Reproductive Health Class 12: Concepts, Methods and Board Answers

What Reproductive Health is about

Weightage: This chapter is part of Unit VI, Reproduction, which carries 16 of the 70 theory marks together with Sexual Reproduction in Flowering Plants and Human Reproduction.Source: CBSE Biology (044) syllabus 2026-27, course structure, Unit VI Reproduction

In real board papers: asked in 8 of the 8 board papers we hold (2023 to 2026), on average 4.1 marks per paper. See the questions

Key concepts

Reproductive health: meaning, problems and strategies

NCERT section 3.1 Reproductive Health – Problems and Strategies

Meaning: a reproductively healthy society is one whose people have physically and functionally normal reproductive organs and normal emotional and behavioural interactions in all sex-related matters.

India's effort: India was among the first countries to start national action plans for reproductive health. The family planning programmes began in 1951 and have been reviewed over time; the wider programmes today are the Reproductive and Child Health Care (RCH) programmes.

Strategies:

• Awareness: government and non-government agencies use audio-visual and print media; parents, relatives, teachers and friends also share correct information.
• Sex education in schools: gives young people the right facts (reproductive organs, adolescence, safe and hygienic sexual practices, STDs, AIDS) and discourages myths and misconceptions.
• Educating couples: about birth control options, care of pregnant mothers, post-natal care of mother and child, the importance of breast-feeding, and equal opportunities for male and female children.
• Awareness of social problems: uncontrolled population growth, sex abuse and sex-related crimes.
• Infrastructure and expertise: medical help for pregnancy, delivery, STDs, abortions, contraception, menstrual problems and infertility.
• Legal and health programmes: the statutory ban on amniocentesis for sex determination (to check female foeticide) and massive child immunisation.
• Research: for example, Saheli, an oral contraceptive pill for women developed at the Central Drug Research Institute (CDRI), Lucknow.

Signs that reproductive health has improved: better awareness of sex-related matters, more medically assisted deliveries and better post-natal care (so lower maternal and infant mortality rates), more couples with small families, better detection and cure of STDs, and more medical facilities overall.

Worked example

Is sex education necessary in schools? Give two reasons. (2 marks)

Try it first, then show the solutionSolution

1. Yes. It gives adolescents correct information about reproductive organs, adolescence and its changes, so they do not believe myths and misconceptions. (1)
2. It teaches safe and hygienic sexual practices and how STDs and AIDS spread and can be prevented, helping young people lead a reproductively healthy life. (1)

Answer: Yes: it replaces myths with correct facts about the body and adolescence, and teaches safe practices that prevent STDs and AIDS.

Population explosion and the need for birth control

NCERT section 3.2 Population Stabilisation and Birth Control (population growth and the ideal contraceptive)

Better health facilities and living conditions in the last century made the population grow explosively.

Figures given in NCERT: world population about 2 billion in 1900, about 6 billion by 2000 and 7.2 billion in 2011. India: about 350 million at independence, close to a billion by 2000, and over 1.2 billion in May 2011. The 2011 census reported a growth rate of a little under 2 per cent, that is about 20 per 1000 per year, still enough for rapid growth.

Probable reasons:

• Rapid fall in the death rate.
• Fall in the maternal mortality rate (MMR) and infant mortality rate (IMR).
• More people in the reproducible age group.

Danger: such growth could cause an absolute shortage of basic needs (food, shelter, clothing) despite progress.

Measures:

• Motivating smaller families with contraceptives (slogan 'Hum Do Hamare Do'; many young urban couples choose a one-child norm).
• Raising the legal marriageable age to 18 years for females and 21 years for males.
• Incentives for couples with small families.

An ideal contraceptive is user-friendly, easily available, effective, reversible, with no or least side-effects, and it should not interfere with sexual drive, desire or the sexual act.

Categories of methods: natural/traditional, barrier, IUDs, oral contraceptives, injectables, implants and surgical methods.

