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AITS 03Biology · Chapter 6 of 6

Biology · last-minute revision

Reproductive Health

Reproductive health and RCH, population control, every contraceptive method and how it acts, MTP law, STIs, and assisted reproductive technologies — written to NCERT wording.

Day 10 → 17fertile window avoided in periodic abstinence

Reproductive health and RCHMust

WHO: reproductive health means total well-being in all aspects of reproduction — physical, emotional, behavioural and social. India was among the first countries to plan for it nationally: family planning began in 1951 and was later widened into Reproductive and Child Health Care (RCH) programmes.

RCH actionExamples
AwarenessAudio-visual and print media; sex education in schools; birth-control options; care of pregnant mothers, post-natal care of mother and child; importance of breastfeeding; equal opportunities for male and female children; sex abuse and sex-related crimes.
Medical facilitiesCare for menstrual problems, pregnancy, delivery, MTP, contraception, infertility and STIs.
Legal and public-health stepsStatutory ban on amniocentesis for sex determination to check female foeticide; massive child immunisation.
ResearchNew contraceptives — Saheli, a once-a-week non-steroidal oral pill from CDRI, Lucknow.
Signs of improvementLower maternal and infant mortality, more medically assisted deliveries, better post-natal care, more small families, better STI detection.
Amniocentesis

Sampling amniotic fluid to detect genetic or chromosomal disorders of the foetus is legitimate. Using it to find the sex of the foetus is banned in India.

Population growth and its controlHigh yield

Population growth of the world and India with the census figures quoted in NCERTWorld~2 bn1900~6 bn20007.2 bn2011India~350 mn1947~1 bn2000>1.2 bnMay 2011Why: falling death rate, MMR and IMR, and more people of reproductive age2011 census: growth rate below 2% (≈ 20 per 1000 per year)
Figures as quoted in NCERT. Rapid growth followed a fall in death rate, MMR and IMR.
Measures
Motivating small families with contraception; slogans Hum Do Hamare Do; incentives for small families
Legal marriageable age
female 18 years · male 21 years
Ideal contraceptive
user-friendly, easily available, effective, reversible, with no or least side effects, and not interfering with sexual drive, desire or the sexual act

Contraceptive methodsMust

28-day menstrual cycle showing the days 10 to 17 avoided in periodic abstinence and the 21 pill days with a 7-day gapPeriodic abstinenceCombined oral pill (28-day cycle)112233445678910111213141516171819202122232425262627272828▲ ovulation ~ day 14avoid coitus: days 10–17days 1–4: menses, no pilldays 5–25: one pill daily × 217-day gapStart the pack within the first five days of the cycle; the next pack begins after the 7-day gap.
Periodic abstinence avoids the fertile days 10–17. Combined pills are taken for 21 days from within the first five days, then a 7-day gap during which menstruation occurs.
MethodExamplesHow it works / remember
NaturalPeriodic abstinence (days 10–17); withdrawal (coitus interruptus); lactational amenorrhoeaNo drugs or devices, so no side effects — but high failure rate. Lactational amenorrhoea works only with intense breastfeeding, up to 6 months after parturition, because ovulation and the cycle do not occur.
BarrierCondoms (male, female; Nirodh); diaphragm, cervical cap, vault; spermicidal creams, jellies, foamsStop ovum and sperm meeting. Condoms also protect against STIs and AIDS; diaphragms, caps and vaults cover the cervix and are reusable; spermicides add efficiency.
IUDsNon-medicated: Lippes loop · Copper: CuT, Cu7, Multiload 375 · Hormone: Progestasert, LNG-20All ↑ phagocytosis of sperm in the uterus. Cu ions suppress sperm motility and fertilising capacity. Hormone IUDs make the uterus unsuitable for implantation and the cervix hostile to sperm. Ideal for delaying pregnancy and spacing children.
Oral pillsProgestogen or progestogen–estrogen combination; Saheli (non-steroidal, weekly)Inhibit ovulation and implantation; alter cervical mucus to block sperm. 21 days + 7-day gap.
Injections, implantsProgestogens alone or with estrogen, under the skinSame mode as pills; effective for much longer.
EmergencyProgestogens, progestogen–estrogen combinations, or IUDsWithin 72 hours of coitus — after rape or casual unprotected intercourse.
Surgical (sterilisation)Vasectomy · tubectomyVasectomy: small part of vas deferens removed or tied through a small incision on the scrotum. Tubectomy: small part of fallopian tube removed or tied through a small incision in the abdomen or through the vagina. Very effective, very poor reversibility.
Sites where each contraceptive method acts in the male and female reproductive tractsMaletestisvas deferens6Female123451Ovary — pills, injections, implants stop ovulation2Fallopian tube — tubectomy (cut and tied)3Uterus — IUD (drawn in brass)4Cervix — diaphragm, cervical cap, vault5Vagina — female condom (+ spermicides)6Vas deferens — vasectomy
Numbered badges mark where each method acts.
Trap · Side effects are not zero

