDS involves acquired deficiency of immune defence. A syndrome is a group of symptoms; HIV is the virus that can lead to AIDS, rather than another name for the syndrome itself.

How can STIs be prevented and why is early detection important?

Prevention, early detection and treatment are major parts of reproductive health programmes. All persons are vulnerable to STIs, although their incidence is reported to be very high in the 15 to 24 age group. Early symptoms may be too minor to attract attention.

What precautions reduce transmission?

• Avoid sexual intercourse with unknown or multiple partners.
• Use condoms during intercourse to help prevent sexually transmitted infection.
• If infection is suspected, consult a qualified doctor for early detection and complete treatment if diagnosed.
• Prevent blood-borne HIV transmission through safe blood supplies and disposable needles and syringes.

Hepatitis B and HIV can also spread through shared contaminated injection needles or surgical instruments, infected blood transfusions, and from an infected mother to the foetus. Their routes of transmission are therefore not restricted to sexual intercourse.

HIV is not transmitted by mere touch or ordinary physical contact. People living with infection need care and support. Excluding them from family and society does not follow from the actual routes of transmission.

What complications can follow delayed treatment?

Untreated infections could lead to pelvic inflammatory disease (PID), inflammation involving the female reproductive organs in the pelvis. Other possible complications include abortion, stillbirth, ectopic pregnancy, infertility and cancer of the reproductive tract.

Stillbirth means birth of a dead baby. An ectopic pregnancy develops outside the normal uterine site. Infertility is inability to produce children despite unprotected sexual cohabitation. These possible consequences explain why minor initial symptoms should not be dismissed.

Do not assume every STI is completely curable. Hepatitis B, genital herpes and HIV are important exceptions. Prevention and timely medical care remain necessary even when early symptoms are absent or slight.

What causes infertility and how can affected couples be helped?

Infertility can involve factors in either partner. Unprotected sexual cohabitation means sexual intercourse without contraception. Inability to produce children despite this does not justify automatically blaming the female partner; both partners need appropriate assessment.

Which categories of causes are recognised?

• Physical causes: Problems affecting reproductive structures or their functioning.
• Congenital causes: Conditions present from birth.
• Disease-related causes: Disorders that interfere with normal reproductive processes.
• Drug-related causes: Effects of drugs on reproductive functioning.
• Immunological causes: Factors involving the immune system, the body's defence system.
• Psychological causes: Factors involving mental or emotional processes.

Specialised infertility clinics could diagnose and correct some disorders, enabling affected couples to have children. The cause determines whether corrective treatment is possible. A single technique is not suitable for every form of infertility.

What support is available if correction is not possible?

Assisted reproductive technologies (ART) are special techniques used to help couples have children when the underlying problem cannot be corrected. They may assist fertilisation, transfer reproductive cells or embryos, or introduce semen artificially.

These techniques require highly precise handling by specialised professionals and expensive equipment. Cost and emotional, religious or social factors can limit their adoption. The availability of several techniques should not be taken as a guarantee that a particular procedure will succeed.

Legal adoption is another route to parenthood. It is separate from medical treatment of infertility. A complete discussion of support includes both professional assessment of reproductive difficulties and the wider choices available to people who wish to become parents.

How do the different assisted reproduction techniques compare?

In vitro fertilisation (IVF) means fertilisation outside the body under conditions almost similar to those inside it. It can be followed by embryo transfer (ET), placement of the resulting embryo into the female reproductive tract for further development.

What happens during IVF and embryo transfer?

1. Ova are collected from the wife or a female donor, and sperm from the husband or a male donor.
2. The gametes are brought together under simulated conditions in the laboratory so that fertilisation forms a zygote, the cell produced by fusion of the gametes.
3. The zygote divides to form an early embryo. Its individual cells are called blastomeres.
4. The zygote or embryo is transferred to an appropriate site in the female reproductive tract, according to its developmental stage, for further development.

Zygote intrafallopian transfer (ZIFT) transfers a zygote or early embryo with up to eight blastomeres into a fallopian tube. Intrauterine transfer (IUT) places an embryo with more than eight blastomeres into the uterus.

“Test-tube baby programme” describes IVF followed by transfer; it does not mean a baby completes development in a laboratory vessel. Embryos produced by in vivo fertilisation, fusion of gametes within the female body, can also be used for transfer.

How do gamete transfer, sperm injection and insemination differ?

Gamete intrafallopian transfer (GIFT) can transfer a donor ovum into the fallopian tube of a woman unable to produce an ovum but able to provide a suitable environment for fertilisation and development.

Intracytoplasmic sperm injection (ICSI) injects a sperm directly into an ovum to form an embryo in the laboratory. “Intracytoplasmic” means into the cytoplasm, the material within a cell surrounding its nucleus. The nucleus is the cell compartment containing chromosomes.

Artificial insemination (AI) introduces semen collected from the husband or a healthy donor into the vagina or uterus. It could help where the male partner cannot inseminate the female or has a very low sperm count.