Worked example

Give three probable reasons for the population explosion in India and two measures taken by the government to check it. (3 marks)

Try it first, then show the solutionSolution

1. Rapid decline in death rate; decline in maternal mortality rate and infant mortality rate; increase in the number of people of reproducible age (any three). (1½)
2. Measures: motivating small families with contraceptives (Hum Do Hamare Do); raising the legal marriageable age to 18 years for females and 21 years for males; incentives for small families (any two). (1½)

Answer: Falling death rate, MMR and IMR and more people of reproducible age; promoting contraception for small families and raising the marriageable age (or incentives).

Natural and barrier methods

NCERT section 3.2 Population Stabilisation and Birth Control (natural and barrier methods)

Natural (traditional) methods avoid the chance of ovum and sperms meeting. They use no medicine or device, so side effects are almost nil, but failure rates are high.
1. Periodic abstinence: the couple avoids coitus from day 10 to day 17 of the menstrual cycle, when ovulation is expected. This is the fertile period, because the chance of fertilisation is highest then.
2. Withdrawal (coitus interruptus): the male withdraws the penis from the vagina just before ejaculation, avoiding insemination.
3. Lactational amenorrhoea: during intense breast-feeding after childbirth, ovulation and the menstrual cycle do not occur, so the chance of conception is almost nil while the mother breast-feeds fully. It works only up to a maximum of six months after parturition.

Barrier methods physically stop sperms and ovum from meeting.

• Condoms: thin rubber or latex sheaths covering the penis (male) or the vagina and cervix (female), worn just before coitus so semen does not enter the female tract. 'Nirodh' is a popular brand for men. Condoms also protect against STIs and AIDS, which is why their use has grown. Both types are disposable and can be self-inserted, giving privacy.
• Diaphragms, cervical caps and vaults: rubber barriers inserted into the female tract to cover the cervix during coitus, blocking sperm entry. They are reusable.
• Spermicidal creams, jellies and foams are usually used with these barriers to increase their efficiency.

Worked example

A couple practising periodic abstinence has a regular 28-day cycle. Between which days should they avoid coitus and why? Give one drawback of this method. (2 marks)

Try it first, then show the solutionSolution

1. Days 10 to 17, because ovulation is expected in this window (around day 14), so the chance of fertilisation is highest: the fertile period. (1)
2. Drawback: high failure rate, for example if ovulation shifts in an irregular cycle; it also offers no protection from STIs. (1)

Answer: Days 10–17 (fertile period around ovulation); it has a high chance of failure.

Intra-uterine devices (IUDs)

NCERT section 3.2 Population Stabilisation and Birth Control (IUDs)

IUDs are inserted into the uterus through the vagina by doctors or expert nurses.

Types with examples:

• Non-medicated: Lippes loop.
• Copper-releasing: CuT, Cu7, Multiload 375.
• Hormone-releasing: Progestasert, LNG-20.

How they work:
1. All IUDs increase phagocytosis of sperms inside the uterus.
2. Copper ions released by Cu-IUDs suppress sperm motility and the fertilising capacity of sperms.
3. Hormone-releasing IUDs also make the uterus unsuitable for implantation and the cervix hostile to sperms.

Who should use them: IUDs are ideal for women who want to delay pregnancy or space children. They are among the most widely accepted contraceptive methods in India.

IUDs inserted within 72 hours of unprotected coitus also work as emergency contraceptives.

Worked example

Compare the mode of action of a CuT with that of LNG-20. (2 marks)

Try it first, then show the solutionSolution

1. CuT (copper-releasing IUD): increases phagocytosis of sperms in the uterus, and released Cu ions suppress sperm motility and fertilising capacity. (1)
2. LNG-20 (hormone-releasing IUD): also increases phagocytosis, and in addition makes the uterus unsuitable for implantation and the cervix hostile to sperms. (1)

Answer: CuT: phagocytosis plus Cu ions reduce sperm motility and fertilising ability; LNG-20: phagocytosis plus hormones make the uterus unsuitable for implantation and the cervix hostile to sperms.

