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SOHSS-AREEKODE, , Chapter-01, Human Reproduction, Introduction,  Humans are sexually reproducing and, viviparous organisms.,  Reproduction is ability to reproduce, individuals of same species. The main, events in reproduction include-, , NAVAS CHEEMADAN, ,  All these reproductive events occur only, after puberty.,  There, are, remarkable, differences, between the reproductive events in the, male and in the female, The sperm, formation (Spermatogenesis) continues in, old men, but formation of ovum, (Oogenesis) ceases in women around the, age of 50 years., , The Male Reproductive System, , Gametogenesis-------> Insemination ------->, fertilsation-----> implanation----> gestation---> delivery/Parturition., a)Gametogenesis: it is the formation of gametes.,  Male gametes are sperms and female, gametes are egg/ovum.,  Formation of sperm is called, spermatogenesis,  Formation, of, egg, is, called, oogenesis, b)Insemination: it is the transfer of sperms into the, female genital tract, c)Fertilisation: it is the fusion of male and female, gamete. It results in the formation of, zygote, d)Implantation: Attachment of Blastocyst on the, inner wall of uterus (Endometrium) is, called implantation, e)Gestation: Embryonic development within the, uterus of mother is called gestation.,  Human gestation period is 9 month., Or,  The duration between fertilization, and parturition is called gestation., f)Parturition: Delivery of the baby is the parturition, NAVAS CHEEMADAN/2021, , The male reproductive system is located in, the pelvis region. It consists of, a) A pair of testis, b) Accessory ducts, c) Glands, d) External genitalia., a)Testes,  The testes are situated outside the, abdominal cavity, (Extra abdominal ), within a pouch called scrotum.,  The scrotum helps in maintaining the, low temperature of the testes (2–2.5oc, lower than the normal internal body, temperature), necessary, for, spermatogenesis., , [email protected]

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SOHSS-AREEKODE, , Shape of Each Testis: Oval, Length: 4 to 5 cm, Width: 2 to 3 cm, Position: Within scrotum,  The testis is covered by a dense covering.,  Each testis has about 250 compartments, called testicular lobules.,  Each Testicular lobule contains one to, three highly coiled seminiferous tubules, in which sperms are produced.,  Each seminiferous tubule is lined on its, inside by two types of cells called,  Male germ cells (spermatogonia), and,  Sertoli cells.,  The male germ cells undergo meiotic, divisions finally leading to sperm, formation, while Sertoli cells (Nursing, cells ) provide nutrition to the germ, cells., , NAVAS CHEEMADAN, , b)Accessory Duct,  The male sex accessory ducts include,  Rete testis,,  Vasa efferentia,,  Epididymis and,  Vas deferens.,  The seminiferous tubules of the testis, open into the vasa efferentia through, rete testis (They are irregular cavities, present in testes ).,  The vasa efferentia leave the testis and, open into epididymis.,  The epididymis leads to vas deferens.,  Vas deferens, receives a duct from, seminal vesicle and opens into urethra as, the ejaculatory duct .,  These ducts store and transport the, sperms from the testis to the outside, through urethra.,  The urethra originates from the urinary, bladder and extends through the penis to, its external opening called urethral, meatus., Seminiferous tubules Rete testis Vasa, efferentia  EpididymisVas deferens, Ejaculatory duct  Urethra  Urethral, meatus, c)External Genitalia,  The penis is the male external genitalia .,  It is made up of special tissue ( Spongy, erectile tissue ) that helps in erection of, the penis to facilitate insemination.,  The enlarged end of penis called the, glans penis is covered by a loose fold of, skin called foreskin., ,  The regions outside the seminiferous, tubules called interstitial spaces, contain, small blood vessels and interstitial cells, or Leydig cell.,  Leydig cells synthesise and secrete, testicular hormones called androgens., Other immunologically competent cells, are also present., , NAVAS CHEEMADAN/2021, , d) Accessory Glands,  It include, i)Paired seminal vesicles,, ii)A prostate and, iii)Paired bulbourethral glands, (Cowper’s gland ).,  Secretions of all these glands constitute, the seminal plasma which is rich in, fructose, calcium and certain enzymes.,  The secretions of bulbourethral glands, also helps in the lubrication of the, penis., [email protected]

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SOHSS-AREEKODE, ,  Seminal plasma along with sperm is, called Semen, Seminal Plasma+Sperm= Semen, , The Female Reproductive System, ,  The female reproductive system is located, in pelvic region and,  it consists of, a)A pair of ovaries,, b)Accessory ducts and, c)External genitalia, These parts of the system along with a pair, of the mammary glands are integrated, structurally and functionally to support the, processes, of, ovulation,, fertilisation,, pregnancy, birth and child care., , NAVAS CHEEMADAN/2021, , NAVAS CHEEMADAN, , a)Ovary,  Ovaries are the primary female sex, organs,  Ovaries produce the female gamete, (ovum) and several steroid hormones, (ovarian, hormones-Estrogen, and, progesteron).,  The ovaries are located one on each side, of the lower abdomen,  Each ovary is about 2 to 4 cm in length, and is connected to the pelvic wall and, uterus by ligaments.,  Each ovary is covered by a thin epithelium, which encloses the ovarian stroma.,  The stroma is divided into two zones –, a peripheral cortex and an inner, medulla, b) Accessory ducts,  Accessory ducts include,  The oviducts (fallopian tubes),,  Uterus and,  Vagina, Oviduct :,  Each fallopian tube is about 10-12 cm, long), the part closer to the ovary is the, funnel-shaped infundibulum.,  The edges of the infundibulum, possess finger-like projections called, fimbriae, which help in collection of, the ovum after ovulation.,  The infundibulum leads to a wider, part of the oviduct called ampulla.,  The last part of the oviduct, isthmus, has a narrow lumen and it joins the, uterus, Uterus (Womb) ;,  The shape of the uterus is like an, inverted pear.,  The uterus opens into vagina, through a narrow cervix.,  The cavity of the cervix is called, cervical canal which along with, vagina forms the birth canal.,  The wall of the uterus has three layers of, tissue., i) Perimetrium:It is the The external thin membranous, layer of uterus, , [email protected]

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SOHSS-AREEKODE, , ii) Myometrium: It is the middle thick layer of uterus. It, contains, smooth, muscle., The, myometrium, exhibits, strong, contraction during delivery of the, baby., iii)Endometrium, It is the inner most layer of uterus and, is a glandular layer. The Endometrium, undergoes cyclical changes during, menstrual cycle, c) External genitalia, The female external genitalia include, i)Mons pubis,, ii)Labia majora,, iii)Labia minora,, iv)Hymen and, v)Clitoris, , NAVAS CHEEMADAN, , Mammary Gland, , , , , , , , , , The mammary glands are paired, structures (breasts) that contain,  Glandular tissue and,  Variable amount of fat., The glandular tissue of each breast is, divided into 15-20 mammary lobes, containing clusters of cells called alveoli ., The cells of alveoli secrete milk, which is, stored in the cavities (lumens) of, alveoli., The alveoli open into mammary tubules., The mammary tubules of each lobe join to, form a mammary duct., Several mammary ducts join to form a, wider mammary ampulla which is, connected to lactiferous duct through, which milk is sucked out., , i)Mons pubis:, It is a cushion of fatty tissue covered by skin, and pubic hair., ii)The labia majora:, They are fleshy folds of tissue, which extend, down from the mons pubis and surround the, vaginal opening., iii)The labia minora:, They are paired folds of tissue under the labia, majora., iv)Hymen :, The opening of the vagina is often covered, partially by a membrane called hymen., [The hymen is often torn during the first, coitus (intercourse). However, it can also be, broken by a sudden fall or jolt, insertion of a, vaginal tampon, active participation in some, sports like horseback riding, cycling, etc. In, some women the hymen persists even after, coitus. In fact, the presence or absence of, hymen is not a reliable indicator of, virginity or sexual experience], , Alveoli  Mammary tubules , Mammary ducts  Mammary ampulla,  lacteiferous duct, , v)Clitoris :, The clitoris is a tiny finger-like structure, which lies at the upper junction of the two, labia minora above the urethral opening., NAVAS CHEEMADAN/2021, , [email protected]

