Class 12 Biology Notes Chapter 4 (Reproductive Health) – Examplar Problems Book

Alright class, let's delve into Chapter 4, 'Reproductive Health'. This chapter is extremely important, carrying significant weight not only from a biological understanding perspective but also due to its direct relevance in public health and consequently, various government exams. Pay close attention to the definitions, programmes, methods, and technologies discussed.

Chapter 4: Reproductive Health - Detailed Notes for Competitive Exams

1. Reproductive Health: Problems and Strategies

• Definition (WHO): Reproductive health means total well-being in all aspects of reproduction, i.e., physical, emotional, behavioural, and social. It's not merely the absence of disease or infirmity.
• Significance in India: India was among the first countries globally to initiate national-level action plans and programmes ('Family Planning', initiated 1951) to attain total reproductive health as a social goal.
• Current Programme: 'Reproductive and Child Health Care (RCH)' programmes cover a wider range of reproduction-related areas.
• Major Goals of RCH:
  • Creating awareness among people about various reproduction-related aspects.
  • Providing facilities and support for building up a reproductively healthy society.
• Strategies Employed:
  • Awareness: Using audio-visual aids, print media, government and non-governmental agencies to spread awareness about reproduction-related aspects. Role of parents, teachers, and close relatives is also crucial.
  • Sex Education: Introduction in schools to provide right information, discourage myths and misconceptions about sex-related issues. Proper information about reproductive organs, adolescence & related changes, safe and hygienic sexual practices, STIs including AIDS.
  • Healthcare Infrastructure: Providing medical facilities and care for reproduction-related problems like pregnancy, delivery, STIs, abortions, contraception, menstrual problems, infertility, etc. Better awareness about sex-related problems, increased number of medically assisted deliveries, better post-natal care leading to decreased maternal and infant mortality rates.
  • Research: Supporting research on various reproduction-related areas.
• Statutory Ban: Amniocentesis (a foetal sex determination test based on chromosomal pattern in amniotic fluid) is banned for sex determination to prevent female foeticide, though it's useful for detecting certain genetic disorders.

2. Population Explosion and Birth Control

• Population Explosion: Rapid increase in population size over a relatively short period.

  • Reasons in India: Rapid decline in death rate (MMR - Maternal Mortality Rate and IMR - Infant Mortality Rate), increase in the number of people in the reproducible age group.
  • Consequences: Scarcity of basic requirements (food, shelter, clothing), strain on resources and infrastructure.

• Need for Birth Control (Contraception): To check population growth, maintain individual reproductive health.

• Characteristics of an Ideal Contraceptive: User-friendly, easily available, effective, reversible with no or least side-effects, should not interfere with the sexual drive, desire and/or the sexual act of the user.

• Contraceptive Methods:

  • a) Natural/Traditional Methods: Work on the principle of avoiding chances of ovum and sperms meeting.

    • Periodic Abstinence (Rhythm Method): Avoiding coitus from day 10 to 17 of the menstrual cycle (fertile period when ovulation is expected). High failure rate.
    • Withdrawal (Coitus Interruptus): Male withdraws his penis from the vagina just before ejaculation. High failure rate.
    • Lactational Amenorrhea (LAM): Absence of menstruation during the period of intense lactation following parturition. Ovulation does not occur. Effective only up to a maximum period of six months following parturition. High failure rate eventually.

  • b) Barrier Methods: Prevent physical meeting of ovum and sperms. Available for both males and females.

    • Condoms: Barriers made of thin rubber/latex sheath. Used by males (cover penis) or females (cover vagina/cervix). Prevent STIs and AIDS transmission. Disposable. Popular brand for males: Nirodh.
    • Diaphragms, Cervical Caps, Vaults: Barriers made of rubber, inserted into the female reproductive tract to cover the cervix during coitus. Reusable. Spermicidal creams/jellies/foams are usually used along with these barriers to increase contraceptive efficiency.

  • c) Intra Uterine Devices (IUDs): Devices inserted by doctors or expert nurses into the uterus through the vagina. Currently one of the most widely accepted methods in India.