When semen is introduced into the uterus, the method is called intrauterine insemination (IUI). Distinguish IUI from IUT: the first transfers semen, while the second transfers an embryo.

Glossary

• Reproductive health — Total well-being in the physical, emotional, behavioural and social aspects of reproduction.
• Contraception — Prevention of conception or pregnancy using natural, barrier, medicinal, device-based or surgical methods.
• Periodic abstinence — Avoidance of sexual intercourse during the fertile period to reduce chances of conception.
• Lactational amenorrhoea — Absence of menstruation associated with intense lactation, used as a natural contraceptive method after childbirth.
• Spermicidal agent — A substance that kills sperm, usually combined with barriers to increase contraceptive efficiency.
• Intrauterine device — A contraceptive device inserted into the uterus by a doctor or expert nurse.
• Vasectomy — Male sterilisation involving removal or tying of a small part of the vas deferens.
• Tubectomy — Female sterilisation involving removal or tying of a small part of the fallopian tube.
• Medical termination of pregnancy — Intentional or voluntary ending of pregnancy before full term, also called induced abortion.
• Amniocentesis — Sampling amniotic fluid to examine foetal cells and dissolved substances for certain genetic disorders.
• Asymptomatic — Having no noticeable symptoms, even though an infection may be present in the body.
• Infertility — Inability of a couple to produce children despite unprotected sexual cohabitation.
• In vitro fertilisation — Fertilisation outside the body under conditions almost similar to those within the body.
• Blastomere — An individual cell produced during the early divisions of the zygote after fertilisation.
• Artificial insemination — Introduction of collected semen into the female vagina or uterus by artificial means.

Common errors and misconceptions

• Misconception: Reproductive health means healthy reproductive organs alone. Correct: It also includes emotional, behavioural and social well-being related to reproduction.
• Misconception: Any breastfeeding prevents pregnancy indefinitely. Correct: Lactational amenorrhoea is associated with intense lactation and has been reported effective only up to a maximum of six months after childbirth.
• Misconception: All IUDs release copper. Correct: Non-medicated and hormone-releasing IUDs also exist; copper-releasing devices form a separate group.
• Misconception: Sterilisation stops gamete formation. Correct: Vasectomy and tubectomy block transport of gametes by interrupting the relevant ducts.
• Misconception: No symptoms means no STI. Correct: Infected females may often be asymptomatic, and early symptoms of most STIs are minor.
• Misconception: Amniocentesis and MTP are the same procedure. Correct: Amniocentesis examines a fluid sample for diagnostic information; MTP intentionally terminates a pregnancy.
• Misconception: Every embryo transfer places the embryo in the uterus. Correct: ZIFT transfers a zygote or early embryo into a fallopian tube; IUT transfers a later embryo into the uterus.
• Misconception: IUI transfers an embryo. Correct: IUI introduces semen into the uterus; IUT transfers an embryo.

Exam-style questions with model answers

Q1. Define reproductive health and state one major task of Reproductive and Child Health Care programmes. [2 marks]

1. Reproductive health is total well-being in the physical, emotional, behavioural and social aspects of reproduction.
2. A major task of Reproductive and Child Health Care programmes is creating awareness about reproduction-related matters and healthy reproductive behaviour.

Q2. Explain periodic abstinence, withdrawal and lactational amenorrhoea, giving the timing or condition on which each depends. [3 marks]

1. Periodic abstinence avoids intercourse during days 10 to 17 of the menstrual cycle, when ovulation could be expected and chances of fertilisation are very high.
2. Withdrawal involves removing the penis from the vagina just before ejaculation, so that insemination is avoided.
3. Lactational amenorrhoea depends on intense lactation suppressing ovulation and menstruation. Conception chances are almost nil during full breastfeeding, but effectiveness is reported only up to a maximum of six months after childbirth.

Q3. State four contraceptive effects, distinguishing the general action of intrauterine devices from the additional actions of copper-releasing and hormone-releasing devices. [4 marks]

1. Intrauterine devices increase phagocytosis of sperm inside the uterus, meaning that cells engulf sperm and remove them.
2. Copper-releasing devices release copper ions that suppress sperm motility, reducing their movement, and suppress their capacity to fertilise an ovum.
3. Hormone-releasing devices additionally make the uterus unsuitable for implantation, the embedding of the developing embryo in its lining.
4. Hormone-releasing devices also make the cervix hostile to sperm, adding an effect at the entrance to the uterus.

Q4. Compare vasectomy and tubectomy by giving the duct interrupted in each, their shared mechanism, and their reversibility. [4 marks]

1. Vasectomy interrupts the vas deferens in the male by removing or tying a small part through a small scrotal incision.
2. Tubectomy interrupts the fallopian tube in the female by removing or tying a small part through an abdominal incision or through the vagina.
3. Both prevent conception by blocking gamete transport, thereby preventing sperm and ovum from meeting; their action is not prevention of gamete formation.
4. Both are highly effective, but reversibility is very poor, so they are generally advised as terminal contraceptive methods.