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SOHSS-AREEKODE, , Reproductive events, The main events in reproduction includeA)Gametogenesis, B)Insemination, C)Fertilisation, D)Implantation, E)Gestation, F)Parturition, Gametogenesis-------> Insemination ------->, fertilsation-----> implanation----> gestation---> delivery/Parturition., , A) GAMETOGENESIS,  The process of formation of gamete is, called gametogenesis.,  The gametes of male is called Sperm, and of female is called Egg/Ovum,  The process of formation of sperm is, called spermatogenesis.,  The process of formation of egg/Ovum is, called Oogenesis., , NAVAS CHEEMADAN, , , , Each spermatogonium is diploid and, contains 46 chromosomes., , Steps in Spermatogenesis,  Some of the spermatogonia called, primary, spermatocytes, periodically, undergo meiosis.,  A primary spermatocyte completes the, first meiotic division (reduction division), leading to formation of two equal, haploid, cells called secondary spermatocytes,, which have only 23 chromosomes each.,  The secondary spermatocytes undergo, the second meiotic division to produce, four equal, haploid spermatids,  The spermatids are transformed into, spermatozoa (sperms) by the process, called spermiogenesis.,  Ie: Spermiogenesis is the conversion of, spermatid into sperm is called, spermiogenesis, , a)Spermatogenesis,  The process of formation of sperm is, called spermatogenesis.,  It takes place at testis.,  Each testis has about 250 compartments, called, testicular, lobules., Each, Testicular lobule contains one to three, highly coiled seminiferous tubules in, which sperms are produced.,  Each seminiferous tubule is lined on its, inside by two types of cells called male, germ, cells, (spermatogonia/Sperm, mother cells) and Sertoli cells, , , , , NAVAS CHEEMADAN/2021, , After spermiogenesis, sperm heads, become embedded in the Sertoli cells,, and are finally released from the, seminiferous tubules by the process, called spermiation., The, release, of, sperm, after, spermatogenesis from seminiferous, tubule is called spermiation, , [email protected]

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SOHSS-AREEKODE, , , , , From a single Primary spermatocyte 4, sperms are produced, From a single secondary Spermatocyte 2, sperms are produced, , Qn. How many sperms are produced from, 100 primary spermatocyte ?, Ans:, Qn. Which of the following is haploid cell/s ?, Spermatogonia, Primary spermatocyte,, secondary spermatocyte,, spermatid, Sperm, , NAVAS CHEEMADAN, , LH (luteinising hormone ),  LH acts at the Leydig cells and, stimulates synthesis and secretion of, androgens.,  Androgens, in turn, stimulate the, process of spermatogenesis., FSH (follicle stimulating hormone),  FSH acts on the Sertoli cells and, stimulates secretion of some factors, which help in the process of, spermiogenesis, , , Structure of sperm, , Ans:, , It is a microscopic structure composed, , Hormonal Control of Spermatogenesis, / Male reproductive system, , of, , , ,  The human male ejaculates about 200 to, 300 million sperms during a coitus of, which, for normal fertility, at least 60 per, cent sperms must have normal shape, and size and at least 40 per cent of, them must show vigorous motility.,  The seminal plasma along with the, sperms constitute the semen, , , , Spermatogenesis starts at the age of, puberty due to significant increase in, the secretion of gonadotropin releasing, hormone (GnRH-GnRH is secreted by, Hypothalamus)., The increased levels of GnRH then acts, at, the, anterior, pituitary, gland, (Adenohypophysis ) and stimulates, secretion of two gonadotropins –, luteinising hormone (LH) and follicle, stimulating hormone (FSH)., , NAVAS CHEEMADAN/2021, ,  A head,,  Neck,,  A middle piece and,  A tail., A plasma membrane envelops the whole, body of sperm., The sperm head:, The head contains an elongated, haploid nucleus, the anterior portion of which, is covered by a cap-like structure, acrosome., The acrosome is filled with enzymes, (Hyaluronidase) that help fertilisation of the, ovum., The middle piece:, Middle Piece possesses numerous, mitochondria, which produce energy for the, movement of tail that facilitate sperm motility, essential for fertilization, Tail :, it helps in sperm movement, , [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , , , ., , b)Oogenesis,  The process of formation of a mature, female gamete is called Oogenesis.,  Oogenesis is initiated during the, embryonic development stage when a, couple of million gamete mother cells, (oogonia) are formed within each fetal, ovary; no more oogonia are formed and, added after birth.,  These cells start division and enter into, prophase-I of the meiotic division and, get temporarily arrested at that, stage,called primary oocytes.,  Each, primary oocyte then gets, surrounded by a layer of granulosa cells, and is called the primary follicle.,  A large number of these follicles, degenerate during the phase from birth to, puberty. Therefore, at puberty only, 60,000-80,000 primary follicles are left in, each ovary.,  The primary follicles get surrounded by, more layers of granulosa cells and a new, theca and are called secondary follicles., , NAVAS CHEEMADAN/2021, , , , , , , , , , , The secondary follicle soon transforms, into a tertiary follicle which is, characterised by a fluid filled cavity called, antrum. The theca layer is organised into, an inner theca interna and an outer theca, externa.., First meiotic division, an unequal, division resulting in the formation of a, large haploid secondary oocyte and a, tiny first polar body, The secondary oocyte retains bulk of the, nutrient rich cytoplasm of the primary, oocyte., The tertiary follicle further changes into, the mature follicle or Graafian follicle., The secondary oocyte forms a new, membrane, called, zona, pellucid, surrounding it., The Graafian follicle now ruptures to, release the secondary oocyte (ovum), from the ovary by the process called, ovulation., , [email protected]

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SOHSS-AREEKODE, , Structure of Human egg/ovum, , NAVAS CHEEMADAN, , a)Bleeding phase/Menstrual phase,  This phase lasts for 3-5 days.,  The menstrual flow results due to, breakdown of endometrial lining of the, uterus and its blood vessels which forms, liquid that comes out through vagina.,  Menstruation only occurs if the released, ovum is not fertilised., , , It is round, non motile, haploid, female, gamete. The human egg at ovulation is at the, secondary oocyte stage. It has centrally, located nucleus and dense cytoplasm. The, cytoplasm stores food material required for, the entire process of development. The ovum, has 4 envelops. They are, a)Plasma membraneb)Vitelline membrane, c)Zona pellucida, D)Corona radiate, (Structure of Human egg/ovum is NOT in, text book), , Menstrual Cycle, The reproductive cycle in the female, primates (e.g. monkeys, apes and human, beings) is called menstrual cycle.,  The first menstruation begins at puberty, and is called menarche.,  Menstrual cycles ceases around 50 years, of age; that is termed as menopause.,  Cyclic menstruation is an indicator of, normal, reproductive, phase, and, extends, between menarche, and, menopause,  In human females, menstruation is, repeated at an average interval of about, 28/29 days, and the cycle of events, starting from one menstruation till the next, one is called the menstrual cycle.,  The menstrual cycle may be said to be a, combination of ovarian cycle and uterine, cycle., NAVAS CHEEMADAN/2021, , Lack of menstruation may be indicative, of pregnancy. However, it may also be, caused due to some other underlying, causes like stress, poor health etc., , b)Follicular phase/proliferative phase, The menstrual phase is followed by, the follicular phase.,  During this phase, the primary follicles, in the ovary grow to become a fully, mature, Graafian, follicle, and, simultaneously the endometrium of, uterus, regenerates, through, proliferation.,  These changes in the ovary and the, uterus are induced by changes in the, levels, of, pituitary, and, ovarian, hormones.,  The secretion of gonadotropins (LH and, FSH) increases gradually during the, follicular phase and stimulates follicular, development as well as secretion of, estrogens by the growing follicles.,  FSH (Follicle stimulating hormone), stimulate the growth of ovarian follicle to, become mature ovarian follicle (graffian, follicle).During the growth of ovarian, follicle, the growing ovarian follicle secrete, Steroid hormone called Estrogen.,  Estrogen helps in the proliferation of, endometrium. Hence this phase of, menstrual cycle is also called Proliferative, phase.,  Follicular phase or menstrual phase lasts, for about 8-12 days., c) Ovulatory phase,  Both LH and FSH attain a peak level in, the middle of cycle (about 14th day).,  Rapid secretion of LH leading to its, maximum level during the mid-cycle called, LH surge induces rupture of Graafian, [email protected]