Oral pills, injectables, implants and emergency contraception

NCERT section 3.2 Population Stabilisation and Birth Control (oral pills, injectables, implants, emergency contraceptives)

Oral pills: small doses of progestogens alone or progestogen–estrogen combinations, taken as tablets.

Schedule: one pill daily for 21 days, starting preferably within the first five days of the menstrual cycle; then a 7-day gap (when menstruation occurs); then repeat the same pattern for as long as the woman wants to avoid conception.

How pills work (three actions):
1. Inhibit ovulation.
2. Inhibit implantation.
3. Change the cervical mucus so it prevents or slows sperm entry.
Pills are very effective, with fewer side effects, and are well accepted by women.

Saheli: an oral contraceptive containing a non-steroidal preparation; taken just once a week, it is highly effective and causes very few side effects, developed at CDRI, Lucknow.

Injectables and implants: progestogens alone or with estrogen, given as injections or as implants under the skin. They work like pills, but their effect lasts much longer.

Emergency contraception: progestogens, progestogen–estrogen combinations or IUDs used within 72 hours of coitus are very effective in avoiding a possible pregnancy after rape or casual unprotected intercourse.

Possible ill-effects of contraceptives (not very significant, but not to be ignored): nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding, and even breast cancer. The choice of method should always be made with a qualified medical professional.

Worked example

Explain how oral contraceptive pills prevent pregnancy and state the schedule a woman must follow. (3 marks)

Try it first, then show the solutionSolution

1. Pills contain small doses of progestogens or progestogen–estrogen combinations. (½)
2. They inhibit ovulation and implantation and alter the cervical mucus to prevent or retard sperm entry. (1½)
3. Schedule: one pill daily for 21 days, starting within the first five days of the cycle; a 7-day gap (menstruation); then repeat. (1)

Answer: Progestogen (± estrogen) pills inhibit ovulation and implantation and thicken cervical mucus; take daily for 21 days from within the first 5 days of the cycle, stop 7 days, repeat.

Surgical methods (sterilisation)

NCERT section 3.2 Population Stabilisation and Birth Control (surgical methods)

Sterilisation is a terminal (permanent) method, advised to the male or female partner when no more pregnancies are wanted. Surgery blocks gamete transport, so conception cannot occur. It does not stop gamete formation.

• Vasectomy (male): a small part of the vas deferens is removed or tied through a small incision on the scrotum. Sperms cannot reach the urethra, so semen has no sperms.
• Tubectomy (female): a small part of the fallopian tube is removed or tied through a small incision in the abdomen or through the vagina. The ovum cannot meet sperms.

Both are highly effective, but their reversibility is very poor.

Why removing the gonads is not a contraceptive option: testes and ovaries also make hormones (androgens, estrogens, progesterone) needed for secondary sexual characters and normal body functions, and an ideal contraceptive must be reversible and must not interfere with sexual drive. Removing gonads fails on all these counts.

Note: contraceptives are not regular requirements for reproductive health; they are used against a natural event (conception) to prevent, delay or space pregnancy for personal reasons.

Worked example

Name the surgical contraceptive method for a man. Explain how it is done and why it prevents conception. Will the man still produce sperms? (3 marks)

Try it first, then show the solutionSolution

1. Vasectomy. (½)
2. Through a small cut on the scrotum, a short piece of the vas deferens is removed or tied. (1)
3. Sperms cannot pass from the epididymis to the urethra, so the ejaculated semen has no sperms and fertilisation cannot occur. (1)
4. Yes: the testes keep producing sperms; only their transport is blocked. (½)

Answer: Vasectomy: cutting/tying the vas deferens blocks sperm transport; sperm production continues.

Medical termination of pregnancy (MTP) and amniocentesis

NCERT section 3.1 (amniocentesis) and 3.3 Medical Termination of Pregnancy (MTP)

MTP (induced abortion) is the intentional or voluntary ending of a pregnancy before full term. Worldwide, nearly 45–50 million MTPs are performed each year, about one-fifth of all conceived pregnancies. Its legal acceptance is debated because of emotional, ethical, religious and social issues.

