1. Urghh hate doing this! Why! Pointless!
2Back
One white board between you
1s faces board
2s away from board
No cheating!
Now 1’s DESCRIBE what you see [3]
2s can you see what it is yet?
Urghh hate doing this! Why! Pointless!
Great data handling skill in the exam – many of you FAILED to score an easy 2 marks in the NAB. Make sure you describe each part

3. Luteinising hormone! One actual patient – so not exact
1 mark - steadily increases from day 1 to 12 +/- 1 day
1 mark – peaks day 13+/- 1 day at 18 IU/L
1 mark - EITHER – decreases to 2 IU/L but then increases on day 16 up to 6 IU/L
OR - sharp decrease from 5.5 IU/L to 1 IU/L on day 22.
NOW SWAP OVER !

5. Progesterone hormone One actual patient – so days may be out etc.
1 mark - Remains very low, just over 0ng/mL for first 9 days
1 mark – Rises from day 10 to 18 up to peak of 24 ng/mL
1 mark - Decreases back to baseline from day 19 to 27.

6. Apply the principles of the biology fertilisation in;
Learning Outcomes
Examine the fertile period in females (cyclical) compared with continuous fertility in males
Apply the principles of the biology fertilisation in;
Treatments for infertility
Methods of contraception
Compare and contrast contraception methods

7. My cycle is just once a year – whereas humans are twelve times that !
Fertile Period
Men are continuously fertile as they maintain a relatively steady level of testosterone, which means they regularly secrete sperm.
However women are only fertile cyclically, 1-2 days after ovulation
Not so different now!
My cycle is just once a year – whereas humans are twelve times that !

8. Calculation of the fertile period
3 main ways ;
Temperature
Temperature increases by 0.2 – 0.5oC ~ 1 day after ovulation and remains high during the luteal phase
Fertile for ~ 3 days after this rise in temp
Cervical Mucus
Becomes less viscous during fertile period
Increases in viscosity due to progesterone after
Rhythm Methods of contraception
Avoiding sexual intercourse based on temperature and mucus viscosity to indicate fertile period
Not reliable because cycle period varies

9. TEMPERATURE AND OVULATION
Body temperature rises by about 0.5oC one day after ovulation (under the action of progesterone) and remains high during the luteal phase

10. CERVICAL MUCUS
High levels of oestrogen prior to ovulation stimulate the cervix to produce a watery mucus making it easier for the sperm to swim through.
Chance of fertilisation is increased

11. Rainbow 4’s Activity Get yourselves into groups of 4s. Choose a colour
– red or orange or green or blue
Research your the category
2 using books.
2 using computers
Compare the pros and cons of each method of research.

12. Infertility - disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual activity (WHO)

13. Treatments for infertility
4 main ones we will examine;
Stimulating ovulation
Hormone treatment for ovulation
Artificial insemination
Low sperm count treated by introducing several samples into reproductive tract.
In vitro fertilisation (IVF) + PGS/PGD
 Counteracts oviduct blockage by fusion of gametes outside body, then once into 8 cells+ reinsert into womb
Intracytoplasmic sperm injection
If sperm inactive directly fuse in IVF

14. Contraceptive Methods
Contraception is the intention of prevention of conception/pregnancy by natural or artificial means.
2 categories of contraception;
Physical
Chemical
PHYSICAL
CHEMICAL
Pill containing combination hormones
Morning after pill
Mini Pills
Barrier method
Inter-uterine devices (IUD)
Sterilisation procedures

15. Rainbow 4’s Activity 10 minutes of research
Books
Computers
10 minutes of research
Come back together and share/disseminate what you have found out.

16. Rainbow 4’s Activity 10 minutes of research
Books p131-2, p136 and p137
Computers
Books p and p136
10 minutes of research
Come back together and share/disseminate what you have found out.