Q5. Define medical termination of pregnancy, give two reasons for considering it, and explain its distinction from amniocentesis and the prohibited misuse of amniocentesis. [5 marks]

1. Medical termination of pregnancy is the intentional or voluntary ending of pregnancy before full term. It is also called induced abortion.
2. It may be considered for an unwanted pregnancy resulting from unprotected intercourse, contraceptive failure or rape.
3. It may also be essential where continuing pregnancy could be harmful or even fatal to the mother, the foetus or both.
4. Amniocentesis samples amniotic fluid and examines foetal cells and dissolved substances for certain genetic disorders. It provides diagnostic information rather than terminating pregnancy.
5. Using amniocentesis to determine foetal sex is prohibited, whether or not an abortion follows; female foeticide is also prohibited. This misuse must be distinguished from its role in detecting certain genetic disorders.

Q6. State three measures to prevent or control sexually transmitted infections and explain two reasons why an infection may remain undetected. [5 marks]

1. Avoid sexual intercourse with unknown or multiple partners. This is a preventive measure directed at sexual transmission of infection.
2. Use condoms during intercourse. Besides preventing conception, condoms provide the additional benefit of helping protect against sexually transmitted infections.
3. Consult a qualified doctor when infection is suspected, seek early detection, and complete treatment if an infection is diagnosed.
4. Early symptoms of most STIs are minor, such as itching, discharge, slight pain or swelling. Infected females may often be asymptomatic, so infection may remain undetected.
5. Social stigma can discourage infected people from seeking timely diagnosis and proper treatment, allowing an infection and its complications to progress.

Q7. Compare zygote intrafallopian transfer and intrauterine transfer by giving the developmental stage transferred and the destination for each. [2 marks]

1. Zygote intrafallopian transfer places a zygote or early embryo with up to eight blastomeres into a fallopian tube.
2. Intrauterine transfer places an embryo with more than eight blastomeres into the uterus for further development.

Q8. Explain six techniques used in assisted reproduction: IVF, ZIFT, IUT, GIFT, ICSI and AI. Include what IUI means within AI. [6 marks]

1. In vitro fertilisation (IVF) brings ova and sperm together outside the body under simulated conditions to form a zygote, followed by transfer for further development.
2. Zygote intrafallopian transfer (ZIFT) transfers a zygote or early embryo with up to eight blastomeres into a fallopian tube.
3. Intrauterine transfer (IUT) transfers an embryo with more than eight blastomeres into the uterus to continue development.
4. Gamete intrafallopian transfer (GIFT) transfers a donor ovum into the fallopian tube of a woman unable to produce ova but able to support fertilisation and development.
5. Intracytoplasmic sperm injection (ICSI) introduces a sperm directly into an ovum to form an embryo in the laboratory.
6. Artificial insemination (AI) introduces semen from the husband or a healthy donor into the vagina or uterus. Introduction into the uterus is intrauterine insemination (IUI).

Key takeaways

• Reproductive health combines physical, emotional, behavioural and social well-being; awareness and medical services are complementary requirements.
• Contraceptive methods prevent, delay or space pregnancy, and their selection and use require qualified medical guidance.
• Natural methods avoid gamete meeting through timing or behaviour, but their chances of failure are high.
• IUDs increase sperm phagocytosis; copper and hormone-releasing devices have additional actions on sperm or reproductive conditions.
• Vasectomy and tubectomy interrupt gamete transport, are highly effective, and have very poor reversibility.
• Amniocentesis provides diagnostic information about certain genetic disorders; medical termination of pregnancy intentionally ends a pregnancy.
• STIs can remain unnoticed because symptoms are minor or absent, making prevention and timely assessment essential.
• Assisted reproductive techniques differ in the material transferred, where fertilisation occurs, and the site of transfer.

Test yourself

Why is reproductive health broader than normal reproductive organs?

It includes emotional, behavioural and social well-being as well as the physical health and functioning of reproductive organs.

What is the reported maximum period of effectiveness of lactational amenorrhoea after childbirth?

It has been reported effective only up to a maximum of six months after childbirth, in association with intense lactation.

How do copper ions contribute to contraception?

They suppress sperm motility and the capacity of sperm to fertilise an ovum.

How does Saheli differ from the cyclic daily pill pattern?

Saheli is a non-steroidal contraceptive taken once a week, rather than in the daily 21-day pill pattern.

Why does sterilisation not mean stopping gamete formation?

Its contraceptive action is interruption of the ducts carrying gametes, which blocks transport and prevents the gametes from meeting.

Why should absence of obvious symptoms not be used to rule out an STI?

Early symptoms of most STIs are minor, and infected females may often be asymptomatic for a long time.

What distinguishes GIFT from ZIFT?

GIFT transfers a donor ovum into a fallopian tube; ZIFT transfers a zygote or an early embryo with up to eight blastomeres.

What is the difference between IUI and IUT?

IUI introduces semen into the uterus; IUT transfers an embryo with more than eight blastomeres into the uterus.