Law in India: MTP was legalised in 1971 with strict conditions to prevent misuse, such as female foeticide. Under the MTP (Amendment) Act, 2017, meant to reduce illegal abortions and the maternal deaths and illness they cause:

• Up to 12 weeks: on the opinion of one registered medical practitioner.
• More than 12 but fewer than 24 weeks: two registered medical practitioners must agree, in good faith, that the grounds exist.
• Grounds: continuing the pregnancy would risk the woman's life or cause grave injury to her physical or mental health; or there is a substantial risk that the child, if born, would be seriously handicapped by physical or mental abnormalities.

Why MTP is done: to end unwanted pregnancies (casual unprotected intercourse, contraceptive failure, rape), or when continuing the pregnancy could harm or kill the mother, the foetus or both.

Safety: relatively safe in the first trimester (up to 12 weeks); second-trimester abortions are much riskier. A disturbing trend is that many MTPs are done illegally by unqualified quacks, which is unsafe and can be fatal. Counselling, avoiding unprotected coitus and better health-care facilities can reverse this.

Amniocentesis: some amniotic fluid around the developing foetus is taken and the foetal cells and dissolved substances are analysed. It tests for genetic disorders such as Down's syndrome, haemophilia and sickle-cell anaemia, and helps judge the survivability of the foetus.

• Misuse: it also reveals the sex of the foetus; if found female, the pregnancy is sometimes ended. This is illegal.
• So there is a statutory ban on amniocentesis for sex determination, to check female foeticide.

Worked example

Define amniocentesis. Why has the government banned it for sex determination despite its medical value? (2 marks)

Try it first, then show the solutionSolution

1. Amniocentesis is a prenatal test in which some amniotic fluid is withdrawn and the foetal cells and dissolved substances are analysed for genetic disorders such as Down's syndrome. (1)
2. It also reveals the sex of the foetus; it was misused to identify female foetuses, followed by MTP (female foeticide), so its use for sex determination is legally banned. (1)

Answer: A test of amniotic fluid for foetal genetic disorders; banned for sex determination because it was misused for female foeticide.

Sexually transmitted infections (STIs)

NCERT section 3.4 Sexually Transmitted Infections (STIs)

Infections passed on through sexual intercourse are called sexually transmitted infections (STIs), venereal diseases (VD) or reproductive tract infections (RTI).

Examples: gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and HIV (leading to AIDS, the most dangerous).

Other routes: hepatitis-B and HIV also spread by sharing injection needles or surgical instruments, blood transfusion, and from an infected mother to the foetus.

Curable or not: all are completely curable if detected early and treated properly, except hepatitis-B, genital herpes and HIV.

Why they go untreated: early symptoms are minor (itching, fluid discharge, slight pain, swellings in the genital region); infected women are often asymptomatic; and there is a social stigma. So people delay testing.

Complications if untreated: pelvic inflammatory diseases (PID), abortions, still births, ectopic pregnancies, infertility, even cancer of the reproductive tract.

Who is at risk: everyone, but incidence is reported to be very high in the 15–24 years age group.

Prevention (three simple rules):
1. Avoid sex with unknown or multiple partners.
2. Always try to use condoms during coitus.
3. If in doubt, see a qualified doctor for early detection and complete treatment.

Worked example

Name two STIs that are not completely curable and two that can spread without sexual contact. Why do many infected women not seek treatment early? (2 marks)

Try it first, then show the solutionSolution

1. Not completely curable: any two of hepatitis-B, genital herpes, HIV. Spread without sexual contact: hepatitis-B and HIV (needles, transfusion, mother to foetus). (1)
2. Infected women are often asymptomatic, early symptoms are minor, and social stigma deters testing. (1)

Answer: Incurable: hepatitis-B, genital herpes, HIV; non-sexual spread: hepatitis-B, HIV; women are often symptom-free and stigma delays treatment.

Infertility and assisted reproductive technologies (elementary idea)

NCERT section 3.5 Infertility

Infertility: a couple's failure to conceive after 2 years of living together with regular unprotected intercourse. Causes can be physical, congenital, diseases, drugs, immunological or psychological. In India the woman is often blamed, but very often the problem lies with the male partner. Infertility clinics can diagnose and correct some disorders; where correction is impossible, assisted reproductive technologies (ART) help.