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SOHSS-AREEKODE, , , , NAVAS CHEEMADAN, , follicle and thereby the release of ovum, (ovulation)., Ovulatory phase is the shortest phase in, the menstrual cycle., , d)Luteal phase/Secretory phase, The ovulation (ovulatory phase) is, followed by the luteal phase during which the, remaining parts of the Graafian follicle, transform as the corpus luteum.,  The corpus luteum secretes large, amounts of progesterone which is, essential for maintenance of the, endometrium. Such an endometrium is, necessary for implantation of the fertilized, ovum and other events of pregnancy.,  During pregnancy all events of the, menstrual cycle stop and there is no, menstruation.,  This phase lasts for about 14 days,  In the absence of fertilisation, the, corpus luteum degenerates (and become, corpus, albican)., This, causes, disintegration, of, the, endometrium, (because, level, of, progesterone, decreased) leading to menstruation,, marking a new cycle,  10-17 days of menstrual cycle is called, fertile period (The remaining days are, called safety period ). because chance of, fertilization is very high during this period., , Menstrual hygiene, , , , , , , , , , , , , NAVAS CHEEMADAN/2021, , Maintenance of hygiene and sanitization, during menstruation is very important., Take bath and clean yourself regularly., Use sanitary napkins or clean home mad, pads., Change sanitary napkins or homemade, pads after every 4-5 hrs as per the, requirement., Disopose of the used sanitary napkins, properly warpping it with a used paper., Do not throw the used napkins in the drain, pipe of toilet or in the open area., After handling the napkin wash hands with, soap, B) Insemination, During copulation (coitus) semen is, released by the penis into the vagina, (insemination)., The motile sperms swim rapidly, pass, through the cervix, enter into the uterus, and finally reach the Ampullary region, of the fallopian tube, The ovum released by the ovary is also, transported to the ampullary region, where fertilisation takes place, [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , Clevage, , , , C) Fertilisation, The process of fusion of a sperm with an, ovum is called fertilization., Fertilisation can only occur if the, ovum and sperms are transported, simultaneously to the ampullary, region. This is the reason why not all, copulations lead to fertilisation and, pregnancy., , How Polyspermy is prevented ?,  During fertilisation, a sperm comes in, contact with the zona pellucida layer of, the ovum and induces changes in the, membrane that block the entry of, additional sperms (Prevent poly, spermy ). Thus, it ensures that only one, sperm can fertilise an ovum. The, secretions of the acrosome help the, sperm enter into the cytoplasm of the, ovum through the zona pellucida and the, plasma membrane.,  This induces the completion of the, meiotic division of the secondary, oocyte. The second meiotic division is, also unequal and result in the, formation of a second polar body and a, haploid egg.,  Soon the haploid nucleus of the sperm, and that of ovum fuse together to form, diploid zygote., , , , , , , , , , , , , , NAVAS CHEEMADAN/2021, , After fertilzation zygote starts mitotic, division ., The mitotic division starts as the zygote, moves through the isthmus of the oviduct, called cleavage towards the uterus and, forms 2, 4, 8, 16 daughter cells called, blastomeres., The embryo with 8 to 16 blastomeres is, called a morula ., The morula continues to divide and, transforms into blastocyst as it moves, further into the uterus., The blastomeres in the blastocyst are, arranged into an outer layer called, trophoblast and an inner group of cells, attached to trophoblast called the inner, cell mass., , D) Implantation, Attachment of Blastocyst on the inner, wall of uterus (Endometrium) is called, implantation, The trophoblast layer of blastocyst, gets attached to the endometrium and, the inner cell mass gets differentiated, as the embryo., After attachment, the uterine cells divide, rapidly and covers the blastocyst. As a, result, the blastocyst becomes embedded, in the endometrium of the uterus . This is, called implantation and it leads to, pregnancy., [email protected]

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SOHSS-AREEKODE, , , , NAVAS CHEEMADAN, , Immediately after implantation, the, inner cell mass (embryo) differentiates, into an outer layer called ectoderm and, an inner layer called endoderm. A, mesoderm soon appears between the, ectoderm and the endoderm. These, three layers give rise to all tissues, (organs) in adults., , 2. it helps in the removal of carbon dioxide, and excretory/waste materials produced by, the embryo., 3. Placenta also acts as an endocrine tissue, and produces several hormones like human, chorionic gonadotropin (hCG), human, placental lactogen (hPL), estrogens,, progestogens, etc., , , Inner cell mass contains certain cells, called stem cells which have the potency, to give rise to all the tissues and organs, , , , , 1st month of pregnancy=Heart is, formed, 1st sign of growing foetus may be, noticed by the listing to the heart, sound, By the end of second month-Limbs, and digits formed, By the end of 12 weeks (1st, trimester)= major organs formed, (Limbs and external genital organs, formed), 5th month= 1st movement of foetus,, appearance of hair on head, By the end of 24th week (2nd, trimsester)= Body covered with fine, hairs, eye lids separate, eye lashes, formed, By the end of 9 months of pregnancy,, =the foetus is fully developed and is, ready for delivery, , , , , , , , After implantation, finger-like projections, appear on the trophoblast called, chorionic villi which are surrounded by, the uterine tissue and maternal blood., The chorionic villi and uterine tissue, become interdigitated with each other and, jointly form a structural and functional, unit between developing embryo, (foetus) and maternal body called, placenta, The placenta is connected to the embryo, through an umbilical cord which helps in, the transport of substances to and from, the embryo, , Functions of placenta, 1. The placenta facilitate the supply of oxygen, and nutrients to the embryo, NAVAS CHEEMADAN/2021, , E) Gestation, The duration between fertilization and, parturition is called gestation., , , , , , In the later phase of pregnancy, a, hormone called relaxin is also secreted, by the ovary., , , , , , Placenta, , hCG, hPL and relaxin are produced, in women only during pregnancy., , , , , , , During pregnancy the levels of hormones like, estrogens,, progestogens,, cortisol,, prolactin, thyroxine, etc., are increased, several folds in the maternal blood., Increased production of these hormones is, essential for supporting the fetal growth,, metabolic changes in the mother and, maintenance of pregnancy., , [email protected]

