Chapter
26 Reproductive Health
Reproductive health means a total well-being in all aspects of
reproduction. It includes physical, emotional, behavioural and
social well-being.
India introduced a number of programmes to ensure reproductive
health to all in 1951. E.g. reproductive health programmes and
family planning.
AIMS OF REPRODUCTIVE AND CHILD HEALTH CARE
(RCH) PROGRAMMES
yy To aware people about reproductions related aspects:
Sexually transmitted diseases (STDs) such as AIDS,
gonorrhoea etc. are transmitted from one individual to
another through sexual contact. It can also lead to unwanted
pregnancies. Hence, it is necessary to create awareness
among people especially the youth, regarding various
reproduction related aspects as the young individuals are
the future of the country and they are most susceptible of
acquiring sexually transmitted diseases.
yy To create a reproductively healthy society: Spreading
awareness regarding uncontrolled population growth and
social evils among young individuals will help in bringing
up a reproductively healthy society.
How has the Government taken measures?
yy Several audio visual aids and pamphlets have been developed
by both governmental and non-governmental organisations.
yy Awareness is being created among school children by
introducing sex education in schools.
Aims and needs of sex education in schools
yy To provide right information about sex-related aspects.
yy To avoid sex-related myths and misconceptions.
yy Proper information about reproductive organs, adolescence
and related changes, safe and hygienic sexual practices,
sexually transmitted diseases (STD), AIDS etc.
POPULATION EXPLOSION
yy In 1900 the world population was around 2 billion (2000
million). By 2000, it rocketed to about 6 billion.
yy In India, population was nearly 350 million at the time of
independence. It crossed 1 billion in May 2000. It means
every sixth person in the world is an Indian.
yy According to the 2001 census report, the population growth
rate was still around 1.7% (i.e. 17/1000/year), a rate at which
our population could double in 33 years.
Reasons for Population Explosion
yy Increased health facilities and better living conditions.
yy A rapid decline in death rate, maternal mortality rate
(MMR) and infant mortality rate (IMR).
yy Increase in number of people in reproducible age.
Impacts of Population Explosion
yy It has led to scarcity of basic requirements such as food,
shelter and clothing. Therefore, it is necessary to check this
increase in population.
Control Measures to Check Population Explosion
yy Motivate smaller families by using contraceptive methods.
yy Aware peoples about a slogan Hum Do Hamare Do (we two,
our two). Many couples have adopted a ‘one child norm’.
yy Statutory rising of marriageable age of the female (18 years)
and males (21 years).
BIRTH CONTROL
yy It is essential to ensure birth control to check the population
growth.
yy Governments have come out with various programmes that
encourage smaller families by means of various contraceptive
methods.
yy Contraceptive devices are used to prevent unwanted
pregnancy and to prevent the spreading of STDs.
Contraceptive Method
yy Contraceptive methods are of two types:
²² Natural method of contraception
²² Artificial means of contraception
 Reproductive Health
yy An ideal contraceptive should be
²² User-friendly, easily available, effective and
reversible.
²² No or least side-effects.
²² It should not interfere with sexual drive, desire and sexual
act.
1. Natural/Traditional methods
It works on the principle of avoiding chances of ovum and
sperms meeting. It includes
(i) Periodic abstinence: It involves avoiding of coitus from
days 10 to 17 of the menstrual cycle, when ovulation
could be expected. The chances of fertilization are very
high in this period. It is called fertile period.
(ii) Coitus interruptus (withdrawal): It involves withdrawal
of penis from the vagina just before ejaculation, so as to
avoid insemination into the vagina.
(iii) Lactational amenorrhea: It involves the prevention of
conception by breastfeeding the child. Ovulation and the
cycle do not occur during the period of lactation. It has
no side effect. However, this is effective up to 6 months
following parturition. A chance of failure of this method
is high.
2. Artificial methods
(A) Barrier methods
• This method prevents the physical meeting of sperm
and ovum. It is available for both male and female
partners.
(i) Condoms : Condoms are made of rubber/latex sheath.
They are used to cover the penis in male or vagina and
cervix in the female. They are used just before coitus so
that the semen does not enter into female reproductive
tract.
Condoms are very popular because:
♦♦ It protects the user from STDs and AIDS.
♦♦ It is disposable.
♦♦ It can be self-inserted and thereby give privacy to user.
(ii) Diaphragms, cervical caps and vaults:
♦♦ These are barriers made of rubber that are inserted
into the female reproductive tract to cover the cervix
during coitus.
♦♦ They prevent conception by blocking the entry of
sperms through the cervix.
♦♦ They are reusable.
(iii) Spermicidal creams, jellies and foams are used along
with the barriers to increase contraceptive efficiency.
(B) Intra Uterine Devices (IUDs): These devices are used
only by female. These are inserted by doctors or expert
nurses in the uterus through vagina.
• This includes
(i) Non-medicated IUDs (E.g. Lippes loop)
(ii) Copper releasing IUDs (E.g. CuT, Cu7, Multiload
375)
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(iii) Hormone releasing IUDs (e.g. Progestasert, LNG-20):
It makes the uterus unsuitable for implantation and
the cervix hostile to the sperms.
• IUDs increase phagocytosis of sperms. The Cu ions
suppress motility and fertilising capacity of sperms.
• IUDs are ideal contraceptives for the females who want
to delay pregnancy or space children. 
(C) Oral contraceptives
• This method is used by female only.
• It is used in the form of tablets, hence known as pills.
• They contain hormones- either progestogens or
progestogen–estrogen combinations.
• Pills are taken daily for 21 days starting within the
first five days of menstrual cycle. After a gap of 7 days
(during which menstruation occurs) it has to be repeated
in the same pattern till the female desires to prevent
conception.
• They inhibit ovulation and implantation as well as
alter the quality of cervical mucus to prevent entry of
sperms.
• Pills are very effective with lesser side effects.
• E.g. Saheli: It is a non-steroidal preparation used as
oral contraceptive pills. It is a ‘once a week’ pill with
very few side effects and high contraceptive value.
(D) Injectables
• It involves usage of hormone- Progestogens alone or in
combination with oestrogen, by females as injections
or implants under skin.
• Their mode of action is similar to that of pills. It is very
effective for longer periods.
(E) Emergency contraceptives
♦♦ These are used within 72 hours of coitus, rape or
causal unprotected intercourse.
♦♦ It involves administration of Progestogens or
progestogen-oestrogen combinations and IUDs.
(F) Surgical methods (also known as sterilization
methods)
²² It is the permanent or terminal method to prevent
pregnancy.
²² This method blocks the transport of gamete, thereby
preventing conception. It is very effective but reversibility
is poor.
²² It includes:
(i) Vasectomy: It is the sterilization procedure in males.
In this, a small part of the vas deferens is removed or
tied up through a small incision on the scrotum.
(ii) Tubectomy: It is the sterilization procedure in females.
In this, a small part of the fallopian tube is removed
or tied up through a small incision in the abdomen or
through vagina.