ART techniques (elementary idea):

• IVF–ET (test tube baby): ova (wife or donor) and sperms (husband or donor) are made to form a zygote in the laboratory under conditions like those in the body (in vitro fertilisation), followed by embryo transfer:
• ZIFT (zygote intra fallopian transfer): the zygote or early embryo with up to 8 blastomeres is placed in the fallopian tube.
• IUT (intra uterine transfer): an embryo with more than 8 blastomeres is placed in the uterus.
• Embryos formed by in vivo fertilisation (inside a female) can also be transferred to women who cannot conceive.
• GIFT (gamete intra fallopian transfer): an ovum from a donor is placed in the fallopian tube of a woman who cannot produce ova but can provide a suitable environment for fertilisation and development.
• ICSI (intra cytoplasmic sperm injection): a sperm is injected directly into the ovum in the lab to form an embryo.
• Artificial insemination (AI): for men who cannot inseminate or have very low sperm counts; semen from the husband or a healthy donor is introduced into the vagina or into the uterus (IUI, intra-uterine insemination).

Limitations: they need very precise handling by specialists and costly instruments, so they are available in few centres and affordable to few; emotional, religious and social factors also deter people.

Legal adoption: India has many orphaned and destitute children; the law permits adoption, and it remains one of the best options for couples seeking parenthood.

Worked example

Expand ZIFT and IUT. State the difference between the two in terms of the stage transferred and the site of transfer. (2 marks)

Try it first, then show the solutionSolution

1. ZIFT: zygote intra fallopian transfer; IUT: intra uterine transfer. (1)
2. ZIFT transfers a zygote or early embryo with up to 8 blastomeres into the fallopian tube; IUT transfers an embryo with more than 8 blastomeres into the uterus. (1)

Answer: ZIFT: up to 8-celled embryo into the fallopian tube; IUT: more than 8-celled embryo into the uterus.

Reproductive Health in real life

Each concept, met in an everyday situation. Read the situation, answer the question in your own words, then compare with the model answer. The one-line hook is what to remember.

Topics in this chapter

• Contraceptive Methods and Birth Control
• MTP and Amniocentesis
• Infertility and Assisted Reproductive Technologies

Reproductive Health: key facts

Fertile period (28-day cycle)

$\text{avoid coitus: day }10\text{ to day }17(\text{ovulation around day }14)$

Basis of periodic abstinence.

Pill schedule

$21\text{days of pills (start within days 1–5)}+7\text{days gap}\to \text{repeat}$

Menstruation occurs during the 7-day gap.

Time limits

$\text{emergency contraception: within }72\text{h};\text{lactational amenorrhoea: up to }6\text{months};\text{MTP safest: up to }12\text{weeks}$

MTP between 12 and 24 weeks needs the opinion of two registered medical practitioners.

Embryo transfer rule

$\le 8\text{blastomeres}\to \text{fallopian tube (ZIFT)};>8\text{blastomeres}\to \text{uterus (IUT)}$

GIFT transfers a donor ovum (gamete) into the fallopian tube.

Marriageable age

$\text{female}=18\text{years};\text{male}=21\text{years}$

A statutory measure to slow population growth.

Growth rate (2011 census, from NCERT)

$<2\%=20\text{per }1000\text{per year}$

Still enough for rapid population increase.

Reproductive Health: diagrams to practise

Practise each one on paper: draw it from the checklist, then tick off every label.

How the board asks Reproductive Health

The question patterns to expect, and the method that works for each.

Tricks to remember Reproductive Health

Short memory aids. Say each one aloud once, then use it on a question the same day.

• Copper Cuts motility, Hormone Hampers implantation

  Cu-IUDs: Cu ions reduce sperm motility and fertilising capacity. Hormone IUDs (Progestasert, LNG-20): uterus unsuitable for implantation and cervix hostile to sperms. All IUDs: more phagocytosis of sperms.