NCERT notes possible nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding or even breast cancer with some methods — not very significant, but not to be ignored.

Medical termination of pregnancyMust

Timeline of MTP permission: up to 12 weeks with one practitioner and 12 to 24 weeks with two0 wk4 wk8 wk12 wk16 wk20 wk24 wkup to 12 weeks · one RMP12–24 weeks · two RMPsfirst trimester: relatively safesecond trimester: much riskierMTP (Amendment) Act, 2017 as given in NCERT · India first legalised MTP in 1971RMP = registered medical practitioner · grounds: risk to the mother, or serious foetal abnormality
The cursor moves through pregnancy: first-trimester MTP needs one registered medical practitioner; 12–24 weeks needs two.
Definition
intentional or voluntary termination of pregnancy before full term
Scale
about 45–50 million MTPs a year worldwide — about 1/5 of all conceived pregnancies
Needed when
unwanted pregnancy (unprotected coitus, contraceptive failure, rape) or when continuing would harm mother, foetus or both
Dangers
most MTPs are done illegally by unqualified quacks; misuse of amniocentesis to detect a female foetus is illegal

Sexually transmitted infectionsMust

Also called venereal diseases (VD) or reproductive tract infections (RTI). Incidence is highest in the 15–24 years age group.

InfectionCompletely curable if detected early?
GonorrhoeaYes
SyphilisYes
ChlamydiasisYes
Genital wartsYes
TrichomoniasisYes
Genital herpesNo
Hepatitis BNo — also via shared needles, surgical instruments, blood transfusion, mother to foetus
HIV infectionNo — same extra routes as hepatitis B
Early symptoms
itching, fluid discharge, slight pain, swelling in the genital region; infected females often asymptomatic
Complications if untreated
pelvic inflammatory disease (PID), abortions, still births, ectopic pregnancy, infertility, cancer of the reproductive tract
Prevention
avoid sex with unknown or multiple partners · always use condoms · consult a qualified doctor early

Infertility and assisted reproductive technologiesMust

Infertility — inability to produce children despite unprotected sexual cohabitation — may be physical, congenital, due to disease or drugs, immunological or psychological. The problem lies in the male partner more often than is assumed.

Assisted reproductive technologies and where each one places gametes, zygote or embryolaboratory dish(IVF, ICSI) or donorZIFTGIFTIUTIUIAIZIFTzygote / embryo up to 8 blastomeres → fallopian tubeGIFTdonor ovum → fallopian tubeIUTembryo with more than 8 blastomeres → uterusIUIsemen (husband or donor) → uterusAIsemen → vagina (or uterus = IUI)ICSIsperm injected into ovum in the lab
Each dot travels to the site where that technique places gametes, zygote or embryo. The 8-blastomere boundary decides tube (ZIFT) versus uterus (IUT).
TechniqueWhat is doneUsed when
IVF–ET (test-tube baby)Ova and sperm fused in the lab under simulated conditions; embryo transferredFertilisation cannot occur in the body
ZIFTZygote or early embryo (up to 8 blastomeres) → fallopian tube—
IUTEmbryo with more than 8 blastomeres → uterus—
GIFTOvum from a donor → fallopian tube of another femaleFemale cannot produce ova but can provide a suitable environment for fertilisation and development
ICSISperm injected directly into the ovum to form an embryo in the lab—
AI / IUISemen from husband or healthy donor introduced into vagina (AI) or uterus (IUI)Male cannot inseminate, or very low sperm count

Embryos formed by in vivo fertilisation can also be transferred. ART needs specialists and is expensive; legal adoption is one of the best options for couples seeking parenthood.