558
Fig.: (a) Vasectomy Fig.: (b) Tubectomy
Side effects of anti-natural contraceptives
Nausea, abdominal pain, breakthrough bleeding, irregular menstrual
bleeding, breast cancer etc.
MEDICAL TERMINATION OF PREGNANCY (MTP)
yy The Intentional or voluntary termination of pregnancy before
full term is known as MTP.
yy It is also known as induced abortion.
yy About 45 to 50 million MTPs are performed in a year
all over the world (i.e. 1/5th of total number of conceived
pregnancies).
yy It has a significant role in decreasing population. Sometimes,
it becomes essential when continued pregnancy may prove
to be fatal to the mother, foetus or both.
yy MTPs are safe during the first trimester, (up to 12 weeks of
pregnancy). 2nd trimester abortions are very risky.
yy Government of India legalised MTP in 1971 with some
strict conditions to check indiscriminate and illegal female
foeticides.
Importance of MTP
yy MTP is used to avoid unwanted pregnancies due to casual
intercourse or failure of the contraceptive used during coitus
or rapes.
yy It is essential in cases where continuation of the pregnancy
could be harmful to the mother or to the foetus or both.
Problems related with MTPs
yy Majority of the MTPs are performed illegally.
yy Misuse of amniocentesis (a foetal sex determination test
based on the chromosomal pattern in the amniotic fluid). If
the foetus is female, it is followed by MTP. Such practices
are dangerous for the young mother and foetus.
Amniocentesis:
yy Amniocentesis is a prenatal diagnostic technique that
is used to determine the sex and metabolic disorders of
the developing foetus in the mother’s uterus through the
observation of the chromosomal pattern.
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BIOLOGY
yy This method was developed so as to determine any kind of
genetic disorder present in the foetus. However, unfortunately,
this technique is being misused to detect the sex of the child
before birth and the female fetus is then aborted.
yy Thus, to prevent the increasing female foeticides, it is
necessary to ban the usage of amniocentesis technique for
determining the sex of the child.
SEXUALLY TRANSMITTED DISEASES (STDS)
yy Diseases transmitted through sexual intercourse are called
sexually transmitted diseases (STDs).
yy It is also known as Venereal diseases (VD) or Reproductive
tract infections (RTI).
yy Some of the STDs are: Gonorrhoea, syphilis, genital herpes,
chlamydiasis, genital warts, trichomoniasis, hepatitis-B and
AIDS.
yy Except hepatitis-B, genital herpes and HIV infections,
others diseases are completely curable if detected early and
treated properly.
Early Symptoms
yy Itching, fluid discharge, slight pain, swellings, etc., in the
genital region.
yy STDs remain asymptomatic in female and remain undetected
for long.
yy When not detected and treated in time, it may lead to pelvic
inflammatory diseases (PID), abortions, still births, ectopic
pregnancies, infertility, cancer of the reproductive tract etc.
yy All persons are vulnerable to STDs. These are very high
among persons in the age group of 15-24 years.
yy Therefore, prevention and timely detection and cure of these
diseases are essential to ensure reproductive health.
Prevention
yy Avoid sex with unknown partners/multiple partners.
yy Always use condoms during coitus.
yy In case of doubt, go to a qualified doctor for early detection
and get complete treatment.
INFERTILITY
yy It is the inability of couple to produce baby even after
unprotected intercourse.
yy The reasons for this may be physical, congenital, diseases,
drugs, immunological or even psychological.
yy Problems of infertility may be in male or female.
yy Infertility clinic can help diagnose and treat infertility.
yy In case there are no corrections possible, some special
technologies called assisted reproductive technologies.
(ART) can be used to have children.
 Reproductive Health
ASSISTED REPRODUCTIVE TECHNOLOGIES (ART)
1. In vitro fertilisation (IVF- Test tube baby programme):
In this method, ova from the wife/donor and sperms from the
husband/donor are collected and are induced to form zygote
under simulated conditions in the laboratory. This is followed
by Embryo transfer (ET).
It is of two types:
(a) Zygote intra fallopian transfer (ZIFT): It involves
transfer of zygote or early embryos (with up to 8
blastomeres) into fallopian tube.
(b) Intra uterine transfer (IUT): It involves transfer of
embryos with more than 8 blastomeres into the uterus.
The babies thus produced from this method are known as
test tube babies.
Embryo formed by in vivo fertilisation (fertilisation within
the female) can also be used for such transfer to assist those
females who cannot conceive.
2. Gamete intra fallopian transfer (GIFT)
It is the method of transfer of gamete (ovum) from a donor into
the fallopian tube of another female who is unable to produce
ovum, but can provide right conditions for fertilization and
development of an embryo.
3. Intra cytoplasmic sperm injection (ICSI):
It is a laboratory procedure in which a single sperm (from
559
male partner) is injected directly into an egg (from female
partner). Then the fertilised egg is implanted into the woman’s
uterus.
4. Artificial insemination (AI) technique:
yy It is the method of transferring semen (sperm) collected from
the husband or a healthy donor into the vagina or the uterus
(IUI – intra-uterine insemination) of the recipient female.
yy This technique is useful for the male partner having inability
to inseminate female or has low sperm counts.
5. Surrogacy
yy Here, a woman (surrogate mother) bears a child for a couple
unable to produce children, because the wife is infertile or
unable to carry.
yy The surrogate is impregnated either through artificial
insemination or through implantation of an embryo produced
by in vitro fertilisation.
Problems of ART
yy It requires high precision handling by specialized professionals
and expensive instrumentation. Therefore, these facilities are
available only in very few centres.
yy It has emotional, religious and social problems.
Legal adoption is one of the best methods for couples looking for
parenthood.
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STD's
STD are the diseases which are transmitted through sexual inter course with infected person