  Use it when: Matching IUDs with their mode of action.

• Pills do 'O-I-C'

  Ovulation inhibited, Implantation inhibited, Cervical mucus changed.

  Use it when: Mode of action of pills, injectables and implants.

• 21 on, 7 off

  Start within days 1–5; take 21 days; 7-day break (menstruation); repeat.

  Use it when: Pill schedule.

• ZIFT is Zero to eight, into the Tube

  ZIFT: zygote or embryo with up to 8 blastomeres → fallopian tube. IUT: more than 8 → uterus. GIFT: Gamete (donor ovum) → tube.

  Use it when: ART abbreviations and transfer sites.

• H-H-H can't be cured

  Hepatitis-B, Herpes (genital), HIV: the STIs that are not completely curable.

  Use it when: Curable versus incurable STIs.

• Vasectomy = Vas deferens; Tubectomy = Tube

  The name tells you which tube is cut or tied.

  Use it when: Surgical methods.

Reproductive Health: board-level solved questions

Ordered from board level to HOTS. Cover the solution, write your own, then compare step by step.

Case-study practice (Section D style)

Read the situation, then answer every part. In the board paper this is a 4-mark question split into 1 + 2 + 1 marks.

Where the marks are

How a typical answer is split into step marks. Show every step: a right final answer alone rarely earns full marks.

Where students lose marks in Reproductive Health

The slips examiners see most often, and what to write instead.

• ✗Mistake: Saying sterilisation stops gamete formation

  Wrong working

  Vasectomy stops the testes from producing sperms, so the man becomes sterile.

  Right working

  Vasectomy blocks sperm transport through the vas deferens; sperms are still produced but cannot reach the semen.

  ✓Do this: Write 'blocks gamete transport', not 'stops gamete formation'.

  Usually costs: 1 mark.

• ✗Mistake: Giving the wrong transfer site in ZIFT and IUT

  ✓Do this: Up to 8 blastomeres go into the fallopian tube (ZIFT); more than 8 into the uterus (IUT).

  Usually costs: 1 mark.

• ✗Mistake: Writing that all STIs are curable

  ✓Do this: All are curable if detected early and treated properly, except hepatitis-B, genital herpes and HIV.

  Usually costs: 1 mark.

• ✗Mistake: Choosing a method without justifying it

  ✓Do this: In situation questions, name the method and state its mode of action and why it fits the situation (reversible, spacing, STI protection, emergency or permanent).

  Usually costs: Half the marks of the part.

• ✗Mistake: Calling amniocentesis illegal

  ✓Do this: Amniocentesis is a legal medical test for genetic disorders; only its use for sex determination is banned.

  Usually costs: 1 mark in assertion-reason questions.

• ✗Mistake: Confusing GIFT with ZIFT

  ✓Do this: GIFT transfers a gamete (donor ovum) into the fallopian tube; ZIFT transfers a zygote or early embryo made by IVF.

  Usually costs: 1 mark.

NCERT exercise guide: Reproductive Health

What each exercise in the NCERT chapter tests, how to approach it, and a question of the same kind solved step by step. Questions here are written in our own words.

Reproductive Health: previous year questions

• Asked in 8 of the 8 board papers we hold (2023 to 2026), on average 4.1 marks per paper; 16 questions in all, counting OR alternatives. In 3 of 4 sample papers.

Counted from the real papers on our previous year papers page, not estimated. Average marks are over every board paper we hold, with an OR pair counted once. Chapter tags are ours.

Solved board questions from Reproductive Health

Real questions from recent papers. Try each one first, then open our step-by-step solution with marks per step.

Every Reproductive Health question, by year

Practice questions on Reproductive Health

Write each answer on paper first. Open the hint only if you are stuck, and the answer only when you have finished.

1. Q1 · 1 mark · MCQBoard level

   Which of these is a hormone-releasing IUD?
   (a) Lippes loop (b) Multiload 375 (c) Progestasert (d) Cu7

   Hint

   The other three are non-medicated or copper.

