Reproductive Health Overview and Strategies
Reproductive Health Overview and Strategies
CHAPTER 3
REPRODUCTIVE HEALTH
SUMMARY 1.
2.
Rapid decline in death rate.
Decline in maternal mortality rate (MMR).
3. Decline in infant mortality rate (IMR).
1. REPRODUCTIVE HEALTH - PROBLEMS AND 4. Increase in number of people in reproductive
STRATEGIES age.
Reproductive health means a total well-being
in all aspects of reproduction, i.e., physical, 2.2 Steps to Curb Population Growth
emotional, behavioural and social. Step to curb population growth area as follows :
Problems 1. Raising marriageable age of girls to 18 years
and of boys to 21 years.
1. There is little knowledge of personal hygiene
and hygiene of reproductive organs. This 2. Incentives should be given to couples with
causes sexually transmitted diseases (STDs). small family.
2. Early marriages lead to high maternal and 3. BIRTH CONTROL
infant mortality rates.
The most important step to control population
3. Due to lack of awareness, there has been a growth is to motivate smaller families by using
rapid increase in population size. various contraceptive methods.
4. People encourage beliefs in myths and
misconceptions about sex-related issues. 3.1 Methods of Birth Control
Strategies The contraceptive methods are divided into
following categories:
1. Family planning programmes were initiated
as early as 1951. 1. Natural Methods : These are natural methods
2. Reproductive and Child Health Care (RHC) that work on the principle of avoiding the
programmes were launched in 1997 for: meeting of ovum and sperm.
(a) Creating awareness among people about (a) Periodic Abstinence : Periodic abstinence
various reproduction related aspects. is a method in which a couple avoids or
(b) Providing facilities and support for abstains from coitus from day 10-17 of
building up a reproductively healthy the menstrual cycle, when ovulation is
society. expected to occur.
(b) Coitus Interruptus : Coitus interruptus
2. POPULATION EXPLOSION or withdrawal is a method in which male
The tremendous increase in size and growth rate partner withdraws his penis from the
of population is called population explosion. The vagina just before ejaculation so as to
world population was about 2 billion in 1900 and avoid insemination.
it was 6 billion in 2000. Population of India at the (c) Lactational Amenorrhea : Lactational
time of Independence was about 350 million and amenorrhea is based on the principle
it crossed 1 billion in May 2000. that during the period of lactation after
parturition, ovulation does not occur.
2.1 Reasons for High Population Growth 2. Barrier Methods :
Reasons for high population growth area as (a) Condoms :
follows : (b) Diaphragms, Cervical Caps and Vaults :
(c) Spermicidal Creams, Jellies and Foams :
3. Intra Uterine Devices (IUDs) : These devices 5. SEXUALLY TRANSMITTED DISEASES (STDS)
are inserted by doctors in the uterus through Infections or diseases that are transmitted through
vagina. There are three types of IUDs sexual intercourse are collectively called sexually
available: transmitted diseases (STDs) or venereal diseases
(a) Non-medicated IUDs : (VD) or reproductive tract infections (RTI).
(b) Copper Releasing IUDs : These include gonorrhoea, syphilis, genital herpes,
(c) Hormone Releasing IUDs : chlamydiasis, genital warts, trichomoniasis,
4. Oral Contraceptive : This involves uptake of hepatitis-B, HIV.
hormonal preparations of either progestogens
6. INFERTILITY
or progestogenestrogen combinations in
the form of pills by females. They inhibit It is the inability to produce children in spite of
ovulation and implantation as well as alter unprotected sexual cohabitation. The reasons of
the quality of cervical mucus to prevent entry infertility could be physical, congenital diseases,
of sperms. drugs, immunological or even psychological.
Saheli, an oral contraceptive for females The infertile couples could be assisted to have
children through certain special techniques called
containing a non-steroidal preparation was
assisted reproductive technologies (ART), which
developed by scientists at Central Drug
are given below.
Research Institute (CDRI) in Lucknow. Pills
have high contraceptive value and few side 1. Test Tube Baby Programmes : In this method,
effects. ova from the wife/donor (female) and the
sperms from the husband/donor (male) are
5. Injections and Implants : Progestogens or
collected and induced to form zygote under
progestogen-estrogen combination can also
simulated conditions in the laboratory. This
be used by females as injections or implants
process is called in vitro fertilisation (IVF).
under the skin. Their mode of action is similar
to that of pills but their effective periods are There is two modern types of IVF
(a) ZIFT
longer.
(b) IUT
6. Surgical Methods (Sterilisation) : These are
2. Gamete Intra Fallopian Transfer (GIFT) :
terminal and permanent methods which block
It is the transfer of an ovum collected from
the transport of gametes, thereby preventing
a donor into the fallopian tube of another
conception.
female who cannot produce one, but can
In males, a small part of the vas deferens is
provide suitable environment for fertilisation
removed and tied up through a small incision
and further development of the embryo.
on the scrotum. This is called vasectomy.
3. Intra Cytoplasmic Sperm Injection (ICSI) :
In females, a small part of the fallopian
It is a procedure to form an embryo in the
tube is removed and tied up through a small
laboratory by directly injecting the sperm
incision in the abdomen or vagina. This is
into an ovum.
called tubectomy.
4. Artificial Insemination (AI)
4. MEDICAL TERMINATION OF PREGNANCY (MTP) (a) In this method, the semen collected
either from the husband or a healthy
It is defined as intentional or voluntary termination
donor is artificially introduced into the
of pregnancy before full term. MTP was legalised
vagina or into the uterus (intra uterine
by Government of India in 1971 under strict
insemination or IUI).
conditions to avoid misuse.