Problems and strategies Reproductive health Birth Control

Population explosion
Problems Strategies Due to increase in
These are many Awareness spread population poverty
problems related to among people about increases in the family
Reproductive health family planning by as well as in country. It
like problems related to audio-visual also leads to
pregnancy deliver, programme, education unemployment and
STD's, abortions, in school, caring educational problems.
Temporary Method
contraceptions etc. pregnant mother and
post natal care.

Natural Method I UDS Barrier Method Oral Contraception

Safe period, coitus Plastic or metal devices Spermicides, condoms For birth control oral
interruptus. one used to check the diaphragms, cervical pills are used.
fertilization. cap.

Permanent Method

Vasectomy Tubectomy
Small part of the vas Small part of the
deferens is removed. fallopian tube is
removed.
BIOLOGY

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1. GIFT is 9. Which one of the following is tested by the technique of

(a) Embryo implantation after in vivo fertilization amniocentesis ?
(b) Sperm injection for in vivo fertilization (a) Biochemical abnormalities in the foetus
(b) Errors of metabolism in the foetus
(c) Embryo implantation after in vitro fertilization
(c) Chromosomal abnormalities in the foetus
(d) Egg implantation for in vitro fertilization (d) All of the above
2. The most important component of the oral contraceptive pills 10. MTP is practised mainly to –
is – (a) get rid of unwanted female child legally .
(a) progesterone (b) growth hormone (b) get rid of unwanted pregnancies due to failure of
(c) thyroxin (d) luteinizing hormone contraception of rapes.
3. Action of vaginal diaphragm is – (c) both (a) and (b).
(d) decrease population size.
(a) prevent the ova to come in the uterus
11. Foetal sex can be determined by examining cells from the
(b) prevent the sperm to come in contact with ova amniotic fluid by looking for–
(c) spermicidal (a) Barr bodies (b) Autosomes
(d) anti-implantational (c) Chiasmata (d) Kinetochore
4. Surgical removal of testes is known as – 12. In amniocentesis, the fluid is taken from –
(a) Testectomy (b) Gonadectomy (a) foetal blood
(c) Castration (d) None of these (b) mother's blood
(c) body fluid of mother
5. In vitro fertilisation is a technique that involves transfer of
(d) fluid surrounding foetus
which one of the following into the fallopian tube ?
13. Progesterone pill helps in preventing pregnancy by not
(a) Zygote only allowing –
(b) Embryo only, upto 8 cell stage (a) ova formation (b) gertilization
(c) Either zygote or early embryo upto 8 cell stage (c) implantation (d) None of these
(d) Embryo of 32 cell stage 14. Birth control pills check ovulation in female by inhibiting the
6. Removal of a segment surgically and ligation of cut ends of secretion of –
vas deferens is known as – (a) follicle stimulating hormone
(b) luteinizing hormone
(a) Tubectomy (b) Vasectomy
(c) both (a) and (b)
(c) Gonadectomy (d) Castration
(d) None of these
7. Test-tube baby means a baby born when – 15. Which of the following is not true about the birth control
(a) It develops from a non-fertilized egg pill ?
(b) It developed in a test-tube (a) The pill works by preventing ovulation.
(c) It is developed through tissue culture method (b) The pill works by preventing implantation.
(d) The ovum is fertilised externally and thereafter implanted (c) The ovarian cycle is suspended by the birth control pill.
in the uterus (d) The birth control pill contains low doses of estrogen and
progesterone.
8. Test-tube babies are produced by –
16. Progestasert and LNG-20 are
(a) Fertilising the egg removed from the body of the female (a) implants
with the husband's sperm outside in vitro culture. The (b) copper releasing IUDs
zygote is transferred back to mother's uterus (c) non-medicated IUDs
(b) External fertilisation and development in vitro culture till (d) hormone releasing IUDs
32 cells stage before putting the embryo back into 17. The copper ions of IUDs
mother's uterus (a) suppress the motility and fertilization capacity of sperms
(c) Complete development of a baby in vitro (b) make the uterus unsuitable for implantation
(d) Development upto 32 cells stage and transplanting (c) increase phagocytosis of sperms
embryo in the uterus of a surrogate mother (d) make cervix hostile to sperms
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562 BIOLOGY

18. Which of the following birth control measures can be 22. The diaphragm, cervical cap and vaults are
considered as the safest? (a) disposable contraceptive devices
(a) The rhythm method (b) reusable contraceptives
(b) The use of physical barriers (c) IUDs
(c) Temination of unwanted pregnancy (d) Implants
(d) Sterilization techniques 23. In amniocentesis, the fluid is taken from
19. Correct statement with reference to a test tube baby is : (a) foetal blood
(a) the fertilized egg is placed in the womb of the mother (b) mother’s blood
where the gastrula period is completed. (c) body fluid of mother
(b) unfertilized egg is placed in the womb and allowed to
(d) fluid surrounding foetus
grow parthenogenetically.
24. Test-tube baby means a baby born when
(c) a prematuraly born baby is reared in an incubator.
(a) it develops from a non-fertilized egg
(d) fertilized egg is taken out and grown in a large test-tube.
(b) it developed in a test tube
20. Using which contraceptive also provides protection from
contracting STDs and AIDS ? (c) it is developed through tissue culture method
(a) Diaphragms (b) Spermicidal foams (d) the ovum is fertilised externally and thereafter implanted
(c) Condoms (d) Lactational amenorrhoea in the uterus
21. Action of contraceptive is 25. Birth control pills check ovulation in female by inhibiting the
(a) to prevent the ovulation only. secretion of
(b) prevention of ovulation and fertilization only. (a) follicle stimulating hormone (FSH)
(c) prevention of ovulation, fertilization and implantation (b) luteinizing hormone (LH)
only. (c) both (a) and (b)
(d) prevent the rapid passing of eggs in oviduct. (d) None of these