17. Research Review Criterias Books Computers Access of resources
Research method used
Information gained
Reliability check
OVERALL SCORE
Online difficulties? Logon ok? Enough books?
Content/index? Ask Jeeves/Yahoo answer? Keyword/phase search?
Did you understand it? Over your head? Too simple? Multiple sources?
What gives you confidence the information you are giving to others? Checked? Other website?
So which is better for this type of task? A place for both

18. You are a fertility doctor
Couples will come up with a problem they have
You must explain how to intervene and treat the problem.

19. Choose Your Causes of Infertility
Infertility could be due to one or a combination of factors. Infertility is usually treated by returning hormones to the natural level.
Infertility in Females
failure to ovulate
blockage of oviduct(s)
failure of implantation
Infertility in Males
low sperm count

20. Infertility in Women Causes Failure to ovulate
Blockage of uterine tubes (oviducts)
Failure of implantation

21. Failure to Ovulate Causes Inadequate supply of FSH or LH
Prolonged use of contraceptive pill
Emotional stress
Poor health
Treatments
Fertility Drugs to stimulate FSH, LH production
Injections of FSH, LH (extracted from fertile placentas or menopausal women)

22. Blockage of Oviducts Causes Tissue growth (e.g. tumours) Infections
Treatments
Clear blockage (laser treatment)
IVF (in vitro fertilisation)

23. Failure of Implantation
Causes
Hormone imbalance
Treatments
 Fertility Drugs to stimulate FSH and LH production & restore normal cycle

24. Infertility in Men Low Sperm Count Causes
Failure of pituitary gland to produce adequate quantities of gonadotrophic hormones (FSH and ICSH)
Ill health
Emotional stress
Treatments
Drugs to stimulate FSH and ICSH production
IVF
AI (artificial insemination)

25. Remaining embryos frozen in case a second attempt is needed
In vitro fertilisation (IVF)
Fertilised eggs incubated in nutrient agar to allow cell division 6
Remaining embryos frozen in case a second attempt is needed

26. Artificial insemination
Insemination is the introduction of semen into the female reproductive tract.
This occurs naturally during sexual intercourse.
However, due to infertility, scientists have developed artificial ways to inseminate the female.
Men with low sperm count – semen is frozen and used when the women is at her most fertile.

27. Contraception
….intentional prevention of conception either naturally or artificially.
Indicators of fertile period
Temperature – immediately after ovulation body temperature rises by 0.5°C and stays high during the luteal phase. The infertile period resumes after the 3rd daily recording of the higher temperature due to the disintegration of the unfertilised egg.
Mucus – During the fertile period the cervical mucus is thin and watery, after ovulation the mucus becomes more viscous showing the return of the infertile phase

28. This method is unreliable!
Contraception
Rhythm methods
Women can use temperature and cervical mucus to calculate the fertile period.
This is useful:
as a natural method of contraception – by avoiding sexual intercourse when the female is fertile.
This method is unreliable!
for couples who are trying to conceive and want to know when sexual intercourse is likely to be most successful

29. Contraception: Hormonal methods
Hormonal methods of contraception alter the normal sequence of events in the menstrual cycle to prevent ovulation.
Contraceptive implants
Contraceptive pill
Contraceptive injection
Nowadays, hormonal contraception is also available for men.
View the BBC article:
Image source:

30. Contraceptive Pill
Oral contraceptive pills – contain synthetic progesterone, sometimes combined with oestrogen.
Pill taken daily for 3 weeks from the final day of previous menstrual period. Sometimes dummy (placebo) pills are taken in the 4th week to allow the levels of oestrogen + progesterone to drop & menstruation to occur.

31. Vasectomy
Permanent method of contraception in men also known as male sterilisation.
View the animation

32. Hysterectomy
A hysterectomy is an operation to remove a woman's uterus (womb) as a permanent method of contraception.

33. Hysterectomy
There are several types:

34. The Cap or Diaphragm A barrier method
Image source: cks.library.nhs.uk
Diaphragms and caps prevent sperm meeting an egg. They fit inside the vagina and cover the cervix. They're made of latex (rubber) or polyurethane (plastic). They come in different shapes and sizes.