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SOHSS-AREEKODE, , , , , , , , , , , , NAVAS CHEEMADAN, , F) Parturition, The average duration of human, pregnancy is about 9 months., Vigorous contraction of the uterus at the, end, of, pregnancy, causes, expulsion/delivery of the foetus. This, process of delivery of the foetus, (childbirth) is called parturition., Parturition is induced by a complex neuro, endocrine mechanism., The signals for parturition originate, from the fully developed foetus and the, placenta which induce mild uterine, contractions called foetal ejection, reflex. This triggers release of oxytocin, from the maternal pituitary., Oxytocin acts on the uterine muscle and, causes stronger uterine contractions,, which in turn stimulates further secretion, of oxytocin. The stimulatory reflex, between the uterine contraction and, oxytocin secretion continues resulting in, stronger and stronger contractions. This, leads to expulsion of the baby out of the, uterus through the birth canal (Cervical, canal along with vagina is called birth, canal) – parturition., Soon after the infant is delivered, the, placenta is also expelled out of the uterus., , Lactation,  The mammary glands of the female, undergo differentiation during pregnancy, and starts producing milk towards the, end of pregnancy by the process called, lactation. This helps the mother in, feeding the newborn.,  The milk produced during the initial few, days of lactation is called colostrum, which contains several antibodies (IgA), absolutely, essential, to, develop, resistance for the new-born babies., Breast-feeding during the initial period, of infant growth is recommended by, doctors for bringing up a healthy baby., , , , , Milk synthesizing hormone is =PRL, (Prolactin), Milk ejecting hormone is =OT(Oxytocin), Pregnancy hormone =Progesterone, , NAVAS CHEEMADAN/2021, , [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , Chapter 4, , R, , EPRODUCTIVE, , H, , REPRODUCTIVE HEALTH, According to the, Organisation (WHO),, , Strategies for Reproductive Health, 01-Counseling and creative awareness,  With the help of audio-visual and the printmedia, governmental, and, nongovernmental agencies have taken, various steps to create awareness among, the people about reproduction-related, aspects, , EALTH, , World, , Health, , 02-Sex education,  Introduction of sex education in schools, should also be encouraged to provide, right information to the young so as to, discourage children from believing in, myths and having misconceptions about, sex-related aspects,  Proper information about reproductive, organs,, adolescence, and, related, changes, safe and hygienic sexual, practices, sexually transmitted diseases, (STD), AIDS, etc., would help people,, especially those in the adolescent age, group to lead a reproductively healthy life., , Reproductive health means a total wellbeing in all aspects of reproduction, i.e.,, physical, emotional, behavioural and, social.,  The term ‘Reproductive health’ simply, refers to healthy reproductive organs, with normal functions,  Therefore, a society with people having, physically, and, functionally, normal, reproductive organs and normal emotional, and behavioural interactions among them, in all sex-related aspects might be called, reproductively healthy, REPRODUCTIVE HEALTH – PROBLEMS AND, STRATEGIES,  India was amongst the first countries in, the world to initiate action plans and, programmes at a national level to attain, total reproductive health as a social, goal, , 03-family welfare information,  Fertile couples and those in marriageable, age group must be educated in the, following aspects., I-Available birth control options,, ii- Care of pregnant mothers,, iii-Post-natal care of the mother and child,, Iv-Importance of breast feeding,, v- Equal opportunities for the male and, the female child, etc., Vi-Desired size of the family, , Programmes involved in maintaining, Reproductive health, 1. Family Planning Programme (Initiated in, 1951), 2. ‘Reproductive and Child Health Care, (RCH) programmes’, , Major Task under Family planning, Programme and RCH, 01-Create awareness among people about, various reproduction related aspects, 02-Provide facilities and support for building, up a reproductive healthy society, , NAVAS CHEEMADAN/2021, , 04-Social evils, Social evils like sex-abuse and sexrelated crimes, etc., need to be created to, enable people to think and take up, necessary steps to prevent them and, thereby build up a socially responsible, and healthy society, , , 05-Statutory ban on amniocentesis, Amniocentesis is the pre-natal diagnostic, technique of foetal sex determination and, determination of genetic disorder of the, foetus based on the chromosomal pattern in, the amniotic fluid surrounding the, developing embryo, [email protected]

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SOHSS-AREEKODE, , , , , , , , In amniocentesis, some of the amniotic, fluid of the developing foetus is taken to, analyze the foetal cells and dissolved, substances, Uses of Amniocentesis, This procedure is used to test for the, presence of, 01-Genetic disorder (Down’s syndrome,, Hemophilia, sickle cell anemia etc.),, 02-Determine the survivability of the foetus., 03-This technique also gives sex of the, baby before birth, ., Misuses of Amniocentesis, It is used to determine the sex of the, child, and to kill normal female foetus., Hence, determination, of, sex, by, amniocentesis has been legally banned, to avoid female foeticides, 06-Medical assistance and care,  Medical assistance and care must be, provided to people in reproduction related, problems like the following, I-Pregnancy, Ii-Delivery, Iii-STD’S, Iv-Abortion, V-Contraception, Vi-Menstrual Problems, Vii-Infertility, 07-Research,  Research on various reproduction related, areas are helped and supported by, government, and, non, government, agencies to find out new methods or to, improve upon the existing methods.,  Saheli’–a new oral contraceptive for the, females–was developed by scientists at, Central Drug Research Institute (CDRI), in Lucknow,  Saheli –the new oral contraceptive for the, females, contains, a, non-steroidal, preparation. It is a ‘once a week’ pill with, very few side effects and high, contraceptive value, , NAVAS CHEEMADAN/2021, , NAVAS CHEEMADAN, , POPULATION EXPLOSION AND BIRTH, CONTROL,  The world population which was, around 2 billion (2000 million) in 1900, rocketed to about 6 billion by 2000 and, 7.2 billion in 2011,  Indian, population, which, was, approximately 350 million at the time of, our independence reached close to the, billion mark by 2000 and crossed 1.2, billion in May 2011.,  WORLD POPULATION DAY-JULY-11,  According to the 2011 census report, the, population growth rate was less than 2 per, cent, i.e., 20/1000/year, a rate at which, our population could increase rapidly, Reason for population explosion, 1. A rapid decline in death rate., 2. Decline in maternal mortality rate, (MMR) ., 3. Decline in infant mortality rate, (IMR) ., 4. Increase in number of people in, reproducible age.,  Population growth rate can be checked, by, 1. Motivate smaller families by using, various contraceptive methods., 2. Showing advertisements in the, media as well as posters/bills, etc.,, showing a happy couple with two, children with a slogan ‘Hum Do, Hamare Do’ (we two, our two)., 3. Statutory raising of marriageable, age of the female to 18 years and, that of males to 21 years,, 4. Incentives given to couples with, small families., , [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , Contraceptive methods, It helps, pregnancies., , to, , prevent, , unwanted, , Qualities of a good contraceptive method, An ideal contraceptive should be, 1. User-friendly,, 2. Easily available,, 3. Effective and, 4. Reversible, 5. No or least side-effects., 6. It should not interfere with the sexual, drive, desire and/or the sexual act of, the user.,  A wide range of contraceptive methods, are presently available which could be, broadly grouped into the following, categories, namely, A) Natural/Traditional method, B) Barrier method, C) IUDs, D) Oral contraceptives,, E) Injectables, F) Implants, G) Surgical methods, A) Natural methods, Natural methods work on the principle of, avoiding chances of ovum and sperms, meeting., i)Periodic abstinence :,  It is one of natural method in which the, couples avoid or abstain from coitus from, day 10 to 17 (Fertile period-Because, chances of fertilization re very high, during this period ) of the menstrual, cycle when ovulation could be expected.,  Therefore, by abstaining (Avoiding), from coitus during this period,, conception could be prevented, , occur during the period of intense, lactation following parturition.,  Therefore, as long as the mother breastfeeds the child fully, chances of, conception are almost nil.,  However, this method has been reported, to be effective only upto a maximum, period of six months following parturition., 1. Adventages of Natural methods :, No medicines or devices are used in, natural , side effects are almost nil., 2. Disdventage of Natural methods:, Chances of failure by this method are, also high, B) Barrier method, In barrier methods, ovum and sperms, are prevented from physically meeting with, the help of barriers. Such methods are, available for both males and females. Barrier, methods include, i) Condoms :,  they are barriers made of thin rubber/, latex sheath,  It is used to cover the penis in the male, or vagina and cervix in the female,,  It is used just before coitus so that the, ejaculated semen would not enter into the, female reproductive tract. This can, prevent conception., ‘ Nirodh’ is a popular brand of condom, for the male., , ii) Withdrawal or coitus interruptus :,  Here the male partner withdraws his, penis from the vagina just before, ejaculation so as to avoid insemination., iii)Lactational amenorrhea :, (Absence of menstruation),  This method is based on the fact that, ovulation and therefore the cycle do not, NAVAS CHEEMADAN/2021, , [email protected]