1. The permissible use of the technique amniocentesis is for (a) Eight weeks (b) Twelve weeks
(a) detecting sex of the unborn foetus (c) Eighteen weeks (d) Six weeks
(b) artificial insemination 6. The technique called gamete intrafallopian transfer (GIFT) is
(c) transfer of embryo into the uterus of the surrogate mother recommended for those females:
(d) detecting any genetic abnormality (a) who cannot produce an ovum
2. Copper-T is a device that prevents (b) who cannot retain the foetus inside uterus.
(a) implantation of blastocyst (c) whose cervical canal is too narrow to allow passage for
(b) ovulation the sperms
(c) fertilization (d) who cannot provide suitable environment for fertilisation
(d) egg maturation 7. What is the figure given below showing in particular ?
3. Cu ions released from copper - releasing Intra Uterine Devices
(IUDs):
(a) make uterus unsuitable for implantation
(b) increase phagocytosis of sperms
(c) suppress sperm motility
(d) prevent ovulation
4. Which one of the following is the most widely accepted (a) Ovarian cancer (b) Uterine cancer
method of contraception in India, as at present ? (c) Tubectomy (d) Vasectomy
(a) Cervical caps 8. The test-tube Baby Programme employs which one of the
(b) Tubectomy following techniques?
(c) Diaphragms (a) Intra cytoplasmic sperm injection (ICSI)
(d) IUDs. (Intra uterine devices) (b) Intra uterine insemination (IUI)
5. Medical Termination of Pregnancy (MTP) is considered safe
(c) Gamete intra fallopian transfer (GIET)
up to how many weeks of pregnancy?
(d) Zygote intra fallopian transfer (ZIFT)
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9. Progestasert and LNG-20 are 17. The accompanying diagram shows the uterine tubes of four
(a) implants (b) copper releasing IUDs women (P,Q,R and S).
(c) non medicated IUDs (d) hormone releasing IUDs
10. Oral contraceptive pills are composed of
(a) progestrogens only
(b) progestrogen and estrogen combination
(c) progestrogen-testosterone combination
(d) both (a) or (b)
11. Which of the following cannot be detected in a developing
foetus by amniocentesis?
(a) Sex of the foetus
(b) Down syndrome
(c) Jaundice
(d) Klinefelter syndrome
12. One of the legal methods of birth control is : In which two women is fertilization impossible at present ?
(a) by abstaining from coitus from day 10 to 17 of the (a) P and Q (b) Q and R
menstrual cycle (c) R and S (d) S and P
18. Match Column -I with Column - II.
(b) by having coitus at the time of day break
Column I Column II
(c) by a premature ejaculation during coitus
Method Mode of Action
(d) abortion by taking an appropriate medicine A. The pill 1. Prevents sperms
13. Artificial insemination mean: reaching cervix
(a) Transfer of sperms of husband to a test tube containing B. Condom 2. Prevents implantation
ova C. Vasectomy 3. Prevents ovulation
(b) Artificial introduction of sperms of a healthy donor into D. Copper T 4. Semen contains no
the vagina sperms
(c) Introduction of sperms of a healthy donor directly into (a) A ® (3); B ® (1); C ® (4); D ® (2)
the ovary (b) A ® (4); B ® (1); C ® (2); D ® (3)
(d) Transfer of sperms of a healthy donor to a test tube (c) A ® (3); B ® (4); C ® (1); D ® (2)
containing ova (d) A ® (2); B ® (3); C ® (1); D ® (4)
14. One of the following is not a method of contraception – which 19. Match Column -I with Column - II.
one? Column I Column II
(a) Tubectomy A. Non-medicated IUDs 1. Lippes loop
(b) Condoms B. Hormone releasing 2. Multiload 37
IUDs
(c) Pills of a combination of oxytocin and vasopressin
C. Copper releasing IUDs 3. CuT
(d) Lippes loop
4. Cu7
15. Which one of the following statements is correct regarding
5. LNG-20
Sexually Transmitted Diseases (STD)?
6. Progestasert
(a) The chances of a 5 year boy contacting a STD are very
(a) A ® (a); B ® (2, 6); C ® (3, 4, 5)
little
(b) A ® (a); B ® (5, 6); C ® (2, 3, 4)
(b) A person may contact syphilis by sharing milk with one (c) A ® (b); B ® (5, 6); C ® (1, 3, 4)
already suffering from the disease (d) A ® (b); B ® (1, 6); C ® (3, 4, 5)
(c) Haemophilia is one of the STD 20. Consider the statements given below regarding contraception
(d) Genital herpes and sickle-cell anaemia are both STD and answer as directed thereafter:
16. The stage transferred into the uterus after induced fertilization 1. Medical Termination of Pregnancy (MTP) during first
of ova in the laboratory is: trimester is generally safe.
(a) Zygote 2. Generally chances of conception are nil until mother
(b) Embryo at 4 blastomere stage breast-feeds the infant upto two years.
(c) Embryo at 2 blastomere stage 3. Intrauterine devices like copper-T are effective
(d) Morula contraceptives.
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4. Contraception pills may be taken upto one week after 23. IUDs-
coitus to prevent conception. 1. Increase phagocytosis of sperms.
Which two of the above statements are correct? 2. Release Cu ions that suppress sperm motility and
(a) 1 and 2 (b) 3 and 4 fertilising capacity of sperms.
(c) 1 and 3 (d) 1 and 2 3. Make the uterus unsuitable for implantation.
21. Reproductive health in society can be improved by – 4. Make the cervix hostile to sperms.
1. Introduction of sex education in schools. 5. Prevent semen from entering the female reproductive tract.
2. Increased medical assistance. (a) 1, 2, 3, 4 and 5 (b) 1, 2, 3 and 4
3. Awareness about contraception and STDs. (c) 1 and 2 (d) 2, 3 and 4
4. Equal opportunities to male and female child. DIRECTIONS for Qs. 24 & 25 : Each questions contain
5. Ban on aminocentesis. STATEMENT-1 (Assertion) and STATEMENT-2 (Reason). Each
6. Encouraging myths and misconceptions. question has 4 choices (a), (b), (c) and (d) out of which ONLY ONE
(a) All of these (b) 1, 2, 4 and 6 is correct.
(c) 1, 2, 3, 4 and 5 (d) 2 and 5 (a) Statement- 1 is True, Statement-2 is True, Statement-2 is a
22. What is true for " Lactational amenorrhoea"? correct explanation for Statement -1
1. It means absence of menstruation. (b) Statement -1 is True, Statement -2 is True ; Statement-2 is
2. Ovulation does not occur during the lactational period. NOT a correct explanation for Statement - 1
3. Chances of failure of contraception are almost nil upto (c) Statement - 1 is True, Statement- 2 is False
six months following parturition. (d) Both the Statements are False.
4. Side effects are almost nil. 24. Statement 1 : Test-tube baby has raised several legal problems.
5. Contraceptive efficiency reduces after the period of Statement 2 : It involves in vitro fertilization followed by
intense lactation. embryo transfer.
6. It is natural method of contraception. 25. Statement 1 : Copper-T is an effective contraceptive device in
7. It increases phagocytosis of sperms human females.
(a) 2, 3, 4, 5 and 6 (b) All except 7 Statement 2 : Copper-T prevents passage of sperms from
(c) 2, 3, 4 and 5 (d) All of these vagina upwards into fallopian tubes.