(b) This technique is used in cases where the
MTP is done in the following situations:
male is unable to inseminate sperms in
1. Failure of contraceptive used during coitus or the female reproductive tract or due to
rapes. very low sperm counts in the ejaculation.
2. When continued pregnancy is harmful or
fatal to either mother or foetus or both.
It is safe during first trimester, i.e., up to 12 weeks
of pregnancy.
are inserted by doctors in the uterus through 18. One of the legal methods of birth control is
vagina. These are available as non-medicated (a) by having coitus at the time of day break.
IUDs (i.e., Lippes lopp), copper releasing IUDs (b) by a premature ejaculation during coitus.
(progestasert, LNG-20). Vault cap is hemispheric (c) abortion by taking an appropriate medicine.
dome like rubber or plastic cap with a thick rim (d) by abstaining from coitus from day 10 to 17
which is meant for fitting over the vaginal vault of the menstrual cycle.
over the cervix. Ans : FOREIGN 2017
Thus (b) is correct option.
Intentional or voluntary termination of pregnancy
16. Assisted reproductive technology, IVF involves by taking an appropriate medicine before full term
transfer of is called medical termination of pregnancy (MTP)
(a) ovum into the fallopian tube or induced abortion. Nearly 45 to 50 million MTPs
(b) zygote into the fallopian tube are performed in a year all over the world which
(c) zygote into the uterus account to 1/5th of the total number of conceived
pregnancies in a year. MTP has a significant role
(d) embryo with 16 blastomeres into the fallopian
in decreasing the population though it is not
tube
meant for that purpose. Government of India
Ans : DELHI 2007
legalized MTP in 1971 with some strict conditions
Assisted reproductive technologies (ART) include to avoid its misuse. Such restrictions are all the
a number of special techniques which assist more important to check indiscriminate and
infertile couples to have children. An important illegal female foeticides.
technique of ART is test tube baby programme. Thus (c) is correct option.
The baby produced by conceiving in a culture
dish and nursing in the uterus is called a test tube 19. The stage transferred into the uterus after induced
baby. This method involves in vitro fertilization fertilization of ovum in the laboratory is
(IVF), i.e., fertilization of male and female gamete (a) embryo at 4 blastomeres stage
outside the body in almost similar conditions as (b) embryo at 2 blastmoeres stage
that in the body followed by embryo transfer (c) morula
(ET). Zygote or embryo upto 8 blastomeres is
(d) zygote
transferred into the fallopian tube (ZIFT - Zygota
Intra Fallopian Transfer) and mature embryo with Ans : COMP 2019
more than 8 blastomeres is transferred to uterus Cleavage divisions produce a solid ball of cells
to complete its further development. called morula. It has 8-16 cells, occasionally 32
Thus (b) is correct option. cells. It is transferred into uterus (IUT-Intra-
uterine transfer) for further development.
17. Artificial insemination means Thus (c) is correct option.
(a) artificial introduction of sperms of a healthy
donor into the vagina. 20. One of the following is not a method of
(b) introduction of sperms of a healthy donor contraception. Which one?
directly into the ovary (a) condoms
(c) transfer of sperms of a healthy donor to a test (b) pills of a combination of oxytocin and
tube containing ova vasopressin.
(c) lippes loop
(d) transfer of sperms of husband to a test tube
containing ova (d) tubectomy
Ans : DELHI 2005
Ans : SQP 2014
Oxytocin is a birth hormone and vasopressin
In artificial insemination technique, the semen of
(anti-diuretic hormone) reabsorbs water from the
a healthy donor male is collected and is introduced
renal tubles to conserve water in the body. They
artificially through a flexible polyethylene catheter
have no role in contraception.
into the vagina or into uterus called intrauterine
Thus (b) is correct option.
insemination (IUI). Best results are obtained
when the motile sperm count is more than 10 21. The test-tube baby programme employs which
million. The fertilizing capacity of spermatozoa one of the following techniques?
(sperms) is for 24-28 hours. The procedure may (a) intra cytoplasmic sperm injection (ICSI)
be repeated 2-3 times over a period of 2-3 days. (b) intra uterine insemination (IUI)
Thus (a) is correct option.
(c) gamete intra fallopian transfer (GIFT)
rapes. When pregnancy continuation could be 72. Why is Saheli considered an effective contraceptive
harmful or even fatal to mother or foetus. MTPs for women to space children?
are considered relatively safe during first trimester Ans : FOREIGN 2019
or up to 12 weeks of pregnancy. Second trimester Hormonal preparations (progestogens or
MTPs are much more riskier. progestogens and estrogen) inhibit ovulation and
implantation. Saheli, a new oral pill is used once-
69. What is amniocentesis ?
a-weak, a steroid preparation with very less side
Ans : COMP 2005
effects and high contraceptive value developed by
Amniocentesis is a prenatal test in which a small CDRI, in Lucknow, India.
amount of amniotic fluid is removed from the sac
surrounding the fetus for testing. It is done with the 73. Why is ZIFT a boon to childless couples? Explain
help of a fine needle which is inserted into the uterus the procedure.
through the abdomen, under ultrasound guidance. Ans : COMP 2020
The fluid is then sent to a laboratory for analysis.