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SOHSS-AREEKODE, , Advantages of Condoms, 1. Use of condoms protecting the user, from contracting STIs/STDs and, AIDS., 2. Both the male and the female, condoms are disposable,, 3. It can be self-inserted, 4. It gives privacy to the user, ii) Diaphragms, cervical caps and vaults,  They are also barriers made of rubber,  They are inserted into the female, reproductive tract to cover the cervix, during coitus., Mechanism of action :,  They prevent conception by blocking, the entry of sperms through the cervix.,  Spermicidal creams, jellies and foams, are usually used alongwith these, barriers, to, increase, their, contraceptive efficiency,  They are reusable., C) IUDs (Intra Uterine Devices),  These devices are inserted by doctors or, expert nurses in the uterus through, vagina.,  IUDs increase phagocytosis of sperms, within the uterus,  These Intra Uterine Devices are presently, available are, i) Non-medicated IUDs, E.g., Lippes loop, ii)Copper releasing, IUDs, Eg.CuT, Cu7,, Multiload 375, Mechanism of action :,  Cu ions released suppress sperm, motility and the fertilising capacity of, sperms.,  Non medicated IUD either retard the, sperm motility or have the spermicidal, effect, iii) hormone releasing IUDs, Eg:Progestasert, LNG-20, Mechanism of action :,  It make the uterus unsuitable for, implantation,  It make and the cervix hostile to the, sperms., , NAVAS CHEEMADAN/2021, , NAVAS CHEEMADAN, ,  Medicated IUD release certain hormones, that alter the hormonal balance in the, female body and prevent conception, , Cu-T, IUDs are ideal contraceptives for the, females who want to delay pregnancy, and/or space children. It is one of, most widely accepted methods of, contraception in India., D) Oral contraceptive (Oral Pills ),  Oral administration of small doses of, either progestogens or progestogen–, estrogen, combinations, is, another, contraceptive method used by the, females.,  They are used in the form of tablets and, hence are popularly called the pills.,  Pills have to be taken daily for a period of, 21 days starting preferably 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., Mechanism of action:,  They inhibit ovulation and implantation,  It alter the quality of cervical mucus to, prevent/ retard entry of sperms., Advantage of pills,  Pills are very effective,  It has lesser side effects,  They are well accepted by the females., , [email protected]

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SOHSS-AREEKODE, , Saheli-Once a Week Pill,  Saheli –the new oral contraceptive for, the females contains a non-steroidal, preparation. It is a ‘once a week’ pill, with very few side effects and high, contraceptive value.,  ‘Saheli was developed by scientists at, Central Drug Research Institute (CDRI), in Lucknow, E) Injectabale and Implants,  Progestogens alone or in combination, with estrogen can also be used by, females as injections or implants under, the skin,  Their mode of action is similar to that of, pills and their effective periods are, much longer., , NAVAS CHEEMADAN, ,  Mchanism of action:Surgical intervention, blocks gamete transport and thereby, prevent conception.,  The two types of surgical methods are, Vasectomy and tubectomy, i)Vasectomy :,  Sterilisation procedure in the male is, called ‘vasectomy’.,  In vasectomy, a small part of the vas, deferens is removed or tied up through a, small incision on the scrotum., ii)Tubectomy,  Sterilisation procedure in the Female is, called tubectomy.,  In tubectomy, a small part of the fallopian, tube is removed or tied up through a small, incision in the abdomen or through, vagina., These techniques are highly effective but, their reversibility is very poor., , Emergency Contraceptive method,  Administration, of, progestogens, , or, progestogen-estrogen, combinations, or, IUDs within 72 hours of coitus have been, found to be very effective as emergency, contraceptives as they could be used to, avoid possible pregnancy due to rape or, casual unprotected intercourse., , G) Surgical Methods (sterilisation),  Surgical, methods,, also, called, sterilisation,,  They are generally advised for the, male/female partner as a terminal, method, to, prevent, any, more, pregnancies., NAVAS CHEEMADAN/2021, , Difference between vasectomy and, Tubectomy, Vasectomy, Tubectomy, Sterilisation, Sterilisation, procedure, in, the procedure, in, the, male, is, called Female is called, ‘vasectomy’., tubectomy., In vasectomy, a small, part of the vas, deferens is removed, or tied up through a, small incision on, the scrotum., , in tubectomy, a small, part of the fallopian, tube is removed or, tied up through a, small incision in the, abdomen, or, through vagina., , Passage of sperm is Passage of egg is, prevented, prevented, [email protected]

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SOHSS-AREEKODE, , Ill-Effect of the usage of contraceptive, methods /Birth Controls, , NAVAS CHEEMADAN, , pregnancy. Second trimester abortions are, much more riskier., , ill-effects, , , , , , , , Nausea,, Abdominal pain,, Breakthrough bleeding,, Irregular menstrual bleeding, Breast cancer,, Though not very significant, should not be totally, ignored., , MEDICAL TERMINATION OF PREGNANCY, (MTP),  Intentional or voluntary termination of, pregnancy before full term is called, medical termination of pregnancy, (MTP) or induced abortion.,  Nearly 45 to 50 million MTPs are, performed in a year all over the world, which accounts to 1/5th of the total, number of conceived pregnancies in a, year (20%),  Obviously, MTP has a significant role in, decreasing the population though it is not, meant for that purpose. Whether to, accept /legalise MTP or not is being, debated upon in many countries due to, emotional, ethical, religious and social, issues involved in it.,  Government of India legalised MTP in, 1971 with some strict conditions to avoid, its misuse. Such restrictions are all the, more important to check indiscriminate, and illegal female foeticides which are, reported to be high in India., , i), , ii), , WHY MTP….??, MTP is –, To get rid of unwanted pregnancies, either due to casual unprotected, intercourse or failure of the, contraceptive used during coitus or, rapes., MTPs 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 considered relatively safe during, the first trimester, i.e., upto 12 weeks of, NAVAS CHEEMADAN/2021, , Why MTP legalized in India…?, Dangerous trend is the misuse of, amniocentesis to determine the sex of the, unborn child. Frequently, if the foetus is found, to be female, it is followed by MTP- this is, totally against what is legal. Such practices, should be avoided because these are, dangerous both for the young mother and the, foetus., One disturbing trend observed is that a, majority of the MTPs are performed illegally, by unqualified quacks which are not only, unsafe but could be fatal too., , Remedies from MTP,  Effective counseling on the need to avoid, unprotected coitus,  Awareness of Risk factor involved illegal, abortions,  Providing more health care facilities to, avoid illegal abortions, The Medical Termination of Pregnancy, (Amendment) Act, 2017, , , The Medical Termination of Pregnancy, (Amendment) Act, 2017 was enacted by the, government of India with the intension ofreducing the incidence of illegal abortion and, consequent maternal mortality and morbidity.,  According to this Act, a pregnancy may be, terminated on certain considered grounds, within the first 12 weeks of pregnancy on, the opinion of one registered medical, practitioner. If the pregnancy has lasted, more than 12 weeks, but fewer than 24, weeks,, two, registered, medical, practitioners must be of the opinion,, formed in good faith, that the required ground, exist. The grounds for such termination of, pregnancies are:, (i) The continuation of the pregnancy would, involve a risk to the life of the pregnant woman or, of grave injury physical or mental health; or, (ii There is a substantial risk that of the child were, born, it would suffer from such physical or mental, abnormalities as to be seriously handicapped., [email protected]