Exemplar Questions (i) It is almost irreversible.

(ii) Of the misconception that it will reduce sexual urge/drive.
1. The method of directly injecting a sperm into ovum is assisted
(iii) It is a surgical procedure.
by reproductive technology is called
(iv) Of lack of sufficient facilities in many parts of the country.
(a) GIFT (b) ZIFT
Choose the correct option
(c) ICSI (d) ET
(a) (i) and (ii) (b) (ii) and (iii)
2. Increased IMR and decreased MMR in a population will (c) (ii) and (iv) (d) (i, ii, iii) and (iv)
(a) cause rapid increase in growth rate 5. A national level approach to build up a reproductively healthy
(b) result in decline in growth rate society was taken up in our country in
(c) not cause significant change in growth rate (a) 1950s (b) 1960s
(d) result in an explosive population/exp (c) 1980s (d) 1990s
3. Intensely lactating mothers do not generally conceive due to 6. Emergency contraceptives are effective if used within 72 hrs
the of
(a) suppression of gonadotropins (a) coitus (b) ovulation
(b) hypersecretion of gonadotropins (c) menstruation (d) implantation
(c) suppression of gametic transport 7. Choose the right one amongst the statements given below.
(d) suppression of fertilisation (a) IUDs are generally inserted by the user herself.
4. Sterilisation tecshniques are generally full proof methods of (b) IUDs increase phagocytosis reaction in the uterus.
contraception with least side effects. Yet, this is the last option (c) IUDs suppress gametogenesis.
for the couples because: (d) IUDs once inserted need not be replaced.
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8. Following statements are given regarding MTP. Choose the 16. Artificial insemination mean: [2013]
correct options given below. (a) Transfer of sperms of husband to a test tube containing
(I) MTPs are generally advised during first trimester. ova
(II) MTPs are uded as a contraceptive method. (b) Artificial introduction of sperms of a healthy donor into
(III) MTPs are always surgical. the vagina
(IV) MTPs require the assistance of qualified medical (c) Introduction of sperms of a healthy donor directly into
personnel. the ovary
(a) I and III (b) II and III (d) Transfer of sperms of a healthy donor to a test tube
(c) I and IV (d) I and II
containing ova
9. From the sexually transmitted diseases mentioned below,
17. One of the following is not a method of contraception – which
identify the one which does not specifically affect the sex
one? [NEET Kar. 2013]
organs.
(a) Syphillis (b) AIDS (a) Tubectomy
(c) Gonorrhoea (d) Genital warts (b) Condoms
10. Condoms are one of the most popular contraceptives because (c) Pills of a combination of oxytocin and vasopressin
of the following reasons (d) Lippes loop
(a) these are effective barriers for insemination 18. Which one of the following statements is correct regarding
(b) they do not interfere with coital act Sexually Transmitted Diseases (STD)? [NEET Kar. 2013]
(c) these help in reducing the risk of STDs (a) The chances of a 5 year boy contacting a STD are very
(d) All of the above little
11. Choose the correct statement regarding the ZIFT procedure. (b) A person may contact syphilis by sharing milk with one
(a) Ova collected from a female donor are transferred to the already suffering from the disease
fallopian tube to facilitate zygote formation (c) Haemophilia is one of the STD
(b) Zygote is collected from a female donor and transferred (d) Genital herpes and sickle-cell anaemia are both STD
to the fallopian tube
19. The stage transferred into the uterus after induced fertilization
(c) Zygote is collected from a female donor and transferred
of ova in the laboratory is [NEET Kar. 2013]
to the uterus
(a) Zygote
(d) Ova collected from a female donor are transferred
(b) Embryo at 4 blastomere stage
12. The correct surgical procedure as a contraceptive method is
(a) ovariectomy (b) hysterectomy (c) Embryo at 2 blastomere stage
(c) vasectomy (d) castration (d) Morula
13. Diaphragms are contraceptive devices used by the females. 20. Tubectomy is a method of sterilization in which: [2014]
Choose the correct option from the statements given below (a) small part of the fallopian tube is removed or tied up.
I. They are introduced into the uterus. (b) ovaries are removed surgically.
II. They are placed physical barriers for sperm entry. (c) small part of vas deferens is removed or tied up.
III. They act as physical barriers for sperm entry. (d) uterus is removed surgically.
IV. They act as spermicidal agents.
21. Which of the following is a hormone releasing Intra Uterine
(a) I and II (b) I and III
Device (IUD)? [2014]
(c) II and III (d) III and IV
(a) Multiload 375 (b) LNG - 20
NEET/AIPMT (2013-2017) Questions
(c) Cervical cap (d) Vault
14. Which of the following cannot be detected in a developing 22. Assisted reproductive technology, IVF involves transfer of:
foetus by amniocentesis? [2013] [2014]
(a) Sex of the foetus (a) Ovum into the fallopian tube.
(b) Down syndrome (b) Zygote into the fallopian tube.
(c) Jaundice
(c) Zygote into the uterus.
(d) Klinefelter syndrome
(d) Embryo with 16 blastomeres into the fallopian tube.
15. One of the legal methods of birth control is : [2013]
23. Hysteresctomy is surgical removal of : [2015 RS]
(a) by abstaining from coitus from day 10 to 17 of the
menstrual cycle (a) Prostate gland
(b) by having coitus at the time of day break (b) Vas-deference
(c) by a premature ejaculation during coitus (c) Mammary glands
(d) abortion by taking an appropriate medicine (d) Uterus
 EBD_7051
566 BIOLOGY