   Answer

   (c) Progestasert

2. Q2 · 1 mark · Assertion-reasonBoard level

   Assertion (A): Condoms are increasingly used as contraceptives.
   Reason (R): Condoms also protect the user from STIs and AIDS.
   (a) Both A and R are true and R is the correct explanation of A.
   (b) Both A and R are true but R is not the correct explanation of A.
   (c) A is true but R is false.
   (d) A is false but R is true.

   Hint

   The additional benefit.

   Answer

   (a)

3. Q3 · 1 mark · MCQBoard level

   Emergency contraceptives are effective if used within:
   (a) 24 hours (b) 72 hours (c) 7 days (d) 21 days of coitus

   Hint

   Three days.

   Answer

   (b) 72 hours

4. Q4 · 2 marks · Very short answerHarder board level

   A woman is advised a method that inhibits ovulation and implantation and alters cervical mucus, taken only once a week. Name it and state what makes it different from common pills. (2 marks)

   Hint

   Developed at CDRI.

   Answer

   Saheli (1). It contains a non-steroidal preparation and is taken once a week instead of daily, with very few side effects (1).

5. Q5 · 2 marks · Very short answerHarder board level

   Why are second-trimester MTPs discouraged, and what two dangerous trends related to MTP are seen in India? (2 marks)

   Hint

   Quacks and sex determination.

   Answer

   Second-trimester abortions are much riskier than first-trimester ones (1). Trends: illegal MTPs by unqualified quacks, which can be fatal; and misuse of amniocentesis to find the sex of the foetus, followed by MTP of female foetuses (1).

6. Q6 · 2 marks · Very short answerHarder board level

   Give two reasons each for (a) the high failure rate of natural methods and (b) the popularity of IUDs in India. (2 marks)

   Hint

   Timing versus convenience.

   Answer

   (a) They depend on correct timing (ovulation can vary; withdrawal may be late) and lactational amenorrhoea works only while feeding fully and for up to six months (1). (b) IUDs are effective, reversible, need no daily action and suit women who want to delay or space children (1).

7. Q7 · 3 marks · Short answerBoard level

   Explain three strategies used under the RCH programmes to build a reproductively healthy society. (3 marks)

   Hint

   Awareness, education, infrastructure.

   Answer

   Creating awareness through audio-visual and print media, with help from parents, teachers and friends (1). Sex education in schools to give correct information and remove myths (1). Infrastructure, medical expertise and research to handle pregnancy, delivery, STDs, abortions, contraception and infertility, plus legal steps such as the ban on sex determination (1).

8. Q8 · 3 marks · Short answerHarder board level

   Compare the barrier methods used by women in terms of what they cover and whether they are reusable. Why are spermicides used with them? (3 marks)

   Hint

   Female condom versus diaphragm.

   Answer

   Female condom: covers the vagina and cervix; disposable (1). Diaphragms, cervical caps and vaults: cover the cervix during coitus; reusable (1). Spermicidal creams, jellies or foams kill sperms and increase the contraceptive efficiency of these barriers (1).

9. Q9 · 3 marks · Short answerHarder board level

   An STI test shows that a pregnant woman has hepatitis-B. (a) Can it be completely cured? (b) How could the baby be affected? (c) Name two other routes by which she might have been infected. (3 marks)

   Hint

   Not only through sex.

   Answer

   (a) No: hepatitis-B is one of the STIs that are not completely curable (1). (b) It can pass from an infected mother to the foetus (1). (c) Sharing injection needles or surgical instruments, or transfusion of infected blood (1).

10. Q10 · 5 marks · Long answerHarder board level

    (a) Describe how IUDs, oral pills and vasectomy each prevent pregnancy. (3)
    (b) Explain why contraceptives are not considered regular requirements for reproductive health, and mention two possible ill-effects. (2) (5 marks)

    Hint

    Mode of action for each.