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SOHSS-AREEKODE, , SEXUALLY TRANSMITTED INFECTIONS, (STIs), Diseases or infections which are, transmitted through sexual intercourse, are, collectively, called, sexually, transmitted, infections, (STIs), or, venereal diseases (VD) or reproductive, tract infections (RTI)., Eg :,  Gonorrhoea,  Syphilis,  Genital herpes,  Chlamydiasis,  Genital warts,  Trichomoniasis,  Hepatitis-B,  AIDS (HIV infections), , NAVAS CHEEMADAN, , , , This could lead to complications later,, which include,  Pelvic inflammatory diseases (PID),,  Abortions,,  Still births (Birth of dead foetus),  Ectopic, pregnancies, (Tubular, pregnanacy ),,  Infertility,  Cancer of the reproductive tract, All persons are vulnerable to these infections,, their incidence are reported to be very high, among persons in the age group of 15-24, years-the age group to which you also, belongs, STD can be prevented by, 1. Avoid, sex, with, unknown, partners/multiple partners, 2. Always use condoms during coitus., 3. In case of doubt, one should go to, a qualified doctor for early, detection, and, get, complete, treatment, if, diagnosed, with, disease., ,  Except for hepatitis-B, genital herpes and, HIV infections, other diseases are, completely curable if detected early and, treated properly., Hepatitis–B and HIV can also be transmitted, by sharing of injection needles, surgical, instruments, etc., with infected persons,, transfusion of blood, or from an infected, mother to the foetus too, Symptoms of STIs, Early symptoms of most of these are, minor and include,  Itching,,  Fluid discharge,,  Slight pain,,  Swellings, etc., in the genital region., Infected females may often be asymptomatic, and hence, may remain undetected for long., , Infertility, , , The reasons for this could be many–,  Physical,  Congenital,,  Diseases,,  Drugs,,  Immunological,  Psychological, , , , Complications of STIs,  Absence or less significant symptoms in, the early stages of infection and the, social stigma attached to the STIs, deter, the infected persons from going for timely, detection and proper treatment., NAVAS CHEEMADAN/2021, , Inability to produce children inspite of, unprotected sexual co-habitation is called, infertile., , In India, often the female is blamed for the, couple being childless, but more often, than not, the problem lies in the male, partner., Specialised health care units called, infertility clinics could help in diagnosis, and corrective treatment of some of these, disorders and enable these couples to, have children. However, where such, corrections are not possible, the couples, could be assisted to have children through, certain special techniques commonly, known, as, assisted, reproductive, [email protected]

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SOHSS-AREEKODE, , technologies (ART). The ART includes, the following, a) In vitro fertilization and Embryo transfer, (IVF-ET),  Fertilisation outside the body is called, Invitro fertilisation.,  Invitrofetilisation is done in almost similar, conditions (as that in the body) followed, by embryo transfer. This method is, popularly known as test tube baby, programme., Steps/Procedure in IVF-ET,  Ova/Egg from the wife/donor (female) and, sperms from the husband/donor (male), are collected,  Oth sperm and egg are induced to form, zygote under simulated conditions in the, laboratory (This step is called IVF),  The zygote or early embryos thus formed, (with upto 8 blastomeres) could then be, transferred into the fallopian tube (ZIFT–, zygote intra fallopian transfer) and, embryos with more than 8 blastomeres,, into the uterus (IUT – intra uterine, transfer), to complete its further, development. (This step is called Embryo, transfer),  Embryos formed by in-vivo fertilisation, (fusion of gametes within the female) also, could be used for such transfer to assist, those females who cannot conceive, b) GIFT (Gamete Intra Fallopian Transfer), Transfer of an ovum collected from a, donor into the fallopian tube (GIFT – gamete, intra fallopian transfer) of another female, who cannot produce one, but can provide, suitable environment for fertilisation and, further development ., c) Intra cytoplasmic sperm injection (ICSI), it is another specialised procedure to, form an embryo in the laboratory in which a, sperm is directly injected into the ovum., , NAVAS CHEEMADAN, , the ejaculates, could be corrected by, artificial insemination (AI) technique., In this technique, the semen collected, either from the husband or a healthy donor is, artificially introduced either into the vagina or, into the uterus (IUI – intra-uterine, insemination) of the female., , , , , , The ultimate aim of ART is to have, children, Though options are many, all these, techniques, require, extremely, high, precision, handling, by, specialised, professionals, and, expensive, instrumentation. Therefore, these facilities, are presently available only in very few, centres in the country. Obviously their, benefits is affordable to only a limited, number of people., Since the ultimate aim of all these, procedures is to have children, in India we, have so many orphaned and destitute, children, who would probably not survive, till maturity, unless taken care of. Our laws, permit legal adoption and it is as yet, one, of the best methods for couples looking, for parenthood, , SCAN QR CODE FOR VIDEO LESSON, 01-HUMAN REPRODUCTION, , 02-Reproductive Health, , d)AI (Artificial insemination ):, infertility cases either due to inability, of the male partner to inseminate the, female or due to very low sperm counts in, NAVAS CHEEMADAN/2021, , [email protected]

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SOHSS-AREEKODE, , Previous year question paper, , NAVAS CHEEMADAN, 11. Explain different types of Intra uterine devices with, their example, (3), , HSE-August 2021, 1. Expand the following terms, (1), a)MMR b)IMR, 2. Identify the odd one, (1), (hPL, Androgen, Relaxin, hCG ), 3. Disease or infections which are transmitted, through sexual intercourse are called sexually, transmitted disease (STDs), a)Give any two examples for STDs, b)Write any two preventive measures to avoid, STDs?, (2), 4. Identify the two types of cells lined on the inside of, seminiferous tubule. Distinguish their function (2), 5. Mention two programmes implemented in India to, attain, total, reproductive, health?, (2), 6. How many spermatozoa and ova are produced, from 25 primary spermatocyte and 25 primary, oocytes ?, (2), 7. Distinguish, between, spermiogenesis, and, spermiation?, (2), 8. Fill in the blanks with suitable terms given in, bracket, (Progestogen, Multiload-375, Vaults, Periodic, abstinence, Tubectomy, Saheli), (2), Barrier, Copper, Natural, Surgical, method, releasing, method, method, IUDs, Condom, (B), Coitus, (D), interrupts, (A), Cu-T, (C), Vasectomy, 9. The wall of uterus has 3 layers of tissues, (2), a)Name the three layers of uterine wall, b)Among these 3 layers, which layer is glandular, and undergo cyclic changes during menstrual cycle, ?, 10. Identify the pars of oviduct (fallopian tue) from, below description :, a)Finger like projection of oviduct that helps in, collection of the ovum after ovulation, b)The part of oviduct with narrow lumen that joins, the uterus, c)Funnel shaper part of oviduct that is closer to the, ovary, (3), NAVAS CHEEMADAN/2021, , HSE-March 2021, 12. Name the oral contraceptive for female developed, by CDRI., (1), 13. During luteal phase of menstrual cycle, Graafian, follicle transforms into ____, (1), 14. Expand the following terms related with Assisted, Reproductive Technologies :, (2), (a) ICSI (b) GIFT, 15. Fill in the blanks to complete the schematic, representation, (2), , 16. Write any four objectives of Reproductive and, Child Health Care (RCH) programmes, (2), 17. Write, any, four, differences, between, Spermatogenesis and Oogenesis., (2), 18. In women, some hormones are secreted only, during pregnancy. Name any such hormones, (2), 19. Match the following, (2), , 20. Match the following, , (2), , 21. ‘LH and FSH play significant role in, spermatogenesis.’, (3), (a) Write the functions of LH and FSH in, spermatogenesis., [email protected]