24. Ectopic pregnancies are referred to as: [2015 RS] (b) Intra uterine Increase phagocytosis of
(a) Implantation of embryo at site other than uterus. devices sperms, suppress sperm
(b) Implantation of defective embryo in the uterus motility and fertilizing capacity
(c) Pregnancies terminated due to hormonal imbalance. of sperms
(d) Pregnancies with genetic abnormality. (c) Hormonal Prevent/retard entry
25. A childless couple can be assisted to have a child through a contraceptives of sperms, prevent ovulation
technique called GIFT. The full form of this technique is : and fertilization
[2015 RS] (d) Vasectomy Prevents
(a) Gamete intra fallopian transfer spermatogenesis
(b) Gamete internal fertillization and transfer 28. The function of copper ions in copper releasing IUD’s is :
(c) Germ cell internal fallopian transfer [2017]
(d) Gamete inseminated fallopian transfer (a) They inhibit gametogenesis
26. In context of Amniocentesis, which of the following statement (b) They make uterus unsuitable for implantation
is incorrect ? [2016] (c) They inhibit ovulation
(a) It is usually done when a woman is between 14-16 weeks (d) They suppress sperm motility and fertilising capacity of
pregnant. sperms
(b) It is used for prenatal sex determination 29. In case of a couple where the male is having a very low sperm
(c) It can be used for detection of Down syndrome count, which technique will be suitable for fertilisation ? [2017]
(d) It can be used for detection of Cleft palate (a) Gamete intracytoplasmic fallopian transfer
27. Which of the following approaches does not give the defined (b) Artificial Insemination
action of contraceptive ? [2016] (c) Intracytoplasmic sperm injection
(a) Barrier methods prevent fertilization (d) Intrauterine transfer
 Reproductive Health 567

Hints & Solutions

EXERCISE - 1 in GIFT, site of fertilization is fallopian tube, not
laboratory.
1. (b) 2. (a) 3. (b)
7. (c) The figure shows the tubectomy. This is a surgical method
4. (c) Permanent method of birth control in which testes are
to prevent pregnancy in women. In tubectomy small part
surgically removed, is called castration.
of the fallopian tube is removed or tied through a small
5. (c) 6. (b) 7. (d) 8. (b) 9. (c) 10. (b)
cut in the abdomen or through vagina. It is very effective
11. (a) 12. (d) 13. (a) 14. (c)
method but reversibility is very poor.
15. (b) The birth control pill interferes with the maturation of the
8. (d) Test-tube baby programme employs zygote intrafallopion
follicles and the ova, inhibiting release of an egg.
transfer (ZIFT) technique. In this technique fusion of
16. (d) 17. (a)
ovum and sperm is done outside the body of woman to
18. (d) Sterilization techniques can be considered as the safest
form zygote which is allowed to divide forming 8
birth control measures. It provides a permanent and sure
blastomeres, then it is transfered the fallopion tube of
birth control. It is called vasectomy in male and tubectomy
the woman.
in female.
19. (a) For test-tube babies, fertilization of egg is done in vitro 9. (d) 10. (d)
and the zygote at gastrula stage is implanted in the womb 11. (c) Jaundice cannot be detected in a developing foetus by
of the mother. amniocentesis. It is a foetal sex determination test based
20. (c) 21. (b) 22. (b) on chromosomal pattern in the amniotic fluid surrounding
23. (d) In amniocentesis the fluid is taken from aminotic fluid, the developing embryo. It is now legally ban in India.
which is immediate surrounding of foetus. 12. (d) Medical termination of pregnancy (MTP) or induced
24. (d) Test-tube baby means ovum fertilised outside the mother abortion become legal in India from 1971 with some strict
body and then implanted in uterus for growth and conditions to avoid its misuse. Such restrictions are
development. important to check indiscriminate and illegal female
25. (c) foeticides which are reported to be high in India. All the
other options are of natural methods of contraception.
EXERCISE - 2 13. (b) In Artificial Insemination (AI) technique, the semen
1. (d) Amniocentesis involves prenatal diagnosis of metabolic collected either from the husband or a healthy donor is
error and other genetic abnormalities. artificially introduced either into the vagina or into the
2. (a) Copper ‘T’ is an intrauterine device which prevents the uterus (IUI – intrauterine insemination) of the female.
fertilized egg becoming implanted in the wall of the womb. 14. (c) Oxytocin is birth hormone and acts on the smooth muscles
3. (c) Cu ions released by copper releasing intra uterine devices of our body and stimulates their contraction. Vasopressin
suppresses sperm motility. acts mainly at the kidney and stimulates resorption of
Intra-uterine devices are inserted by doctors in the uterus water and electrolytes and reduces loss of water through
through vagina. They are available as the non-medicated urine. Hence, it is also called as anti-diuretic hormone
IUDs, copper releasing IUDs and hormonereleasing IUDs. (ADH).
4. (d) Intra uterine device (IUD) is a method of contraception 15. (a) STDs are more common in 15-24 years age group.
in India. The IUD is inserted in the woman’s uterus Gonorrhoea, syphilis, genital herpes, chlamydiasis,
through the cervix. genital warts, trichomoniasis, hepatitis-B and AIDS are
5. (b) Medical termination of pregnancy is considered safe up some of the common STDs. Haemophilia is sex-linked
to twelve weeks of pregnancy. recessive disease, which show its transmission from
6. (a) Gamete intrafallopian transfer (GIFT) is recommended for unaffected carrier female to some of male progeny. Sickle
those females who cannot produce an ovum. In this cell anaemia is an autoimmune linked recessive trait in
process, the eggs of the donor woman are removed and which both the partners are carrier for the gene.
in a form of mixture with sperm transferred into fallopian
16. (d) In Intra-Uterine Transfer (IUT) embryo with more than 8-
tube of another woman who cannot produce ovum, but
blastomeres stage (morula) is used for transfer into the
can provide suitable environment for fertilization. Thus
uterus.

