Reproductive Health

- Mode of Action: 1. Contraceptive pills contain synthetic hormones (estrogen and progesterone) that prevent ovulation by inhibiting the secretion of FSH and LH from the pituitary gland. 2. They thicken cervical mucus, making it difficult for sperm to enter the uterus. 3. They alter the endometrial lining, preventing implantation of a fertilized egg. - Schedule for Effective Outcome: - Pills should be taken daily for 21 days starting from the 5th day of the menstrual cycle, followed by a 7-day gap during which withdrawal bleeding occurs.

- Basic Steps in ART Programme: 1. Retrieval of eggs from the female and collection of sperm from the male.
2. Fertilization of the egg and sperm outside the body in a laboratory dish (in vitro fertilization).
3. Development of the fertilized egg (embryo) in a controlled environment.
4. Transfer of the embryo into the uterus for implantation and pregnancy.
- Reason for Test Tube Baby Programme: The term “test tube baby” refers to the process of fertilization occurring outside the human body, typically in a laboratory setup, rather than a test tube.

Prokaryotes: Transcription occurs in the cytoplasm. Eukaryotes: Transcription occurs in the nucleus.

The broad base of Rwanda’s age pyramid indicates: A high birth rate and rapid population growth. A large percentage of the population consists of younger individuals, as shown by the higher proportions in the 0-14 age group.

‘Nirodh’ prevents the sperm from entering the female reproductive tract by covering the penis with a latex sheath, thereby avoiding fertilization. Thus, the Reason correctly explains the Assertion.

Step 1: For (a), two reasons copper-releasing IUDs are effective contraceptives are: (i) Copper ions released by the IUD are toxic to sperm, reducing their motility and viability, thus preventing fertilization. (ii) The IUD causes a local inflammatory response in the uterus, creating an environment hostile to implantation of a fertilized egg.
Step 2: For (b), oral contraceptive pills contain synthetic hormones (estrogen and progesterone) that mimic pregnancy conditions. They inhibit the release of GnRH from the hypothalamus, preventing the secretion of FSH and LH from the pituitary, which stops ovulation. Additionally, they thicken cervical mucus, making it harder for sperm to reach the egg, and alter the uterine lining to prevent implantation.
Thus, copper IUDs prevent fertilization and implantation, while oral pills prevent ovulation and create barriers to fertilization.

Assertion (A) states that the male contraceptive 'Nirodh' works on the principle of avoiding the chances of ovum and sperm meeting. This is true. Contraceptive methods aim to prevent fertilization, which occurs when the sperm and ovum fuse.
Reason (R) states that 'Nirodh' is made of a thin rubber/latex sheath and is used to cover the penis before coitus. This is also true. 'Nirodh' is a condom, which is a barrier method of contraception made of latex or rubber that covers the penis during sexual intercourse. The reason (R) directly explains how 'Nirodh' achieves the principle stated in the assertion (A). By covering the penis, the condom acts as a physical barrier, preventing the release of semen containing sperm into the female reproductive tract. This effectively avoids the meeting of sperm and ovum, thus preventing fertilization. Therefore, Reason (R) is the correct explanation of Assertion (A).

Step 1: Understanding the Concept:
Infertility cases can be resolved using Assisted Reproductive Technologies (ART) depending on the specific physiological hurdle identified in the male or female partner.
Step 2: Detailed Explanation:
Case I: The male has a structural blockage (no connection between epididymis and vas deferens), meaning sperms are produced but cannot be ejaculated. Since they don't want a donor, sperms can be surgically collected from the testes or epididymis. These sperms are then directly injected into the ovum using ICSI (Intra Cytoplasmic Sperm Injection).
Case II: The female has blocked fallopian tubes, preventing natural fertilization. Since her eggs and the male's sperms are normal, fertilization can be performed in a lab (In Vitro). The resulting embryo can then be transferred to the uterus or fallopian tube (beyond the block). This is IVF-ET (In Vitro Fertilization and Embryo Transfer), specifically ZIFT (Zygote Intra Fallopian Transfer) if transferred early.
Case III: The male has oligozoospermia (low count) and asthenozoospermia (low motility). To overcome this, sperms can be concentrated and introduced directly into the female's reproductive tract (vagina or uterus). This is AI (Artificial Insemination) or IUI (Intra Uterine Insemination).
Step 3: Final Answer:
Case I: ICSI.
Case II: IVF-ET / ZIFT.
Case III: IUI / AI.

Step 1: Understanding the Concept:
IUDs are devices inserted by doctors in the uterus through the vagina. Copper-releasing IUDs utilize the chemical properties of copper ions to prevent conception.
Step 2: Detailed Explanation:
1. Examples: Two common copper-releasing IUDs are CuT (Copper T), Cu7, and Multiload 375.
2. Effectiveness Reasons:
- Suppression of Sperm Motility: The copper ions released by these devices suppress the motility and the fertilizing capacity of the sperms, ensuring they cannot reach the ovum.
- Phagocytosis: The presence of the IUD increases the phagocytosis (cell-eating) of sperms within the uterus, reducing the number of viable sperms.
Step 3: Final Answer:
Two IUDs are CuT and Multiload 375. They are effective because they suppress sperm motility and increase sperm phagocytosis in the uterus.