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SOHSS-AREEKODE, (b) Write a single term used to denote LH and FSH, together., 22. Sexually Transmitted Diseases (STDs) are seen to, be high among people with age group 15 – 24 yrs., (a) Write the names of any 4 STDs., (b) Mention the measures to be taken to prevent, STDs., (3), , HSE –July-2020, 23. The embryo with 8 to 16 blastomeres is called a, ________., (1), (a) Gastrula, (b) Morula, (c) Blastula, (d) Trophoblast, 24. Observe the diagrammatic view of male, reproductive system given below and name the, parts labeled ‘a’, ‘b’, ‘c’ and ‘d’., (2), , NAVAS CHEEMADAN, , (a) Identify A and B., (b) Explain this surgical method., (c) Why this method is generally advised as a, terminal method of contraception ?, , HSE –March-2020, 28. Name the technique of transferring embryos up to, 8 blastomeres into the fallopian tube., (1), a)GIFT b)ZIFT c)ICSI d) IUI, 29. “All copulations lead to fertilization and, pregnancy”. Do you agree with this statement?, Justify, your, answer., (2), 30. Amniocentesis for sex determination is legally, banned now., (2), (a) What is amniocentesis ?, (b) Why it is banned ?, 31. The graph given below shows the level of the, ovarian hormones in a normally menstruating, woman during the follicular phase., (3), , 25. Rearrange the following human reproductive, events in the correct order of their occurrence (2), , 26. (a) Expand ART., (2), (b) Suggest the ART which may be successful in the, following condition :, (i) Inability of the male partner to inseminate, the female., (ii) Female cannot produce ovum but can, provide suitable environment for, fertilisation and further development., 27. Observe the diagrams A and B given below related, to contraceptive methods., (3), , NAVAS CHEEMADAN/2021, , (a) Name ‘A’ and ‘B’., (b) Reconstruct the graph showing the level of, hormones in luteal phase., (c) Name the hormone secreted by Corpus Luteum, and mention its function., , HSE-June-2019, 32. Find out the correct sequence :, (1), (a) Fertilisation- zygote - Blastula - Morula cleavage - Implantation, (b) Fertilisation- zygote - cleavage - Morula Implantation - Blastula, [email protected]

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SOHSS-AREEKODE, (c) Fertilisation- zygote - Morula - cleavage Implantation - Blastula, (d) Fertilisation- zygote - cleavage - Morula Blastula – Implantation, 33. 'LH Surge' induces the rupture of Graffian follicle, (a) Which gland produces LH and in which day LH, Surge happens?, (b) Write the role of LH in males., (2), 34. There are several method of in vitro fertilisation to, assist couples who lack the ability of fertilisation., (a) Give the popular name of the programme, (b) Suggest two techniques of in vitro fertilisation and, their conditions of transfer to assist these people, , HSE-March-2019, 35. The milk produced during the initial few days of, lactation is called…………………….., (1), 36. "The sex of the baby is determined by the father, and not by the mother.”, Do you agree with this statement? Substantiate, your answer., (2), , 37. A wide range of contraceptive methods are, presently available. If so,, (2), (a) Name one contraceptive method having least, side effect., (b) Which contraceptive method is generally, advised for females as a termination method to, prevent any more pregnancies ?, (c) List out any two possible ill-effects of the usage, of contraceptive methods., 38. (a) Expand STDs., (b) Cite any two examples for STD., (c) Suggest any two methods for the prevention of, STDs., (3), NAVAS CHEEMADAN/2021, , NAVAS CHEEMADAN, , HSE-Model-2019, 39. Name the loose pouch of skin which, suspended testis outside the abdominal cavity, ? (1), 40. Note the relationship between the first two words, and suggest a suitable word for the 4th place,, a) Female: Tubectomy, male:……………………(1/2), 41. Mothers milk is considered as very essential for a, new born baby., a) Name the first milk released from the mother, just after birth., (1), b) What is its importance?, (1), 42. Suggest any 3 methods to assist infertile couple tohave children, (3), , HSE-March-2018, 43. Name the cells in testis which synthesize and, secrete androgens?, (1), 44. Different contraceptive methods are given, below. Pick out the odd one, (1), a)Cu T b)Saheli, c)Multiload 375 d)Lippes loop, 45. In a class room discussion, a student said that, sex of the baby is determined by the father., Analyse the statement and give reason for it ?, (2), 46. Different contraceptive methods are used to, control population explosion. Summarise the, natural method and barrier method of, contraception ?, (2), 47. Sexually transmitted disease (STD) are mainly, transmitted through sexual contact, (3), a)Name any two examples of STD?, b)Explain any two methods adopted to, prevent STD ?, HSE-March-2018 Model Exam, , 48. The middle layer of uterus is called………, (1), 49. Vasectomy and tubectomy are said to be, effective and irreversible contraceptive, methods. Differentiate between these two, methods., (2), [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , 50. From an infertility clinic a doctor advised a, childless couple to undergo GIFT., l. Expand GIFT, 2. Mention the steps involved in this, procedure, (2), HSE-JUNE-2017, 51. Human female possess 44+XX chromosome, number. The chromosome number of, secondary oocyte is, (1), a)44+XX b)22+X c)44+XX d)22+XX, 52. Observe the diagram and answer the question, (2), , a) Identify A and B, b) Write the function of B, 53. Prepare a brief notes to be presented in an, awareness programme for adolescent about, AIDS, their causes and preventive measures?, (3), , 57. What is ART ? Categorize the following ART’s, based on their application in male sterility and, female sterility:, GIFT, AI, HSE-SAY-2016, 58. The process of fusion of sperm with ovum is, called........................., (1), 59. Match the column A and B, (2), , 60. Select the odd one and justify your selection?, Malaria, Gonorrhoea ,Amoebiasis, filariasis (1), 61. Diagnostic report of two couples having, infertility problem are given below :, (2), 1) The Women cannot produce ovum, 2) The man has very low sperm count in, semen., Suggest a suitable assisted reproductive, technology (ART) for each problem in, expanded form., , HSE-March-2017, 54. Which of the following pairs of STDs is, completely curable ?, (1), a)HIV, Hepatitis B, b)Hepatitis B, Gonorrhoea, c)Symphils, Gonorrhoea, d)Chlamydomonas, Genital Herpes, 55. Feeding...................in the first few days is, essential for preventing infection in a newly, born baby, (1), 56. LH and FSH are gonadotrophins. Distinguish, their roles in male and female?, (2), , NAVAS CHEEMADAN/2021, , HSE-March-2016, 62. Breast feeding during initial period of infant growth, is necessary to develop immunity of new born, babies. Why ?, (1), 63. Categorise the given birth control methods into, three groups with proper heads., (Cervical caps, Vasectomy, Cu T, Tubectomy,, Diaphragms, Condoms, Lippes Loop ), (3), 64. match the columns A and B, (2), A, B, Corpus Luteum, Embryo, Leydig cells, Implantation, Blastocyst, Progesterone, [email protected]