568
17. (c)
18. (a) A. The pill — Prevents ovulation
B. Condom — Prevents sperm reaching cervix
C. Vasectomy — Semen contains no sperms
D. Copper-T — Prevent implantation.
19. (b) 20. (c)
21. (c) Reproductive health in society can be improved by
creating awareness among people about various
reproduction related aspects and providing facilities and
support for building up a reproductively health society.
22. (b) 23. (b)
24. (b) In very rare cases, a surrogate mother may have to be
used to bring up in vitro fertilized ovum to maturity.
Though biological realization of a test tube baby is a
remarkable achievement, it has raised several ethical and
legal problems like the right over the child.
The technique of in vitro fertilization followed by the
embryo-transfer in the uterus of the normal female to
start the development and finally leading to normal birth,
is called test tube-baby.
25. (c) Intra-uterine device (IUD) Copper-T is plastic or metal
object placed in the uterus by a doctor. Copper-T prevent
the fertilization of the egg or implantation of the embryo.
EXERCISE - 3
Exemplar Questions
1. (c) ICSI (India Cytoplasmic Sperm Injection) is a specialised
method to form an embryo in the laboratory in which a
sperm is directly injected into the ovum placed in a nutrient
broth.
GIFT (Gamete Intra Fallopian Transfer) is a procedure in
which eggs are removed from woman's ovary with man
sperm and transferred to one of the fallopian tube.
ZIFT (Zygote Intra Fallopian Transter) is a procedure
(similar to in vitro fertilisation and embryo transfer in
which the zygote (early embryo) up to 8 blastomeres is
transferred directly intoi the Fallopian tube.
ET (Embryo Transfer) is a method in which the fertilisation
occurs in vitro and the zygote formed is transferred into
the uterus of the female who cannot conceive.
2. (c) IMR (Infant Mortility Rate) and MMR (Maternal Mortility
Rate) both are responsible for affecting the growth rate
inversely. it means decline in IMR as well as MMR will
result in high population growth and vice-versa.
Here, increased IMR will result in decline in growth rate.
while, decreased MMR will cause rapid increase in growth
rate.
Therefore, IMR increased and MMR has been decreased
EBD_7051
BIOLOGY
in a population, it will not cause any significant change
in growth rate.
3 (a) Breast feeding is one of the natural contraceptive
methods. It reduces fertility by affecting the production
of certain reproductive hormones. It is suppresses the
production of Gonadotropin-Releasing Hormone (GRH)
and Follicle Stimulating Hormone (FSH).
The release of these hormones triggers ovulation. Breast
feeding also leads to increased level of prolactin, that
inhibits ovulation.
4. (a) To prevent any more pregnancies. Surgical methods/
sterilisation techniques are generally opted by the male/
female partner as a terminal method. This method blocks
gamete transport and prevent conception. In males, this
is called vasectomy, while in females, this is known as
tubectomy. It is a surgical and permanent contraceptive
method.
5. (a) India was the first amongst countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal. The
programmes called 'family planning' were initiated in 1951
and were periodically assessed over the past decades.
To create awareness among people about various
reproduction related aspects, providing facilities and
support for building up a reproductively healthy society
are the major tasks of these programmes.
6. (a) Intake of higher dosed progestogens or progestogen-
estrogen combinations within 72 hrs of coitus have been
found to be very effective as emergency contraceptives.
These could be used to avoid possible pregnancy due to
rape or casual unprotected intercourse. These drugs
disrupt the ovulation and fertilisation.
7. (b) Non-mediated IUDs increase phagocytosis of sperms
within the uterus and the cu ions released suppress sperm
motility and the fertilising ability of sperms. Hormone
releasing IUDs make the uterus unsuitable for
implantation and the cervix hostile to sperms, e.g.,
progestasert, LNG-20. Intra Uterine Devices (IUDs) are
used as one of the effective and popular contraceptive
method.
8. (c) During the first trimester, MTP is considered relatively
safe i.e., up to 12 weeks of pregnancy. Second trimester
abortions are much more riskier.
It is done to get rid of unwanted pregancies either due to
casual unprotected intercourse or failure of the
contraceptive used during coitus or rapes. These are also
essential in certain cases where continuation of the
pregnancy could be harmful or even fatal either to the
mother or to the foetus or both.
MTPs are not always surgical. Certain pills also act as
abortants.
 Reproductive Health
In India, majority of the MTPs are performed illegally by
unqualified quacks. These are unsafe and may result in
the death of mother. So MTPs should be done only in the
presence of qualified medical personnel.
9. (b) Syphills, gonorrhoea and genital wants as STD caused
by pallicum, Neissenia gonorrhoeae and human
papilloma virus. These pathogens directly infect and
damage sex organs causing ichting fluid discharge, sight
path and swelling of genitallia.
AIDS (Acquired Immuno Deficiency Syndrome) is a
caused by HIV virus in humans. It is transmitted through
sexual contacts from infected to healthy person. The HIV
virus does not directly affect sex organs as such but
produce other set of symptoms in the body of infected
person.
10. (d) Condoms are used as barriers made of thin rubber/latex
sheath used to cover the penis in the male or vagina and
cervix in females. It prevents the deposition of ejaculated
semen into the vagina of the female. It should be discarded
after a single use. It is also a safe guard against
transmission of AIDS and other Sexually Transmitted
Diseases (STDs).
11. (b) The zygote or early embryo with upto 8 blastomeres is
collected from a female donor and transferred into the
fallopian tube, this process is called Zygote Intra fallopian
transfer of ZIFT.
Embryo more than 8 blastomeres is transferred into the
uterus by the process called Intra Uterine Transfer of
IUT.
When ovum is collected from donor and transferred to
fallopian tube of other female who can not produce ovum
this is known as Gamete Intra Fallopian Transfer (GIFT).
12. (c) Surgical methods, are terminal and permanent methods,
which block the transport of gametes, thereby preventing
conception. In males, this is called vasectomy, while in
females, this is called tubectomy.
13. (c) Diaphragms, cervical caps and vaults are the barriers
made of rubber which are inserted into the female
reproductive tract to cover the cervix during coitus. It
prevent the entry of sperms through cervix.
Spermicidal agents like creams, jellies and foams are used
along with barriers to increase their contraceptive
efficiency.
NEET/AIPMT (2013-2017) Questions
14. (c) Jaundice cannot be detected in a developing foetus by
amniocentesis. It is a foetal sex determination test based
on chromosomal pattern in the amniotic fluid surrounding
the developing embryo. It is now legally ban in India.
15. (d) Medical termination of pregnancy (MTP) or induced
abortion become legal in India from 1971 with some strict
569
conditions to avoid its misuse. Such restrictions are
important to check indiscriminate and illegal female
foeticides which are reported to be high in India. All the
other options are of natural methods of contraception.
16. (b) In Artificial Insemination (AI) technique, the semen
collected either from the husband or a healthy donor is
artificially introduced either into the vagina or into the
uterus (IUI – intrauterine insemination) of the female.
17. (c) Oxytocin is birth hormone and acts on the smooth muscles
of our body and stimulates their contraction. Vasopressin
acts mainly at the kidney and stimulates resorption of
water and electrolytes and reduces loss of water through
urine. Hence, it is also called as anti-diuretic hormone
(ADH).
18. (a) STDs are more common in 15-24 years age group.
Gonorrhoea, syphilis, genital herpes, chlamydiasis,
genital warts, trichomoniasis, hepatitis-B and AIDS are
some of the common STDs. Haemophilia is sex-linked
recessive disease, which show its transmission from
unaffected carrier female to some of male progeny. Sickle
cell anaemia is an autoimmune linked recessive trait in
which both the partners are carrier for the gene.
19. (d) In Intra-Uterine Transfer (IUT) embryo with more than 8-
blastomeres stage (morula) is used for transfer into the
uterus.
20. (a) Tubectomy also referred to as tubal sterilization is a
surgical procedure done on women as a permanent
method of contraception. In this method fallopian tubes
are blocked so that the ova or eggs are prevented from
travelling to the uterus from the ovary. This prevents
any future pregnancies to occur after the surgical
procedure.
Fallopian tubes
Ovary
Uterus
Cervix
Vagina
21. (b) An intrauterine device (IUD) is a small contraceptive
device, often ‘T’-shaped, often containing either copper
or levonorgestrel, which is inserted into the uterus. They
are one form of long-acting reversible contraception
which is the most effective types of reversible birth
control. The LNG-20 is so-called because it releases 20
micrograms of levonorgestrel per 24 hours, compared with
30 micrograms of levonorgestrel in some mini-Pills.