Standard question patternsMust

Mechanism of a named IUD
Cu: sperm motility and fertilising capacity. Hormonal: implantation and cervix. All IUDs: phagocytosis of sperm.
Which contraceptive also protects against STIs
Condoms only.
Transfer into fallopian tube
ZIFT (≤ 8 blastomeres) and GIFT (ovum). Into uterus: IUT (> 8 blastomeres) and IUI (semen).
Low sperm count or inability to inseminate
Artificial insemination / IUI.
Female cannot produce ova
GIFT (donor ovum).
MTP week limits
≤ 12 weeks one RMP · 12–24 weeks two RMPs · first trimester safest.
STIs not completely curable
Hepatitis B, genital herpes, HIV.
Least reversible method
Sterilisation (vasectomy, tubectomy).
Statement set on pills
21 days from within first 5 days · 7-day gap · inhibit ovulation and implantation · alter cervical mucus · Saheli weekly, non-steroidal.

Traps that cost marksMust

Trap · ZIFT versus IUT

Up to 8 blastomeres → fallopian tube (ZIFT). More than 8 → uterus (IUT). Reversing the boundary is the commonest wrong option.

Trap · Lippes loop

Non-medicated. It is not a copper-releasing IUD. CuT, Cu7 and Multiload 375 are copper; Progestasert and LNG-20 are hormonal.

Trap · Saheli

Non-steroidal and taken once a week — not a daily steroid pill.

Trap · Incision sites

Vasectomy: scrotum. Tubectomy: abdomen or through the vagina.

Trap · Assertion–reason

'MTP is relatively safe in the first trimester' is true, and 'the Act allows MTP up to 12 weeks on one RMP's opinion' is also true — but the law does not explain why it is safe. Answer: both true, R not the explanation.

Trap · Amniocentesis

The technique is not banned; its use for sex determination is.

Ten-question checkMust

Pure NCERT lines turned into statements, matches and assertion–reason. Aim for 10/10 in 8 minutes.

Q1.Consider the statements about intra-uterine devices:
a. Cu ions suppress sperm motility and fertilising capacity.
b. Hormone-releasing IUDs make the uterus unsuitable for implantation and the cervix hostile to sperm.
c. Lippes loop is a copper-releasing IUD.
d. IUDs increase phagocytosis of sperm within the uterus.
Choose the correct option.

  1. (A)a, b and d only
  2. (B)a, b, c and d
  3. (C)a and c only
  4. (D)b, c and d only
Show answer

Answer (A). Statement c is false — Lippes loop is non-medicated.

Q2.Match Column I with Column II:
A. ZIFT   B. IUT   C. GIFT   D. ICSI
i. Ovum from a donor into the fallopian tube   ii. Embryo up to 8 blastomeres into the fallopian tube   iii. Sperm injected directly into the ovum   iv. Embryo with more than 8 blastomeres into the uterus

  1. (A)A-ii, B-iv, C-iii, D-i
  2. (B)A-iv, B-ii, C-i, D-iii
  3. (C)A-ii, B-iv, C-i, D-iii
  4. (D)A-i, B-iv, C-ii, D-iii
Show answer

Answer (C). ZIFT tube (≤ 8), IUT uterus (> 8), GIFT donor ovum to tube, ICSI sperm into ovum. The first distractor swaps only rows C and D.

Q3.Assertion (A): MTP is considered relatively safe during the first trimester of pregnancy.
Reason (R): The MTP (Amendment) Act, 2017 permits termination up to 12 weeks on the opinion of one registered medical practitioner.

  1. (A)Both A and R are true, and R is the correct explanation of A
  2. (B)Both A and R are true, but R is not the correct explanation of A
  3. (C)A is true, but R is false
  4. (D)A is false, but R is true
Show answer

Answer (B). Both statements are true, but a legal provision does not explain medical safety. Safety is a biological fact; the law follows it.

Q4.Which group contains only sexually transmitted infections that are not completely curable?

