Unit 2: The continuation of life Higher Human Biology Unit 2: The continuation of life Chapter 16: Intervention in Fertility! 19/04/2017 Mrs Smith Ch16 Intervention in fertility

What you need to know: The arrangements Reproduction Intervention in fertility Causes of infertility to include failure to ovulate, blockage of uterine tubes, failure of implantation and low sperm counts. Treatment of infertility to include fertility drugs, in vitro fertilisation and artificial insemination. The biological basis of contraception by calculation of fertile period and by hormonal methods. Calculation of fertile periods from data on timing of menstruation, body temperature and cervical mucus should be considered both from the point of view of increasing the chances of pregnancy and as a possible means of Contraception. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Learning Intentions Success Criteria List the problems associated with infertility in both male and female. Describe methods used to treat infertility Understanding the Continuation of Life 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Medical condition of the reproductive system that results in the inability to conceive or carry a pregnancy to term Condition is diagnosed after a couple has had a year of unprotected, regular intercourse without conceiving, or when pregnancy occurs but does not result in a live birth. 33% of infertility causes unknown Other factors that can contribute to infertility include stress, smoking, alcohol use, excess weight and overall health 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Infertility in Women Impaired ovulation due to disease, birth defects, or abnormal hormone production Blocked oviducts from infection or scar tissue Inability of the uterus to hold the embryo (this may be due to a variety of reasons, including scar tissue on the walls of the uterus) Endometriosis 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Infertility in Men Low sperm count High percent of abnormally-shaped sperm High percent of sperm that are not moving forward Ejaculation dysfunction Sperm production can be affected by blocked passageways, fevers, infections, or birth defects. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Treatments summary Current types include: In vitro fertilization (IVF): Eggs and sperm are collected and fertilised in the laboratory before the resulting embryo is transferred to the womb. Fertility drugs Artificial insemination: Sperm are inserted into the womb at the time of ovulation using a catheter 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Treating Infertility In vitro fertilisation - (outside the body in the lab) Stage 1 Hormonal treatment to stimulate multiple ovulation Stage 2 Several eggs removed 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Treating Infertility In vitro fertilisation Con’t - (outside the body in the lab) Stage 3 Eggs placed in a dish of nutrient medium containing sperm to allow fertilisation to occur OR injecting sperm into egg. Stage 4 Fertilised eggs incubated in nutrient medium to allow cell division to occur. Stage 5 Two or three embryos are chosen and inserted into uterus via the vagina 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Watch this! 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Treating Infertility In vitro fertilisation SUMMARY- 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Treating Infertility: Artificial Insemination (Inside the body) Insemination is the introduction of semen into the female reproductive tract. It occurs naturally as a result of sexual intercourse. Artificial insemination - The insertion of semen by some other means other than sexual intercourse. Used as a method of treating infertility If a man has a low sperm count or sperm, samples of his semen can be collected and frozen until required. They are then defrosted and released into the female’s cervix region during her most fertile period. Can also be used to insert semen of a donor who has a normal sperm count into a women who’s partner is sterile. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Worlds first Pregnant man http://www.dailymail.co.uk/news/article-2019579/Worlds-pregnant-man-Thomas-Beatie-unveils-muscular-body-3-babies.html Thomas Beatie, the transgender man who gets pregnant by artificial insemination. “Beatie, 34, now has has 3 healthy children -which he has carried in the womb he kept intact when he became a man 10 years ago” 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Essay Questions: SQA 2007 Give an account of female infertility (10) 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Learning Intentions Success Criteria Outline the biological basis of contraception by calculation of the fertile period. Understanding The Continuation of Life 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Fertile Period – Day 1 Calculation of fertile period based on a 28 day cycle Day 1 First day of menstrual flow – period starts Pre-ovulatory infertile phase FSH phase - stimulates development of egg and production of Oestrogen. Oestrogen stimulates repair of uterus. Cervix closed Endometrium 1 mm thick Temperature normal ~36.2°C 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Fertile Period – Day 14 Day 14 (14 days after first day of menstruation) Increase of oestrogen causes sudden flood of LH Increase of LH causes ovulation and development of Corpus Luteum Cervix open – slippery, stretchy mucus present Endometrium 6mm thick Temperature normal ~36.2°C 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Fertile Period: Day 15-17 Day 15 (15 days after first day of menstruation) Egg released into oviduct on this day Cervix open – slippery, stretchy mucus present (allow sperm easy access to female reproductive system) Egg will only survive 24 hours after being released. Therefore, will not be viable after day 16 Sperm, however, can survive for 72 hours (3 days) Therefore, fertile days - 13th day, 14th day 15th day 16th day only Endometrium 6 mm thick Temperature increase ~36.5°C 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Fertile Period: Day 18 Day 18 (18 days after first day of menstruation) Egg has not been fertilised (infertile days) Dry days, Post-ovulatory days After ovulation mucus increases in viscosity (thicker) due to increasing levels of progesterone Endometrium 6 mm thick Temperature increase ~36.7°C. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Fertile Period: Day 22 Day 22 (22 days after first day of menstruation) Lack of LH leads to degeneration of Corpus Luteum Oestrogen & progesterone levels drop Endometrium 5.5 mm thick Temperature increase ~36.8°C 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Fertile Period: Day 28 Day 28 (28 days after first day of menstruation) Ovarian hormones very low Endometrium can no longer be maintained Menstruation ready to begin Endometrium 5.5 mm thick Temperature drops to normal ~36.2°C 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Fertile Period: Day 16 only if egg fertilised Day 16 (16 days after first day of menstruation) If egg is fertilised, fertilised egg secretes hormone - Human Chorionic Gonandotrophin (HCG) Has same effect as LH Presence of which is used in pregnancy testing Maintains Corpus Luteum which continues to secrete progesterone and prevents menstruation After 6 weeks, placenta starts to secrete progesterone Cervical mucus becomes viscous due to high levels of progesterone Pregnancy changes the mucus into a semi-solid plug This protects the fertilised egg from possible infection 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Menstrual cycle comparison of hormone levels, follicle production and uterine changes 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Menstrual cycle: summary 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Menstrual cycle comparison of hormone levels and uterine changes 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Menstrual cycle comparison of hormone levels and body temperature 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Continuous versus cyclical fertility con’t: Implications in calculating fertility! Male – Continuously Fertile Negative feedback of testosterone maintains a relatively constant level of gonadotrophic hormones (FSH & ICSH) Results in a fairly steady quantity of testosterone being produced Female - Cyclical Fertile Egg will only survive 24 hours after being released due to hormone levels Sperm, however, can survive for 72 hours (3 days) Fertility is restricted to 3 – 4 days immediately following ovulation 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Learning Intentions Success Criteria Know the biological bases for contraception. Describe hormonal methods of contraception as an example of this. Understanding the Continuation of Life 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Methods of Contraception

