Reproductive Health: One Mark Questions, Book Back Answers and Notes

About Reproductive Health

Medium ~90 min study

Reproductive health means more than the absence of disease. It includes safe pregnancy and childbirth, the choice of when to have children, protection from infections and help for couples who cannot conceive. A community that looks after these needs has fewer mothers and infants dying and healthier families.

The chapter moves from prevention to treatment. It begins with awareness programmes and sex education, then explains birth control methods, both temporary and permanent. Next come prenatal diagnosis, the law on termination of pregnancy and sexually transmitted infections. It ends with infertility and the laboratory methods used to help such couples.

Questions in this chapter tend to be specific. You may be asked how a copper IUD differs from a hormone-releasing IUD, which STIs are caused by bacteria and which by viruses, what lactational amenorrhoea is, or how ZIFT differs from GIFT. Learn each method along with the exact way it works.

What you'll learn

• Explain the aims of India's reproductive and child health programmes.
• Compare how temporary and permanent birth control methods prevent pregnancy.
• Describe how amniocentesis is done and what it is legitimately used for.
• Classify common STIs by the pathogen that causes them and state which are curable.
• List the physical, hormonal and other causes of infertility in men and women.
• Choose the right assisted reproductive technique for a given cause of infertility.

Before you start

• Structure of the male and female reproductive systems.
• Oogenesis, spermatogenesis and fertilization from Unit 2.
• The main sex hormones and what they do.

Reproductive Health explained

Reproductive Health: Programmes, Contraception, Infections and Infertility

Reproductive Health Programmes in India

India was one of the first countries in the world to start a national family planning programme, in 1951. That programme has since grown into the Reproductive and Child Health Care (RCH) programme, which aims to create awareness and provide medical help for a healthy society. Schools introduce sex education so that adolescents understand the physical and hormonal changes they go through. Health centres provide immunization for pregnant women, care after delivery and nutritional support. Schemes such as Janani Suraksha Yojana aim to reduce the number of mothers and babies who die around childbirth.

Birth Control Methods

Contraceptive methods work by preventing fertilization or implantation. Temporary methods are grouped as natural, barrier, chemical, hormonal and intrauterine devices. Natural methods, such as periodic abstinence and lactational amenorrhoea, depend on the body's own cycles and fail more often. Barrier methods, such as condoms, diaphragms and cervical caps, stop sperm from reaching the ovum. Intrauterine devices (IUDs) change conditions inside the uterus: copper IUDs reduce sperm motility and fertilizing capacity, and non-medicated IUDs increase phagocytosis of sperm. For couples who want no more children, sterilization is available: vasectomy in men and tubectomy in women. These are highly effective, but reversal is difficult and often fails.

Prenatal Diagnosis and the Law

Amniocentesis draws a small sample of amniotic fluid so that foetal cells can be tested for chromosomal and genetic disorders such as Down syndrome. Because the same test can also show the sex of the foetus, it was misused for female foeticide. To stop this and protect the sex ratio, the government has banned prenatal sex determination by law. The Medical Termination of Pregnancy (MTP) Act separately lays down when and by whom a pregnancy can be legally ended. Together these laws allow the technology to be used only for genuine medical reasons.

Sexually Transmitted Infections

Sexually transmitted infections (STIs), also called venereal diseases, damage both general and reproductive health. They are grouped by the pathogen: bacterial STIs include gonorrhoea and syphilis; viral STIs include genital herpes, hepatitis B and AIDS; trichomoniasis is caused by a protozoan. Bacterial and protozoan infections can be cured if treated early. Viral infections such as genital herpes, hepatitis B and HIV cannot be cured and need long-term treatment. Prevention depends on awareness, avoiding risky sexual contact, using condoms and getting tested early, which helps avoid complications such as pelvic inflammatory disease.

Infertility and Assisted Reproductive Technologies

Infertility is the inability to conceive even after unprotected sexual cohabitation. The cause may lie in either partner and may be congenital, hormonal, physical or immunological. Assisted Reproductive Technologies (ART) help by handling gametes outside the body. Intrauterine insemination (IUI) places sperm directly in the uterus and is used when the sperm count is low. In vitro fertilization (IVF) fertilizes eggs in the laboratory, after which the embryo is transferred. Zygote intrafallopian transfer (ZIFT), gamete intrafallopian transfer (GIFT) and intracytoplasmic sperm injection (ICSI) are chosen according to the couple's specific problem.

Common mistakes to avoid

• Thinking spermicides alone are very reliable. They work much better when used together with a barrier method such as a diaphragm or cervical cap.
• Assuming a man is infertile the moment a vasectomy is done. Sperm already stored beyond the cut can remain in the tract for some weeks, so another method is needed until then.
• Assuming all STIs can be cured. Viral STIs such as HIV/AIDS, genital herpes and hepatitis B cannot be cured; treatment only controls them.
• Thinking amniocentesis is a sex-selection test. Its legal medical use is to detect chromosomal and genetic disorders in the foetus.
• Treating ZIFT and GIFT as the same. In ZIFT a zygote or early embryo fertilized in the laboratory is transferred; in GIFT an unfertilized ovum from a donor is placed in the fallopian tube, and fertilization happens inside the body.

Test yourself on these with the practice test, then check the worked reasoning in the solved MCQs.

Frequently asked questions

What is the primary difference between vasectomy and tubectomy?

Vasectomy is sterilization in men: a small part of the vas deferens is cut and tied so sperm cannot pass into the urethra. Tubectomy is sterilization in women: both fallopian tubes are cut and tied so the ovum cannot meet sperm or reach the uterus. Both are very effective but hard to reverse.

How does a copper-releasing IUD prevent pregnancy?

A copper IUD such as Cu-T is placed in the uterus, where it slowly releases copper ions. These reduce sperm motility and their ability to fertilize the ovum. The IUD also increases phagocytosis of sperm inside the uterus. It prevents fertilization without changing the woman's hormone cycle.

Why is amniocentesis banned for gender determination in India?

Amniocentesis tests foetal cells in amniotic fluid for chromosomal disorders, but the result also shows the sex of the foetus. This was misused to abort female foetuses, lowering the sex ratio. The government therefore banned by law the use of prenatal tests to find out the sex of the foetus.

Which sexually transmitted infections are curable and which are not?

STIs caused by bacteria, fungi and protozoa, such as syphilis, gonorrhoea and trichomoniasis, can be cured with the right treatment if detected early. Viral STIs such as genital herpes, hepatitis B and HIV/AIDS cannot be cured; medicines can only control the virus and the symptoms, often for life.

What are ZIFT and GIFT under assisted reproductive technology?

Both treat infertility. In GIFT (gamete intrafallopian transfer), an ovum collected from a donor is transferred into the fallopian tube of a woman who cannot produce ova but can support fertilization and pregnancy, and fertilization takes place there. In ZIFT (zygote intrafallopian transfer), the egg is fertilized in the laboratory and the zygote or early embryo, with up to 8 blastomeres, is transferred into the fallopian tube.

What is lactational amenorrhoea and why is it temporary?

Lactational amenorrhoea is the absence of menstruation while a mother breastfeeds intensely after delivery. Suckling raises prolactin, which suppresses GnRH from the hypothalamus and gonadotropins from the pituitary, so ovulation does not happen. It works only for up to about six months after delivery and is not reliable.