ZIFT (zygote intra-fallopian transfer) is a part of
Amniocentesis can be done for various reasons. test-tube baby programme. It is performed specially
1. Genetic testing- Genetic amniocentesis is where the male partner is infertile. The egg is
performed to diagnose certain conditions, extracted from female and is in-vitro fertilized by
such as Down syndrome. the sperms of husband/donor. The zygote is made
2. Fetal lung testing- It helps to determine to develop into embryo. When the embryos are
at 8-celled blastomere stage, are transferred into
for birth. fallopian tube for further development.
3. Diagnosis of fetal infection- Occasionally, 74. List various artificial birth control measures.
amniocentesis is used to evaluate a baby for
Ans : OD 2023
infection or other illness. The procedure also
can be done to evaluate the severity of anemia 1. Use of contraceptives such as condom,
in babies who have Rh sensitization. diaphragm, cervical cap, IUDs and oral pills
and vaginal tablets, jellies, pastes and creams,
70. What do you think is the significance of (Prevent contact of sperms and eggs).
reproductive health in a society ? 2. Surgical operation, namely vasectomy and
Ans : DELHI 2016 tubectomy (tubal ligation).
Reproductive health refers to a total well being 3. Abortion (MTP).
in all aspects of reproduction i.e., physical,
emotional, behavioural and social. 75. Write short note on RCH programmes.
A reproductively healthy society can solve all the Ans : DELHI 2021
problems of a nation such as population explosion, RCH (reproductive and child health care)
sex abuse, sec related crimes, unhygienic conditions programmes through health centers provide:
and standard living condition. Therefore, for
1. Necessary and right information, guidance
a healthy society, it is important to maintain
reproductive health. and help to the mothers before and after
delivery so that they can properly look after
71. Explain how do the following act as contraceptives: themselves and the infants.
1. Cu-T 2. Ensures safe delivery of infant and postnatal
2. Saheli care.
Ans : SQP 2015 3. Provides for immunization of infants and
1. Cu-T : Cu-T is an intrauterine device used as prophylaxis against anaemia and vitamin
a contraceptive. It releases Cu ++ ions which deficiency.
suppress sperm motility, thereby preventing 4. Arranges milk feeding programmers.
the fertilisation of the ovum. 5. Training midwives.
2. Saheli : Saheli is a new oral pill used once a 6. Educating fertile couples about the benefits
week. It is a steroid preparation with very of small family.
less side effects and high contraceptive value.
76. Who is a surrogate mother ?
It is a hormonal preparation (Progestogens
Ans : COMP 2005
and estrogens) which inhibit ovulation and
A surrogate mother is a mother who substitutes
implantation.
ASSERTION AND REASON (b) Both Assertion and Reason are correct, but
Reason is not the correct explanation of
Assertion.
DDIRECDION : Rach of these questions contains as
(c) The Assertion is correct but Reason is
Assertion following by Ieason. Iead them carefully and
incorrect.
answer the question on the basis of following options.
You have to select the one that best describes the two (d) Both the Assertion and Reason are incorrect.
statements. Ans : DELHI 2009
Intra-uterine device (IUD) Copper-T is plastic or
39. Assertion : Cu-T and Cu-7 do not suppresses metal object placed in the uterus by a doctor.
sperm-motility. Copper-T prevent the fertilization of the egg or
Reason : Hormones released by them affect sperm implantation of the embryo.
motility. Thus (c) is correct option.
(a) Both Assertion and Reason are correct and
Reason is the correct explanation of Assertion.
(b) Both Assertion and Reason are correct, but VERY SHORT ANSWER QUESTIONS
Reason is not the correct explanation of
Assertion.
(c) The Assertion is correct but Reason is 42. Reproductive health refers only to healthy
incorrect. reproductive functions. Comment.
(d) Both the Assertion and Reason are incorrect. Ans : OD 2005
No, reproductive health refers to the total well-
Ans : FOREIGN 2020
being in all aspects of reproduction, i.e. physical,
Cu-7 and Cu-T are intrauterine contraceptive
emotional, psychological and social.
devices for females. They do not suppress sperm
motility. Their mode of action is different. Cu-T 43. Mention one positive and one negative application
and Cu-7 discharge 50-75 micrograms of ionic of amniocentesis.
copper into the uterus daily. These copper ions Ans : DELHI 2010
interfere with life-sustaining functions that Positive application It is a medical procedure
regulate implantation in the uterus. No any used in prenatal diagnosis of chromosomal
hormone is released by them. abnormalities, foetal infections, etc.
Thus (c) is correct option. Negative application It leads to female foeticide
in gender biased communities.
40. Assertion : HIV infection can be avoided by use
of condoms. 44. What are the suggested reasons for the population
Reason : Condoms secrete anti-viral interferons. explosion?
(a) Both Assertion and Reason are correct and
Ans : COMP 2010
Reason is the correct explanation of Assertion.
(i) Rapid decline in the overall death rate
(b) Both Assertion and Reason are correct, but
because of better medical facilities.
Reason is not the correct explanation of
Assertion. (ii) Increase in number of people in reproducible
age.
(c) The Assertion is correct but Reason is
incorrect. 45. How does Cu-7, Multiload 375 and progestasert,
(d) Both the Assertion and Reason are incorrect. LNG-20 differ in contraceptive action?
Ans : SQP 2005 Ans : SQP 2005
The use of condoms has been shown to decrease Cu-7 and Multiload 375 are copper releasing IUDs
the transmission of AIDS because condoms is containing copper ions, whereas progestasert and
contraceptic. LNG-20 are hormone releasing IUDs.
Thus (c) is correct option.