570
22. (b) IVF (In vitro Fertilization) is the process of fertilization
by manually combining an egg and sperm in a laboratory
dish. The process involves monitoring and stimulating a
woman’s ovulatory process, removing ovum or ova (egg
or eggs) from the woman’s ovaries and letting sperm
fertilise them in a fluid medium in a laboratory. The
fertilised egg (zygote) is cultured for 2-6 days in a growth
medium and is then transferred to the mother’s uterus
with the intention of establishing a successful pregnancy.
23. (d) A hysterectomy is a surgery in which woman’s uterus is
removed. It is adopted for the treatment of uterine fibroids
and cancer of uterine zone.
24. (a) In ectopic pregnancies, the implantation of embryo does
not occur in uterus but at other site.
25. (a) GIFT (Gamete Intra Fallopian Transfer) is a technique
helping to have a child.
26. (d) Amniocentesis (also referred to as amniotic fluid test or
AFT) is a medical procedure used in prenatal diagnosis
EBD_7051
BIOLOGY
of chromosomal abnormalities and fetal infections, and
also used for sex determination in which a small amount
of amniotic fluid, which contains fetal tissues, is sampled
from the amniotic sac. Cleft palate is a developmental
abnormality which can only be detected by sonography.
27. (d) Vasectomy is a surgical procedure for male sterilization
or permanent contraception. During the procedure, the
male vas deferens are severed and then tied or sealed in
a manner so as to prevent sperm from entering into the
seminal stream (ejaculate) and thereby prevent
fertilization.
28. (d) Cu2+ interfere in the sperm movement, which suppress
the sperm motility and fertilising capacity of sperms.
29. (b) Infertility cases due to inability of the male partner to
inseminate the female or due to very low sperm count in
the ejaculates, could be corrected by using artificial
insemination (AI) technique. In this procedure semen is
injected directly into the vagina or uterus.