  1. (A)Gonorrhoea, syphilis, HIV infection
  2. (B)Chlamydiasis, trichomoniasis, genital warts
  3. (C)Hepatitis B, syphilis, trichomoniasis
  4. (D)Hepatitis B, genital herpes, HIV infection
Show answer

Answer (D). NCERT: except hepatitis B, genital herpes and HIV, the others are completely curable if detected early and treated properly.

Q5.Combined oral contraceptive pills are taken daily for ____, starting within the first five days of the cycle, followed by a gap of ____.

  1. (A)28 days; 7 days
  2. (B)21 days; 7 days
  3. (C)21 days; 5 days
  4. (D)14 days; 14 days
Show answer

Answer (B). 21 pills, then a 7-day gap during which menstruation occurs, repeated in the same pattern.

Q6.In the periodic abstinence method, a couple avoids coitus from day

  1. (A)1 to 5 of the cycle
  2. (B)14 to 28 of the cycle
  3. (C)5 to 12 of the cycle
  4. (D)10 to 17 of the cycle
Show answer

Answer (D). Ovulation is expected around the middle of the cycle, so days 10–17 are treated as the fertile period.

Q7.Saheli, the oral contraceptive developed at CDRI Lucknow, is

  1. (A)a daily progestogen-only pill
  2. (B)a copper-releasing intra-uterine device
  3. (C)a once-a-week non-steroidal pill
  4. (D)an injectable progestogen–estrogen combination
Show answer

Answer (C). Saheli contains a non-steroidal preparation and is taken once a week, with few side effects and high contraceptive value.

Q8.Assertion (A): Lactational amenorrhoea can prevent conception for up to six months after parturition.
Reason (R): Ovulation and the menstrual cycle do not occur during the period of intense lactation.

  1. (A)Both A and R are true, and R is the correct explanation of A
  2. (B)Both A and R are true, but R is not the correct explanation of A
  3. (C)A is true, but R is false
  4. (D)A is false, but R is true
Show answer

Answer (A). Both true, and the absence of ovulation during intense breastfeeding is exactly why the method works — for a maximum of about six months.

Q9.Emergency contraceptives are effective if used

  1. (A)within 7 days of coitus
  2. (B)only after a missed period
  3. (C)within 72 hours of coitus
  4. (D)within 3 weeks of coitus
Show answer

Answer (C). Progestogens, progestogen–estrogen combinations or IUDs within 72 hours of coitus.

Q10.Assertion (A): Amniocentesis is legally used in India to determine the sex of the foetus.
Reason (R): Amniocentesis can detect chromosomal abnormalities in the developing foetus.

  1. (A)Both A and R are true, and R is the correct explanation of A
  2. (B)Both A and R are true, but R is not the correct explanation of A
  3. (C)A is true, but R is false
  4. (D)A is false, but R is true
Show answer

Answer (D). A is false — there is a statutory ban on amniocentesis for sex determination. R is true: that is its legitimate use.

60-second recap before the paperMust

  1. WHO: physical, emotional, behavioural, social well-being. Family planning 1951 → RCH.
  2. Amniocentesis for sex determination banned. Saheli: weekly, non-steroidal, CDRI Lucknow.
  3. 2011: growth below 2% (20/1000/yr). Marriage age ♀ 18, ♂ 21.
  4. Natural: days 10–17; withdrawal; lactational amenorrhoea ≤ 6 months.
  5. Barriers: condoms (STI protection), diaphragm, cervical cap, vault + spermicides.
  6. IUDs: Lippes loop (non-medicated) · CuT, Cu7, Multiload 375 · Progestasert, LNG-20.
  7. Pills 21 + 7; stop ovulation and implantation; emergency within 72 h.
  8. Vasectomy via scrotum; tubectomy via abdomen or vagina; poorly reversible.
  9. MTP: 1971; ≤ 12 wk one RMP, 12–24 wk two RMPs; 45–50 million/yr (1/5).
  10. Not curable: hepatitis B, genital herpes, HIV. Most affected: 15–24 years.
  11. ZIFT ≤ 8 → tube · IUT > 8 → uterus · GIFT ovum → tube · ICSI · AI/IUI.