    • Non-medicated IUDs: e.g., Lippes loop. Increase phagocytosis of sperms within the uterus.
    • Copper releasing IUDs: e.g., CuT, Cu7, Multiload 375. Copper ions suppress sperm motility and fertilising capacity.
    • Hormone releasing IUDs: e.g., Progestasert, LNG-20. Make the uterus unsuitable for implantation and the cervix hostile to sperms.

  • d) Oral Contraceptives (Pills): Contain either progestogens alone or a combination of progestogen-estrogen. Taken daily for 21 days starting preferably within the first five days of the menstrual cycle, followed by a gap of 7 days (during menstruation).

    • Mechanism: Inhibit ovulation and implantation, alter the quality of cervical mucus to prevent/retard sperm entry.
    • Effectiveness: Very effective with lesser side effects.
    • Saheli: A 'once a week' pill developed by CDRI, Lucknow. Non-steroidal preparation, high contraceptive value with very few side effects.

  • e) Injectables and Implants: Progestogens alone or in combination with estrogen used as injections or implants under the skin.

    • Mechanism: Similar to pills but effective for longer periods.
    • Implants: Provide contraception for several years.

  • f) Emergency Contraceptives: Administration of progestogens or progestogen-estrogen combinations or IUDs within 72 hours of coitus. Used to avoid possible pregnancy due to rape or casual unprotected intercourse.

  • g) Surgical Methods (Sterilization): Terminal method to prevent any more pregnancies. Blocks gamete transport. Highly effective but reversibility is very poor.

    • Vasectomy (Male): A small part of the vas deferens is removed or tied up through a small incision on the scrotum. Prevents sperm transport.
    • Tubectomy (Female): A small part of the fallopian tube is removed or tied up through a small incision in the abdomen or through the vagina. Prevents ovum transport.

  • Side Effects: Nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding, or even breast cancer (though not significant) can be associated with some contraceptives, especially hormonal ones. Need for consultation with qualified medical professionals.

3. Medical Termination of Pregnancy (MTP)

• Definition: Intentional or voluntary termination of pregnancy before full term. Also called induced abortion.
• Legality: MTP Act (Medical Termination of Pregnancy Act, 1971) enacted by the Government of India, with significant amendments in 2017 & 2021. Legalises MTP under certain conditions to decrease illegal abortions.
• Conditions for MTP: To avoid unwanted pregnancies (due to unprotected intercourse, contraceptive failure), or when continuation of pregnancy could be harmful/fatal to mother or foetus (e.g., certain genetic abnormalities).
• Safety: MTPs are relatively safe during the first trimester (up to 12 weeks of pregnancy). Second-trimester abortions are much riskier.
• Misuse: Often misused for female foeticide (illegal).
• Risks: Unsafe/illegal abortions performed by unqualified quacks can be fatal. Need for qualified medical personnel and safe facilities.

4. Sexually Transmitted Infections (STIs)

• Definition: Infections or diseases transmitted through sexual intercourse. Also known as Venereal Diseases (VD) or Reproductive Tract Infections (RTI).
• Common Examples & Causative Agents:
  • Bacterial: Gonorrhoea (Neisseria gonorrhoeae), Syphilis (Treponema pallidum), Chlamydiasis (Chlamydia trachomatis).
  • Viral: Genital Herpes (Herpes simplex virus), Genital Warts (Human Papillomavirus - HPV), Hepatitis B (HBV), HIV leading to AIDS (Human Immunodeficiency Virus).
  • Protozoan: Trichomoniasis (Trichomonas vaginalis).
• Mode of Transmission: Primarily sexual contact. Also via sharing injection needles, surgical instruments, transfusion of infected blood, from infected mother to foetus.
• Symptoms: Often minor or absent in early stages, especially in females. Early symptoms: itching, fluid discharge, slight pain, swellings, etc., in the genital region. Can lead to asymptomatic carriers who transmit the infection.
• Complications if Untreated: Pelvic Inflammatory Diseases (PID), abortions, stillbirths, ectopic pregnancies, infertility, cancer of the reproductive tract.
• Prevention:
  • Avoid sex with unknown/multiple partners.
  • Always use condoms during coitus.
  • Consult a qualified doctor for early detection and complete treatment if any symptoms appear or in case of doubt.
• Curability: Most STIs (except Hepatitis B, Genital Herpes, HIV infection) are completely curable if detected early and treated properly.
• Age Group: Incidence is very high in the 15-24 years age group.