46. Name an IUD that you would recommend to
41. Assertion : Copper-T is an effective contraceptive promote the cervix hostility to sperms.
device in human females. Ans : DELHI 2014
Reason : Copper-T prevents passage of sperms
from vagina upwards into fallopian tubes. LNG-20 are recommended to promote the cervix
(a) Both Assertion and Reason are correct and hostility to sperms.
Reason is the correct explanation of Assertion.
47. How can pregnancy due to rape or casual Ans : COMP 2014
unprotected intercourse be prevented? False, often female is blamed for the couple being
childless, but more often the problem lies in male
Ans : DELHI 2010
partner.
By using emergency contraceptives, e.g. i-pill.
56. Give some reasons for infertility among young
48. How do hormonal pills work as contraceptives?
couples.
Ans :
Ans : OD 2013
An oral pill prevents pregnancy in the following
Drugs, congenital diseases, smoking, etc.
ways
(i) It inhibits ovulation and implantation.
57. What is the method of directly injecting a sperm
(ii) It alters the quality of cervical mucus and into ovum called as?
retards the entry of sperms into cervix.
Ans : DELHI 2017
49. Name the contraceptive recently developed at Intra Cytoplasmic Sperm Injection (ICSI).
CDRI, Lucknow.
Ans : OD 2024, 2009
58. Mention some of the important attributes of
Saheli is an once a week oral contraceptive reproductive health of a society.
developed at CDRI, Lucknow. Ans : OD 2005
Reproductive health means a total well-being in
50. Our government has intentionally imposed strict all aspects of reproduction in physical, emotional,
conditions for MTP in our country. Justify giving behavioural and social.
a reason.
Ans : DELHI 2017
59. List out the consequences of population explosion.
MTP or induced abortion is termination of Ans : FOREIGN 2007
sperms. The hormone releasing IUDs. in addition, and the cervix hostile to the sperms. It is a ideal
make the uterus unsuitable for implantation and contraceptives for females in urban areas.
the cervix hostile to the sperms.
Advantages 85. All reproductive tract infections (RTIs) are STDs,
IUDs are ideal contraceptives for the females who but all STDs are not RTIs. Justify with example.
want to delay pregnancy and /or space children. Ans : FOREIGN 2014
It is one of most widely accepted method of Among the common STDs-gonorrhoea, syphilis,
contraception in India. genital herpes, chlamydiasis, hepatitis-B, AIDs
etc., hepatitis-B, and AIDs are not infections of
82. Briefly explain IVF and ET. What are the the reproductive organs though their mode of
conditions in which these methods are advised? transmission could be through sexual contact also.
Ans : COMP 2005 All other diseases are transmitted through sexual
IVF and ET refers to in vitro fertilization and contact and are also infections of the reproductive
embryo transfer. Gametes from the male and tract.
female are collected hygienically and induced
to fuse in the laboratory setup under simulated 86. Define population density. What are consequences
conditions. The zygote formed is collected and of high population density?
is introduced into the uterine region of a host Ans : COMP 2016
or surrogate mother at an appropriate time Population density is the number of individuals of
(secretory phase). These methods are advised a species per unit area or volume e.g. number of
when the female has blocked fallopian tubes or humans/animals per square kilometre; number of
the male produce few sperms i.e., oligospermic. trees per acre of a forest etc. If the total number
of individuals is represented by letter N and the
83. List the objectives of Reproductive and child number of units of space by letter S, the population
Health Care Programmes (RCH). density D can be obtained as D = N/S.
Ans : COMP 2005
Consequences of Higher Population Density
Different objective of RCH are as follow :
As the population density increases in a country
1. Creating awareness about various beyond its carrying capacity; it causes many
reproduction related problems. problems such as:
2. Providing facilities and support for building 1. Decrease in per capita income
up a reproductively healthy society. 2. Decrease in availability of natural resources
3. Providing audio-visual and print media like hand, minerals, wood, fuel, etc.
support to various government and non- 3. General health goes down.
government organisations.
4. The large population of a country is the result
4. Educating the people and providing right of having large families and the quality of life
information and to save them from myths and gets deteriorated accordingly.
misconceptions.
5. Providing proper education regarding 87. Suggest the aspects of reproductive health which
reproductive organs, adolescence and related need to be given special attention in the present
changes, safe and hygienic sexual practices. scenario.
6. Providing information regarding danger of Ans : DELHI 2018
sexually transmitted diseases, AIDS etc. The following aspects of reproductive health need
to be given special attention in present scenario:
84. A mother of one year old daughter wanted to 1. Educating married couples about available
space her second child. Her doctor suggested Cu- birth control options, care of pregnant
T. Explain its contraceptive actions. mothers, postnatal care of mother and child,
Ans : OD 2007 importance of breast feeding.
Cu-T is intrauterine device. These intrauterine 2. Equal opportunities for male and female
devices are presently available as the non- child.
medicated and their hormone releasing IUDs.
3. Control of human population, preference for
It increases phagocytosis of sperms within the
small families.
uterus and Cu ions released suppress sperms
motility and the fertilizing capacity of sperms. 4. Introduction of sex-education.
It makes the uterus unsuitable for implantation
the real mother to nurse the embryo in her uterus/ 2. Ultrasound imaging or sonography technique
womb because some women can produce normal uses high-frequency sound waves ranging
ovum but cannot support a full term pregnancy between 1 to 15 MHz frequency. This
due to physiological and anatomical reasons. Thus, technique is totally harmless, non-invasive
an in-vitro embryo is implanted into the womb of and it does not use any ionic radiations.
another women who carries it for the full term of
pregnancy and give birth to a healthy baby. 79. What are various oral contraceptive used? How do
they function? What is the advantage of Saheli?