Contraceptive Pill

Male Condom

Female Condom

contraceptive patch

Contraceptive Implant

IUD

diaphragm contraceptive

emergency contraception

Biological Basis of Contraception Contraception is the intentional prevention of conception by natural or artificial means. Artificial Methods: Oral contraceptive pills Injections Implants Natural Methods: Temperature Mucus Rhythm methods 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Biological Basis of Contraception: Natural Methods:Temperature. One day after surge of LH temperature increases by 0.5°C Remains elevated for duration of luteal phase Fertility lasts 3 – 4 days By the 3rd day of the higher body temp the egg has disintegrated. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Biological Basis of Contraception: Natural Methods: Mucus. During fertile period mucus is thin & watery to allow sperm easy access to female reproductive system After ovulation mucus increases in viscosity – becomes thicker, returning to the infertile period. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Biological Basis of Contraception: Natural Methods: Rhythm method. Rhythm Methods Methods of temperature and mucus viscosity are used by couples who want to have a child - they will know when the best time to have sexual intercourse to achieve successful fertilisation. If a couple do not wish to have children, the rhythm method can also be used as a contraceptive. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Natural Contraception: Summary Body temperature - body temperature changes through the menstrual cycle under the influence of oestrogen and progesterone. It rises slightly after ovulation. Cervical mucus - the amount of oestrogen and progesterone alters the quantity, texture and appearance of cervical mucus, Rhythm method - calculating how long the menstrual cycle lasts 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Biological Basis of Contraception: Artificial Methods: Oral contraception. Oral contraceptive pills Normally contain synthetic progesterone sometimes combined with synthetic oestrogen. Increases levels of progesterone & oestrogen – exerts negative feedback Gonadotrophic hormones inhibited Little or no FSH secreted, follicle maturation inhibited, ovulation fails to occur Also thickens the mucus in the cervix and makes the lining of the womb thinner. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

CONTRACEPTIVE IMPLANT Biological Basis of Contraception: Artificial Methods: Injections + Implants Injections & Implants Hormonal method of contraception. Contraceptive implant - slowly releases the progesterone to prevent ovulation. Similar effects to pill Contraceptive injections - contains progesterone. Similar effects to pill CONTRACEPTIVE IMPLANT 19/04/2017 Mrs Smith Ch16 Intervention in fertility

When a woman wants to become pregnant again! A woman must discontinue the pill. After lengthy use there may be a period of delay before their bodies readjust and return to a normal fertile state. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Task: What to do now….. Complete card sort! Table 1.5: Biological methods of contraception (from SCHOLAR). Once completes and correct coppy into your notes or jotter. 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Task: Torrance-TYK pg119 Qu’s 1-3 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Task: Torrance AYK pg120-1 Qu’s 1-5 19/04/2017 Mrs Smith Ch16 Intervention in fertility

Mrs Smith Ch16 Intervention in fertility Essay Questions: SQA 2001 & 2010 Discuss the biological basis of contraception (10) 19/04/2017 Mrs Smith Ch16 Intervention in fertility