    Answer

    (a) IUDs increase phagocytosis of sperms; Cu ions suppress sperm motility and fertilising capacity; hormone IUDs also make the uterus unsuitable for implantation and the cervix hostile (1). Pills (progestogen ± estrogen) inhibit ovulation and implantation and alter cervical mucus (1). Vasectomy removes or ties part of the vas deferens, blocking sperm transport (1). (b) They are used against a natural event (conception) only to prevent, delay or space pregnancy for personal reasons, so they are not needed to stay healthy (1). Possible ill-effects: nausea, abdominal pain, breakthrough or irregular bleeding, even breast cancer (any two) (1).

11. Q11 · 3 marks · Short answerHOTS / competency

    Suppose a couple wants a child, but the wife produces healthy ova and has a normal uterus while sperms from her husband cannot penetrate the ovum on their own. Which ART would you suggest and why? Would GIFT help them? (3 marks)

    Hint

    Bypass penetration.

    Answer

    ICSI: a single sperm is injected directly into the ovum in the laboratory, bypassing the need for the sperm to penetrate it (1), and the embryo is then transferred to the wife (ZIFT or IUT) (1). GIFT would not help, because it supplies an ovum to a woman who cannot produce one; her problem is not the ovum, and fertilisation would still need the sperm to penetrate (1).

12. Q12 · 3 marks · Short answerHOTS / competency

    A state reports a fall in both maternal and infant mortality rates over ten years but a rise in population. Explain how improved reproductive health can raise population growth, and suggest two measures to stabilise it. (3 marks)

    Hint

    Fewer deaths, same births.

    Answer

    Lower MMR and IMR mean more mothers and infants survive, and lower death rates leave more people of reproducible age; if birth rates do not fall equally, population grows faster (2). Measures: promote small families through contraceptives and awareness; enforce the legal marriageable age (18 female, 21 male) and give incentives for small families (any two) (1).

Test your recall

Answer in your head or on paper first, then open the card. Pulling an answer out of memory makes it stick far better than re-reading.

1. 1.What does reproductive health mean according to WHO?Show answer

   Total well-being in all aspects of reproduction: physical, emotional, behavioural and social.

2. 2.When did India start its family planning programme?Show answer

   In 1951.

3. 3.What is RCH?Show answer

   Reproductive and Child Health Care programmes, the present wider programmes for reproductive health.

4. 4.Who developed Saheli and how often is it taken?Show answer

   Scientists at CDRI, Lucknow; it is a non-steroidal pill taken once a week.

5. 5.Give one example each of non-medicated, copper-releasing and hormone-releasing IUDs.Show answer

   Lippes loop; CuT (or Cu7, Multiload 375); Progestasert (or LNG-20).

6. 6.What are diaphragms, cervical caps and vaults?Show answer

   Reusable rubber barriers inserted into the female tract to cover the cervix during coitus.

7. 7.Up to how many weeks is MTP considered relatively safe?Show answer

   Up to 12 weeks (first trimester).

8. 8.Name two complications of untreated STIs.Show answer

   Pelvic inflammatory disease, ectopic pregnancy, still birth, infertility or reproductive tract cancer (any two).

9. 9.What is ICSI?Show answer

   Intra cytoplasmic sperm injection: a sperm is injected directly into the ovum in the laboratory.

10. 10.What is IUI?Show answer

    Intra-uterine insemination: semen from the husband or a donor is introduced into the uterus.

11. 11.How is infertility defined in the NCERT summary?Show answer

    Inability to conceive even after 2 years of unprotected sexual cohabitation.

Quick revision checklist

The night before the exam: can you do each of these without looking?

• ☐Can you define reproductive health and list three RCH strategies?
• ☐Can you give three reasons for the population explosion?
• ☐Can you explain the fertile period, withdrawal and lactational amenorrhoea?
• ☐Can you state the mode of action of copper and hormone IUDs?
• ☐Can you write the pill schedule and the three ways pills work?
• ☐Can you compare vasectomy and tubectomy?
• ☐Can you state the legal conditions for MTP and the reason amniocentesis for sex determination is banned?
• ☐Can you choose between IVF–ZIFT, IUT, GIFT, ICSI and AI for a given couple?

Reproductive Health: frequently asked questions