77. What are permanent methods for contraception? Ans : COMP 2005
Ans : SQP 2010
Oral administration of small doses of either
Sterilization is a permanent and sure method progestogens or progestogen-estrogen
for contraception. It is done by cutting and combinations is another contraceptive method
ligating vas deferens (vasectomy) in males and used by the females. They are used in the form of
cutting and ligating fallopian tubes (tubectomy) tablets and hence are popularly called the pills.
in females. These methods do not interfere the They inhibit ovulation and implantation as well
normal healthy life of the individuals. They block as alter the quality of cervical mucus to prevent/
the transport of gametes to avoid fertilization. retard entry of sperms from vagina. Pills are
very effective with lesser side effects and are well
78. Name two new techniques for determining the
condition of the foetus. accepted by the females.
Ans : FOREIGN 2007 Advantages of Saheli
1. Chorionic villus sampling (CVS) sloughed off Saheli, the new oral contraceptive for the female
foetal cells are sucked into a catheter passed contains a nonsteroidal preparation called
through the cervix without injuring the foetus. centchroman. It is a one a weak pill with very few
This provides a mass of rapidly dividing foetal side effects and high contraceptive value.
cells for detection of any chromosomal disorders. Recently a new pill i-pill has been introduced
by Cipla pharmaceuticals to be used within 72
hours of unprotected sex to avoid unwanted and
undesired pregnancy.
At present the most widely accepted method Amniocentesis is withdrawal of a sample of the
of contraception in India is IUDs. These Intra fluid (amniotic fluid) surrounding a foetus in
Uterine Devices (IUDs) are presently available as the uterus by piercing the amniotic sac through
the nonmedicated IUDs (e.g. lippes loop), copper the abdominal wall, under direct ultrasound
releasing IUDs (CuT, Cu7, Multiload 375) and the guidance. AS the amniotic fluid contains cells
hormones releasing IUDs (Progestasert, LNG-20). from the foetus, cell cultures enable chromosome
IUDs increase phagocytosis of sperms within the patterns to be studied so that prenatal diagnosis of
uterus and the Cu-ions released suppress sperm chromosomal abnormalities can be made. Certain
motility and the fertilizing capacity of sperms. metabolic errors and other abnormalities, such
The hormone releasing IUDs make the uterus as spina bifida, can also be diagnosed prenatally
unsuitable for implantation and cervix hostile to from analysis of the cells or of the fluid.
the sperms. As this technique also helps in detection of
Thus (d) is correct option. sex of the unborn foetus, it has been banned in
order to legally check increasing female foeticide.
23. Medical termination of pregnancy (MTP) Thus (d) is correct option.
is considered safe up to how many weeks of
pregnancy? 26. Cu ions released from copper-releasing intra
(a) eight weeks (b) twelve weeks uterine devices (IUDs)
(c) eighteen weeks (d) six weeks (a) make uterus unsuitable for implantation
Ans : OD 2005
(b) increase phagocytosis of sperms
Medical termination of pregnancy (MTP) or (c) suppress sperm motility
abortion is the termination of pregnancy before (d) prevent ovulation
the foetus becomes viable. MTP is comparatively Ans : FOREIGN 2010
safe upto 12 weeks (the first trimester) of Copper releasing IUDs (i.e., CuT, LNG-20) are
pregnancy. It becomes more risky after the first placed in the uterus of the females. They are
trimester period of pregnancy as the foetus efficient birth control methods. Copper ions
becomes intimately associated with the maternal released by them suppress motility and fertilizing
5. Proper information about safe sex, adolescence 91. Is the use of contraceptives justified? Give reasons.
related problem, STD, AIDS etc. Ans : SQP 2008
6. Different techniques for birth control. Yes, the use of contraceptive is very much justified.
7. Research on various reproduction related By using contraceptive unwanted pregnancy can
areas. be prevented or delayed or a proper gap can be
maintained between the first and second child. It
88. Do you think that reproductive health in our will help in bringing birth rate down and in the
country has improved in the past 50 years? If yes, long run, check uncontrolled growth of population.
mention some such areas of improvement. Use of contraceptives should be promoted and
Ans : OD 2009 encouraged and all the fertile couples should be
Yes, the reproductive health in our country has brought under its cover.
greatly changed and improved in the past 50
92. Amniocentesis for ex determination is banned in
years. Some such areas of improvement are:
our country. It this ban necessary? Comment.
1. Family planning programmes.
Ans : DELHI 2013
2. Large-scale child immunization programme Yes, the ban imposed on amniocentesis technique
e.g., pulse-polio. for sex-determination is quite proper and justified.
3. Maternity and child health. Amniocentesis helps in foetal sex-determination
4. Increased use of easy and availability of and thus there are large number of illegal female
contraceptives. foeticide cases disturbing the normal sex ratio in
5. Improved medical facilities available for the the country, especially the northern states. The
people have a great desire and craze for the male
treatment of diseases.
child, for social security and religious reason,
6. Decline in death-rate of infants. and go for ex-determination and resultantly
7. Increased awareness among people about female foeticide. Technique amniocentesis has
reproduction related aspects. been exploited very much though originally
this technique was developed to prevent the
89. In sex education necessary in schools ? Why ? birth of genetically abnormal children. Though
Ans : SQP 2010 Govt. of India has legally banned amniocentesis,
Yes, the introduction of sex eduction in schools throughout India but it should strictly be imposed
is very necessary to discourage the children from with a severe punishment for defaulters.
believing in myths and having misconceptions
about sex-related aspects. Children have the right 93. Removal of gonads cannot be considered as a
to get proper information about reproductive contraceptive option. Why ?
organs, adolescence and related changes, safe and Ans : COMP 2006
hygienic sexual practices, STD, AIDS etc. Removal of the gonads at all, cannot be considered
as a contraceptive option because it has large
90. What are the suggested reasons for population number of demerits.
explosion ?