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SOHSS-AREEKODE, Inner cell mass, , NAVAS CHEEMADAN, Androgens, Prolactin, , HSE-June-2015, 65. Choose the odd one from the following and, write common features of others., (1), a)Estrogen b)Anrogen c)Relaxin, d)Progesterone, 66. Some techniques commonly used for, infertility treatment are given below. Read, them carefully and answer the question (3), ZIFT,GIFT,ICSI,IUI,IVF, a)which of the above techniques is used, for the collection of sperm from the, husband or a healthy donor and artificially, introduced into the vagina or uterus of, the female?, b)Distinguish between ZIFT and GIFT, c)Write the common term used to denote, the techniques given below ?, 67. Complete, the, flow, chart, showing, spermatogenesis by filling A and B and answer, the question, (2), , 69. It is evident that, it is the genetic makeup of, the sperm that determine the sex of the child, in human being. Substantiate., (2), 70. Identify the diagram and write how it acts (1), , 71. Mothers milk is considered essential for new, born infants, (1), a)Name the fluid secreted by mother from, breast during the initial days of lactation, b)What type of immunity it provides, HSE-SAY-2014, , a)what is the chromosome number of, primary spermatocyte?, b)what is the significance of reduction, division in spermatognenesis?, , 72. ........... and ..........are two, surgical, contraceptive methods in male and female, respectively, (1), 73. Diagram of mammalian sperm is given below., Label the parts marked, (1), , HSE-March-2015, 68. 1)In which part of human reproductive, system the following events occur?, (2), a)Fertilisation b)Implantation, 2)Diagram of a Human blastocyst is given, below .Identify A and B, , NAVAS CHEEMADAN/2021, , [email protected]

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SOHSS-AREEKODE, , 74. Sex of the bay is determined by the father,, not by the mother. Substatntiate?, (2), 75. Amniocentesis for sex determination is, banned in our country? Is this Ban necessary?, Comment one use of amniocentesis?, (2), , HSE-MARCH-2014, 76. Observe the diagram and answer the, question, (3), a) Identify A and B, b) What is the function of C, c) In which of the marked part reduction, division takes place? What is the significance, of it?, , 77. One of our neighbour is suffering from, itching, fluid discharge, slight pain and, swelling in the genital region, (2), a)What do you think the disease he is, suffering from?, b)What measures are to be taken to prevent, such disease, 78. Expand the following abbreviations which are, commonly used in reproductive health, (1), a)ART, b)ZIFT, HSE-SAY-2013, 79. Though one ovum is produced from a primary, oocyte it can result into a male or female, child after fertilisation. But in these case of, spermatocyte though 4 sperms are produced, only two of the can result to a female child, after fertilisation justify?, (1), NAVAS CHEEMADAN/2021, , NAVAS CHEEMADAN, , 80. Sterilization and IUDs are effective birth, control, measures,, but, lactational, amenorrhoea may not be so effective, a)How the sterilization procedure of male, differ from that of female in preventing, pregnancy?, (2), b) Which part of the female reproductive, organ is utilized for the IUD procedure? How, this procedure prevents pregnancy?, (2), c)Why the lactational amenrrhoea is not so, effective?, (1), HSE-MARCH-2013, 81. The following statements compare the, process of Oogenesis and spermatogenesis., Which one is not true, a)Production of ovum ceases at certain age,, but sperm production continues even in old, men, b)Oogenesis begins in the embryonic stages,, but spermatogenesis starts at the oneset of, puberty., c)Meiotic arrest occurs both in Oogenesis and, spermatogenesis., d)Polar bodies are formed in Oogenesis, (1), 82. Suggest the ART which may be successful in, the following conditions, (3), a)A female cannot produce an ovum, but can, provide suitable environment for fertilization, and further development, b)Male partner is unable to inseminate the, female or has very poor sperm count, c)Fusion of gamete and zygote formation, doesnot occur within the body of female, 83. The diagram represents a process of, gametogenesis. Closely observe it and answer, the following, (2), a)Is it spermatogenesis or Oogenesis?, b)What does smaller shaded circle represent?, c)Write down two significance of production, of same?, , [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , 87. “STDs present a major health concern in both, industrialization and developing countries”(3), a) What you meant by STD?, b) Name two STDs?, c) Suggest two preventive measures?, 88. Some stages of embryonic development are, given below. Observe these diagram and, answer the question, (3), , HSE-SAY-2012, 84. Find out the odd one from the following,, write the reason, (1), a)Cu T, b)Cu 7 c)LNG-20 d)Multiload-375, 85. One couple came to know that they have a, girl child during fourth month of pregnancy, and they decided to do MTP, (2), a)What is MTP?, b)At which stage of pregnancy MTP relatively, safe?, c)How will you respond to the decision of, female foeticide by the couple?, 86. Observe the diagram provided (do not copy, the picture), (3), , a)Label A and B, b)On which day of menstrual cycle Graffian, follicle rupture?, c)Name the process induces the rupture of, graffian follicle, d)Write the name and function of the, structure forming inside the ovary after, rupture of Graffian follicle?, HSE-March-2012, , NAVAS CHEEMADAN/2021, , a)What is A and B?, b)Name the two types of cells found in the, Blastocyst?, c)Which layer of blastocyst is attached to the, endometrium? And Name the process?, , HSE-SAY-2011, 89. Note the relationship between first two terms, and suggest a suitable terms for the fourth, place, (1), a)Progesteron, :, Corpus luteum, HCG, :, ........................, b)GIFT, :, Gamete, ZIFT, :, ........................, 90. Observe the Graph provided, , a)What do A and B stands for?, (1), 91. Nalini is four month pregnant at the, insistence of her mother in law, she, underwent an illegal diagnostic procedure by, which the sex of the baby was determined to, be female . Nalini’s mother in law cursed her, for conceiving a girl child., , [email protected]

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SOHSS-AREEKODE, , a)What is the diagnostic procedure used, here?, b) “scientifically, Nalini is not responsible for, conceiving a girl child”. How will you, substantiate this statement?, (1), 92. Observe the diagram provided and identify, the process:, (2), , NAVAS CHEEMADAN, , IVF, , ZIFT, , GIFT, , IUI, , 96., , The above graph shows the level of ovarian, hormones in a normally menstruating women, during follicular phase, (3), a)Name A and B, b)Mention the role of pituitary hormones in, maintaining this condition, c)Reconstruct the graph for luteal phase?, a)Label; A,B,C and D, b)Why the gametes produced are haploid, even though the gamete mother cells are, diploid?, 93. Raju has lost his mother at birth. He is, unhealthy and contract diseases easily. In his, Doctor’s opinion, Raju’s ill health is due to his, not drinking mother’s milk., How will you justify the doctor’s opinion in, the light of your knowledge of immunity? (2), HSE-MARCH-2011, 94. One among the contraceptive method is, peculiar. Find the odd one and what is the, common among others?, (1), a)Periodic abstinence, b)coitus interruptus, c)Lactational amenorrhea, d)IUDs, 95. The treatment facility advertised on the, brochure of a private clinic is shown below, a)Can you suggest what type of clinic is?, b)Make a brief note on any three of the, treatment procedure?, (2), NAVAS CHEEMADAN/2021, , HSE-SAY-2010, 97. Select the ART that uses an early embryo with, upto 8 blastomeres, (1), a)ZIFT )IUT c)GIFT d)IUI, 98. The total population in India is alarmingly, increased to 1 billion according to 2001, censes. The population growth rate was still, around 1.7%, a rate at which our population, could be double in 33 years, Cite the probable reasons for such an, increase in population growth rate?, (2), 99. The graph shown below shows the levels of, LH and FSH at various stages of menstrual, cycle., (3), , a)Name the source of LH and FSH, [email protected]

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SOHSS-AREEKODE, , NAVAS CHEEMADAN, , b)The level of LH is maximum during the, middle day of cycle. Mention its effect?, c)Note the function of LH in male?, , HSE-March-2010, 100. Given below is the diagrammatic, representation of Human blastocyst. Observe, the diagram and answer the following, questions., (2), , a)Identify A and B, b)Write the function of A and B, 101. When the urine sample of a lady is tested,, presence of Human chorionic gonadotropin, (HCG) was detected, (2), a)What does the presence of HCG indicate?, b)Which is the source of HCG?, 102. Diagram shown below is a surgical, method used for female sterilization, (2), a) What is the method shown in the diagram?, b) Mention any two IUDs to prevent, conception?, c)what is surgical method of male sterilization, called?, , NAVAS CHEEMADAN/2021, , [email protected]