5. Infertility

• Definition: Inability to conceive or produce children even after 2 or more years of unprotected sexual cohabitation.
• Causes: Can be due to problems in the male or female partner, or both. Physical, congenital, diseases, drugs, immunological, or even psychological factors.
• Assisted Reproductive Technologies (ART): Specialized techniques to help infertile couples have children.
  • In Vitro Fertilization (IVF) - Fertilization outside the body: Commonly known as 'Test Tube Baby' programme. Ova from wife/donor female and sperms from husband/donor male are collected and induced to form a zygote under simulated conditions in the laboratory.
    • Embryo Transfer (ET): The zygote or early embryo (up to 8 blastomeres) is transferred into the Fallopian tube (ZIFT – Zygote Intra Fallopian Transfer). Embryos with more than 8 blastomeres are transferred into the uterus (IUT – Intra Uterine Transfer).
  • Gamete Intra Fallopian Transfer (GIFT): Transfer of an ovum collected from a donor into the Fallopian tube of another female who cannot produce one but can provide a suitable environment for fertilization and further development.
  • Intra Cytoplasmic Sperm Injection (ICSI): A specialised procedure where a sperm is directly injected into the cytoplasm of an ovum in the laboratory. Used in cases of severe male infertility.
  • Artificial Insemination (AI): Semen collected from the husband or a healthy donor is artificially introduced into the vagina or into the uterus (IUI – Intra-Uterine Insemination) of the female. Used in cases where the male partner has low sperm count or inability to inseminate.
• Considerations: These methods require high precision handling by specialised professionals and expensive instrumentation. Emotional, religious, and social factors are also involved. Adoption remains a viable option for many couples.

Multiple Choice Questions (MCQs)

1. The function of copper ions in Copper Releasing IUDs (Intra Uterine Devices) is:
   a) To inhibit ovulation.
   b) To inhibit implantation.
   c) To suppress sperm motility and fertilising capacity.
   d) To make the cervix hostile to sperms.

2. Which of the following is a non-steroidal oral contraceptive pill developed in India?
   a) Mala-D
   b) Saheli
   c) Progestasert
   d) Norplant

3. Medical Termination of Pregnancy (MTP) is considered relatively safe up to:
   a) 8 weeks of pregnancy
   b) 12 weeks of pregnancy
   c) 20 weeks of pregnancy
   d) 24 weeks of pregnancy

4. Which of the following STIs is caused by a protozoan?
   a) Syphilis
   b) Genital Herpes
   c) Trichomoniasis
   d) Chlamydiasis

5. The technique 'GIFT' (Gamete Intra Fallopian Transfer) is recommended for females who:
   a) Cannot produce an ovum.
   b) Cannot provide a suitable environment for fertilization.
   c) Cannot retain the foetus inside the uterus.
   d) Have blocked fallopian tubes.

6. Vasectomy, a method of sterilisation in males, involves cutting and tying:
   a) Ureter
   b) Epididymis
   c) Ejaculatory duct
   d) Vas deferens

7. Which barrier method of contraception also provides protection from contracting STIs and AIDS?
   a) Diaphragms
   b) Cervical caps
   c) Vaults
   d) Condoms

8. The RCH programmes in India primarily aim to:
   a) Increase population growth rate.
   b) Promote illegal abortions.
   c) Create awareness and provide facilities for reproductive health.
   d) Distribute free medicines for all diseases.

9. In the context of Assisted Reproductive Technologies (ART), ZIFT involves the transfer of:
   a) Ovum into the fallopian tube.
   b) Zygote or early embryo (up to 8 blastomeres) into the fallopian tube.
   c) Embryo with more than 8 blastomeres into the uterus.
   d) Sperm directly into the ovum.

10. Which of the following STIs is generally considered NOT completely curable with current medical treatments?
    a) Gonorrhoea
    b) Syphilis
    c) Genital Herpes
    d) Chlamydiasis

Answer Key:

1. c
2. b
3. b
4. c
5. a
6. d
7. d
8. c
9. b
10. c

Make sure you revise these points thoroughly. Understanding the mechanisms, examples, and implications discussed here is key for tackling questions from this chapter in your exams. Good luck!