1. It is a surgical, irreversible process.
Ans : DELHI 2017
Following are some of the suggested reasons for 2. It will lead to infertility in both male and
population explosion: female.
1. Decline in mortality rate due to increased and 3. It interferes with sexual desire.
improved medical facilities. 4. Surgical removal of gonads will also produce
2. Decline in infant mortality rate, due to side effects, because gonads not only produce
intensive immunization programmes. sex cells but also secrete hormones. The
deficiency of hormones will produce, various
3. Decline in maternal mortality rate.
disorders. Some important metabilic activities
4. Increase in number of people in reproductive
will be affected.
age.
5. Increased food production due to intensive 94. Suggest some methods to assist infertile couples
agriculture leading to very few deaths due to to have children.
starvation, famine etc. Ans : FOREIGN 2007
1. IVF (In-vitro fertilization) in case of blocked 97. Describe the technique by which genetic disorder
fallopian tubes. in a developing foetus can be detected.
2. ET-Embryo transfer technique (test-tube Ans : FOREIGN 2005
babies), surrogate mothers can also be used. Amniocentesis is a technique by which genetic
3. GIFT-Gamete intrafallopian transfer. disorder in a developing foetus can be detected.
4. ICSI-Intracytoplasmic sperm injection. This is based on the chromosomal pattern in
the cells found in the amniotic fluid surrounding
5. IUI-Intra-uterine insemination. the developing embryo. Amniotic fluid contains
95. What are the measures one has to take to prevent cells and molecules shed by the foetus. The
from contracting STDs? chromosomes of foetal cells can also be used to
find out the sex of the foetus and abnormalities
Ans : OD 2009
if any. So, if an abnormality is found, the mother
STDs are sexually transmitted diseases which are
can get the foetus aborted.
transmitted from an infected person to a normal
person through sexual intercourse e.g., AIDS, 98. Write the role of hormones in contraception.
gonorrhoea; syphilis, genital herpes etc. Ans : FOREIGN 2015
Preventive Measures Progestogens or progestogen-estrogen
1. Avoid sex with unknown partners/multiple combinations play an important role in
partners. contraception. They are used in the form of
2. Always use condom during sexual intercourse. tablets or pills. They inhibit ovulation and hence
implantation. They are also used by females
3. Avoid sharing of injection needles, unsterilized as injections or implants under the skin. Their
surgical instruments etc. mode of action is similar to that of pills but their
4. Creating awareness particularly in young effective periods are longer.
peope about the consequences of contracting
STDs. 99. Explain the permanent methods of birth control.
5. In case of doubt do not shy and immediately Ans : COMP 2018
1. Surgical methods of contraception prevent Zygote intra fallopian transfer technique (ZIFT)
contact and transport of male and female is a technique of in vitro fertilization wherein the
gametes during sexual intercourse. zygote or early embryo having up to 8 blastomeres
is transferred into the fallopian tube to complete
2. All sexually transmitted diseases are not
its further development.
completely curable e.g., AIDS. (Few STDs
Intra uterine transfer (IUT) technique is different
are completely curable if defected early and
from ZIFT as the embryos with more than 8
treated properly).
blastomers are transferred into the uterus in IUT.
3. Oral pills are very popular contraceptives
among the educated urban women. 101. How are assisted reproductive technologies helpful
4. In ET techniques, Embryos (produced from to humans? How are ZIFT and GIFT different
in-vitro-fertilized eggs) are transferred into from intra uterine transfers? Explain.
uterus for proper implantation, growth and Ans : FOREIGN 2005
children through certain special techniques known knowns are femidoms. Along with these,
as assisted reproductive technologies (ART). cervical caps, Diaphragms and vaults are
ZIFT other barrier used for contraception.
The zygote or early embryo with up to 8 blastomers (b) IUDs : These are plastic or metal objects
is transferred into the fallopian tube. This is called which are inserted in the uterus through
zygote intra fallopian transfer (ZIFT). vagina by medical professionals IUD
GIFT promotes phagocytosis of sperms inside
It is the transfer of an ovum collected from a uterus. These are available as non-medicated
donor into the fallopian tube of another female, IUDS (e.g. lippese loop), copper, releasing
who cannot produce one but can provide IUDS (CuT, Multiload 375) and hormone
suitable environment for fertilization and further releasing IUDS (LNG-20, Progestasert).
development of the embryo. Copper IUDs release copper ions that
Intra uterine transfer (IUT) refers to the suppresses motility and fertilizing
introduction of embryo with more than 8 capacity of sperms.
blastomeres into the uterus of a female to complete 3. Chemical Methods : Chemical spermicide such
its further development. as lactic acid, zin sulphate etc. in form of cream
or jell are applied in female reproductive tract
LONG ANSWER QUESTIONS before inter course These chemicals destroy
sperms released during ejaculation.