35. The Coil or Intra Urine Device (IUD)
A barrier method

36. Spermicide
Spermicides are chemical contraceptive gels, foams or jellys which destroy sperms. But they're not effective enough to use on their own. If you use them by themselves, there's a high chance that sperm will get through sometimes - and cause pregnancy. Such chemical contraception should only be used in combination with a 'barrier method' - such as a condom, diaphragm or a cap.

37. IVF
After hormone treatment to stimulate multiple ovulations, ova are harvested.
Sperm are collected.
Ova and sperm are mixed to fertilise the ova.
Embryos are grown then 2 or 3 are implanted in the uterus.

38. Artificial Insemination In Vitro Fertilisation
Insertion of semen into female by some other means other than by sexual intercourse

39. Treatment of Infertility
Which types of infertility could be helped by in vitro fertilisation?
Which types of infertility could be helped by artificial insemination?
Which type of infertility could be helped by laser treatment?
Which types of infertility could be helped by hormone (fertility) drugs?

40. Contraception
Contraception is the deliberate prevention of fertility / conception

41. Condoms 85 – 98% effective- Prevent STIs No prescription
Advantages
Prevent STIs
No prescription
No hormonal side effects
May decrease incidence of cervical cancer
Disadvantages
Can burst/leak
Possible allergic reaction
Decreased sensation

43. Diaphragm 86 – 94% effective
Rubber dome with a springy & flexible rim  fits over the cervix & is held in place by vaginal muscles
Holds spermicide over the cervix (kills sperm)
Leave in place for 6-8 hours

44. Diaphragm Can be inserted 2 hours before intercourse Comfortable
Advantages
Can be inserted 2 hours before intercourse
Comfortable
Doesn’t alter menstrual cycles
Doesn’t affect future fertility
Disadvantages
No protection against STIs
Possible allergic reaction
Requires fitting in a clinic
Increased risk of bladder infections

46. IUD (intra-uterine device)
% effective
Inserted through cervix and placed in uterus
Can last years
Changes lining of uterus and fallopian tubes affecting movement of eggs and sperm  prevents fertilisation

47. IUD Requires no daily attention Immediately effective Long lasting
Advantages
Requires no daily attention
Immediately effective
Long lasting
Disadvantages
No protection against STIs
Requires clinic visits
Can cause very difficult menstruation
Above average risk of infection
Possible risk to future fertility

48. Contraceptive Implant

49. Contraceptive Implant
Soft capsules - ~ 2 inches long are placed under the skin in the upper arm
Constantly release progestin  thickens cervical mucus and stops ovulation

50. Contraceptive Implant
Advantages
Can be worn for 3-5 years
Easy to use
No Menstruation
Disadvantages
No protection against STIs
Increased risk of heart attack or stroke
Requires prescription

51. Sterilisation - Males

52. Sterilisation - Females

53. Sterilisation 99.5% effective
Male – cut vas deferens so sperm cannot mix with semen
Female – Cut fallopian tubes – still get ovulation but eggs are reabsorbed by the body

54. Sterilisation Permanent contraception
Advantages
Permanent contraception
Immediately effective (in females)
No daily attention
Disadvantages
No protection against STIs
Requires surgery – risks
Not reversible
Not immediately effective (in males)

55. Contraceptive Pill
The “pill” contains progesterone (and oestrogen) which inhibits release of FSH (maturation of follicles inhibited-ovulation inhibited)
Highly reliable

56. Other hormonal methods
Implants and injections work on the same principle as the contraceptive pill
Implants allow slow controlled release of synthetic hormones (avoids the need to remember to take the pill daily)
Prolonged use of these can lead to temporary infertility when discontinued

57. Natural Contraception
Uses body temperature and vaginal mucus texture to identify fertile periods and safe periods
Very unreliable