102. Discuss various methods of contraception for the 4. Hormonal Methods : In this method,
regulation of population. hormones (progesterone or progesterone
oestrogen combination) in the form of pills
Ans : OD 2018
The method of deliberately prevent fertilisation to are used by females to avoid pregnancy
avoid pregnancy are called contraceptive methods. They alter or inhibit ovulation and fertilisation
The increase in population can be regulated by or modify the quality of cervical mucus to
using these methods. The various methods used prevent entry of sperms. Most commonly used
for birth control are as follows. oral contraceptives are -D and Saheli.
1. Natural Methods : The natural method of Beside these, there are emergency
contraception work on the principle of avoiding contraceptives that can be taken within
chances of meeting of gametes (fertilisation). 72 hours of coitus to avoid pregnancy. It
This can be achieved by following techniques. is specially beneficial in case of rape or
(a) Rythm Method : Sexual intercourse is unprotected sex. e.g. unwanted-72, -pill etc.
avoided specially during the ovulation 5. Injectables or Implants : Hormone injections
period of menstrual phase. containing progesterone can be also be used
(b) Lactational Amenorrhea : This method in regular interval to avoid pregnancy. Along
is based on the fact that ovulation with it subcutaneous implants of synthetic
(menstruation cycle) do not occur during progesterone are also used. These act
the period of intense lactation after child similarly to oral cont raceptives. These work
birth. This method is considered effectively
upto, period of 5 years
only upto maximum, six months after
delivery and has no side effects. 6. Strerilisation : It is a permanent method of
(c) Coitus Interrupts : Here, penis is contraception In it, ducts conducting gametes
withdrawn from vagina before ejaculation from gonads to penis in males and uterus in
females is blocked by surgical method. It is called
2. Barrier Methods : It is based on prevention
as vasectomy in males and tubectomy in females.
of fertilisation (meeting of ovum and sperm)
by placing a physical or chemical barrier in 103. Write a short essay on reproductive health.
female reproductive tract. Ans : OD 2010
(a) Condom : It is thin, strong rubber sheath Reproductive health is a state of complete
used to cover, the penis in male or vagina physical, mental and social well-being, and not
and cervix in female during coitus to prevent merely the absence of reproductive disease or
entry of sperm in the vagina. It is cheap, infirmity. Reproductive health deals with the
easy and convenient to use. It also help to reproductive processes, functions and system
prevent The female condoms are at all stages of life. It is a reflection of health
(C) Hormonal Most effective spacing Easy to use. May show side ill
effects.
Contraceptives Methods of contraception; oral
contraceptives of combined
type: app. 100% effective
to prevent pregnancy. More
than 65 million young people
of world are estimated to be
fail to pass into uterus and the sperms do not a bacterium Nisseria gonorrhoea, gram +
reach there for fertilization. bacterium. It may be detected by gram
2. Intra Uterine Devices : Loop or copper T are staining of discharge as well as the culture.
5. Genital Herpes : It is caused by Herpes simplex
the entry of spermatozoa into the uterus. virus. It is detected by clinical examination
3. Oral Contraceptive Pills : They check ovulation and antigen test as well as polymerase chain
because they inhibit the secretion of FSH reaction (PCR).
and LH (which are essential for ovulation in 6. Genital Warts : These are caused by Human
woman). Hence no eggs are released in woman. papilloma virus. This may be detected by
Conception is then not possible. clinical examination that is followed by antibody
detection, culture and DNA hybridisation.
106. Name some important sexually transmitted
7. Syphilis : This is caused by Treponema
diseases and their causative agents. How are they
detected? pallidium. It can be detected by antibody-
detection method.
Ans : FOREIGN 2005
Some of sexually transmitted diseases (over 30 are 107. Give fertility regulating methods in a tabular
known in humans) are following : form. Mention the method of contraceptives and
1. Trichomoniasis : examples of each.
due to infection by Trichomonas vaginalis. It Ans : FOREIGN 2016
is easily detected by microscopic examination The Fertility Regulating Methods are as follows :
and culture both. 1. Contraceptive Methods
2. Chlamydiasis : It is caused by a bacteria, These are definite and preventive methods to
Chalmydia trachomatis, detected by clinical keep women from unwanted pregnancies these All
examination, gram staining of discharge, antigen involve the temporary and permanent measures
detection and nucleic acid hybridisation etc. to prevent pregnancy resulting from coitus/inter-
3. Chanchroids : It is caused by Haemo-philus course.
ducrei. It is detected by clinical appraisal, The contraceptives methods are mainly grouped
and culture also. into two types : (1) Spacing Methods and (2)
Terminal Methods.
4. Gonorrhoea : It occurs due to infection of
They are following:
of sac like structures which join vasa deferentia biochemicals and enzymatic abnormalities. It is
to form ejaculatory duct. They secrete seminal usually done when woman is 14-16 weeks pregnant.
fluid which contains fructose, prostaglandins and Cleft palate can be detected by ultrasound.
clotting protein, but no sperms. In a male who Thus (b) is correct option.
has undergone vasectomy, the ejaculatory duct
will receive seminal fluid but due to cut in vasa 12. A childless couple can be assisted to have a child
deferentia sperms will not be transported from through a technique called GIFT. The full form
epididymis hence the semen will lack sperms. of this technique is
Thus (b) is correct option. (a) gamete internal fertilisation and transfer
(b) germ cell internal fallopian transfer
9. Embryo with more than 16 blastomeres formed (c) gamete inseminated fallopian transfer
due to in vitro fertilisation is transferred into
(d) gamete intra fallopian transfer
(a) uterus (b) fallopian tube
(c) fimbriae (d) cervix Ans : FOREIGN 2013
(a) it can be used for detection of LNG-20 is the hormone releasing IUD, multiload
syndrome 375 and Cu7 are copper releasing IUDs and
(b) it can be used for detection of cleft palate Lippes loops is a non-medicated IUD.
(c) it is usually done when a woman is between Thus (a) is correct option.
14-16 weeks pregnant 15. Which of the following is a hormone releasing
(d) it is used for prenatal sex determination Intra Uterine Device (IUD)?
Ans : SQP 2016 (a) multiload 375 (b) LNG-20
Amniocentesis is fetal sex determination and (c) cervical cap (d) vault
disorder test based on the chromosomal pattern Ans : OD 2008
in the amniotic fluid surrounding the developing
At present the most widely accepted method
embryo. It can be used to determine the sex of
of contraception in India is IUDs. Intra uterine
the infant, to identify some abnormalities in the
devices (IUDs) are plastic or metal objects which
number of chromosomes and to detect certain
is based as the presumption or fact that Amniocentesis is the prenatal diagnostic technique
menstrual cycle and thus ovulation do not by which foetal cells can be made available to
occur during the period of intense lactation
following birth of a child. Therefore, as far 1. Use of Amniocentesis : For detection of
as the mother breast feed her baby chances congenital diseases and sex determination.
of conception are almost nil. However this 2. Misuse of Amniocentesis : This beneficial
method is not fully safe. technique has been presently misused by
2. Barriers : Use of barriers prevent the physical many unscruplous doctors and parents. Since
union of male gamete with the female gamete. it is easy to find the sex of the foetus by this
These methods are available both for males and technique, female foetus which would have
females and are 100% safe. Some of these are: been absolutely normal have been ruthlessly
(a) Condoms : These are made up of thin rubber destroyed in order to have a male child only.
or latex sheath. They are used to cover the
penis in the males or the vagina and cervix
in the females just before the sex, so that the
ejaculated sperms would not enter into the
female reproductive tract.
(b) Diaphragms, Cervical Caps and Vaults :
These are also made up of rubber or latex
and are inserted into the female vagina
and cervix before the sex. They block the
entry of sperms through the cervic and
prevent conception.
3. Intra Uterine Devices (IUDs) : These devices
are inserted into the uterus of the female
through her vagina. Commonly available intra
uterine devices are : non-medicated IUDs (e.g.
Lippes loop), Copper releasing IUDs (CuT,
Cu7, multiload 375) and hormone releasing
IUDs (Progestasert, LNG-20) IUDs prevent
110. Write brief notes on the following: 1. Test Tube Baby Programme : It involves in-
1. What is artificial insemination? What is its vitro fertilization and transfer of zygote (at
significance?. 8 celled stage in the fallopian tubes or more
2. What are implants? Where they are placed in than 8 Blastomeres in the uterus) in the
the body? What is their importance? female reproductive tract. For this ova from
Ans : COMP 2008 the wife/donor (female) and sperms from the
husband or donor (male) are collected and
1. Artificial Insemination : In this technique the
are induced to form zygote under simulated
semen collected either from the husband or
conditions in the laboratory. The zygote or
from donor male is artificially injected into
early embryos (upto 8-blastomeres) are then
the vagina or uterus of the female to get her
transferred into the fallopian tubes (ZIFT-
conceived.
Zygote intra fallopian transfer) and embryo
Artificial insemination is useful in cases where with more than 8 blastomeres into the
the male is either having very low sperm uterus (IUT-intra uterine uterine transfer) to
count or his semen is without sperms or he complete further development. baby born by
is suffering from penial dysfunction. In such this methods is called a test-tube baby.
cases he is unable to get her wife conceived. 2. In-Vivo Fertilized Zygotes : (fusion of sperm
By artificial insemination her wife is able to and eggs within the female) and developed
produce young one. embryo taken from one female and transfer
2. Implants : Implants are the contraceptive to another female who cannot conceive for
materials these are placed in the body of a further development is also employed or to
female. They are generally implanted under assist for getting a baby.
the skin. Norplant (six rods implanted under
3. Gamete Intra Fallopian Transfer : Transfer
the skin) and implanous (one rod implant) of an ovum collected from a donor into
are 99% effective to prevent pregnancy. They the fallopian tubes of another female who
inhibits ovulation. cannot produce one, but can provide suitable
111. State the role of education upon women in our environment for fertilization is another ART
society. for producing a baby.
Ans : DELHI 2011 4. Intra Cytoplasmic Sperm Injection (ICSI) :
Education plays role in development of child. The In this technique an embryo is developed in
female child with more education tend to be more the laboratory in which a sperm is directly
prosperous and healthier. Educated women have injected into the ovum. This embryo is then
a few but healthier children. Some evils like early transferred in the fallopian tubes or uterus for
pregnancy. Child bearing and poverty are mostly further development of the baby.
related to less educated women. The young women 5. Artificial Insemination : Infertility cases
of age between15-19 years face serious health either due to inability of the male partner
risks. The reason is their incomplete growth. The to inseminate the female or due to very
height and pelvic size do not grow fully. This cause low sperm count in the ejaculates, could be
great risk of obstructed labour. If birth canal is corrected by artificial insemination technique.
blocked, it may cause injury or death of the foetus
In this technique the semen collected either
delivered child or even the mother.
from the husband or from a healthy donor is
The infants of young mothers are most immature.
artificially injected either into the vagina or
They have low birth rates also. So education has
into the uterus of the female for conceiving
a key role in womens and children of our society.
the female.
112. What is infertility? Give a brief account of assisted
reproductive technologies (ARTs) to overcome
the problem of infertility.
Ans : DELHI 2005