1. Match Up the Statements Fertile Period Infertile Period Thick mucus Thin Watery Mucus Increase Body Temp. Normal Body Temp.

2. Match Up the Statements Fertile Period Infertile Period Thick mucus Thin Watery Mucus Increase Body Temp. Normal Body Temp.

3. Learning Outcomes Review topic understanding Complete activities to ensure comprehensive notes Revise for checktest

4. Using last lesson information – summarise it in here (take full A4 sheet landscape)...... Stimulating Ovulation Artificial Insemination In-Vitro Fertilisation (IVF/PGS and PGD) Intra- cytoplasmic sperm injection (ICSI) Problem Solution Side Effects

5. 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 (ICSI)  If sperm inactive directly fuse in IVF

6. Stimulating ovulation Problem Women fail to ovulate, problem with FSH/LH or pituitary gland. Solution Thus take a drug – mimicking LH/FSH Or take drugs that prevent negative feedback of oestrogen on FSH in luteal period. Side Effect Can cause “super-ovulation” where multiple births occur. Also used in IVF for releasing of eggs

7. Artificial insemination Problem Low sperm count Solution Several samples of semen, frozen and then defrosted and released together into cervical region when she is most likely to be fertile. Side Effect If male sterile, a donor can use same method.

8. In vitro fertilisation (IVF) + PGS/PGD Problem Blockage of oviducts Solution Fertilisation occurs outside of body in several stages (see next slide) Side Effect Examination for genetic abnormalities via pre-implantation genetic screening (PGS) for single gene or common chromosomal abnormalities Pre-implantation genetic diagnosis (PGD) specific approach check for known chromosomal/gene defect (eg CF gene)

9. In vitro fertilisation (IVF) + PGS/PGD Eggs mixed with sperm in medium for fertilisation (ICSI alternative – see next) Fertilised eggs incubated in nutrient media for 2-3 days allowing for cell division to form embryo of 8 or more cells Women hormone treatment to stimulate multiple ovulation (egg collection) Surgery to remove egg from ovary 2 or 3 embryos choosen, inserted into mothers uterus (ready for implantation) Remaining embryos frozen in case second attempt needed for implantation

10. Intracytoplasmic sperm injection (ICSI) Problem Sperm inactive, so either low count and mature sperm defective Solution Using a syringe remove healthy sperm and inject directly into an egg for fertilisation. Egg needs to be held in place by holding tool

11. Using last lesson information – summarise it in here (take full A4 sheet landscape) and add complications from case studies p137- 138...... How it worksComplications Barrier method ( condoms/ diaphragm / cervical cap) Intra-uterine devices (IUD) Sterilisation; Vasectomy Tube ligation Pill - combined Morning after pill Mini pill/ implant

12. Physical Methods How it worksComplications Barrier method (condoms/ diaphragm / cervical cap) Physically blocks sperm reaching ovum Not as effective as chemical methods Intra-uterine devices (IUD) T structure into uterus to prevent implantation of embryo, stimulate WBC /substances hostile to sperm / mobility. ?Not prevent conception? Ethics! Inflammation/ irritation of uterus allows failure to implant embryo Ectopic pregnancy issue Sterilisation; Vasectomy Tube ligation Cutting/tying sperm ducts / oviducts Irreversible normally but highly effective

13. How it worksComplications Pill - combined Synthetic oestrogen and progesterone so inhibit FSH and LH (- feedback). Thus no mature egg or ovulation. Dummy/placebo on 4 th week for menstruation to occur 99% effective – however if vomiting or diarrhoea / antibiotics not protected. Increase risk in breast /cervical and liver cancer, however lowers risk of endometrium/ovarian and colon cancer Oestrogen may cause blood to clot Morning after pill High dose of progesterone and oestrogen- prevent implantation ?Not prevent conception? Ethics! Chemical Methods

14. How it worksComplications Mini pill / implant Progesterone only – can be high or low dosage. 50% inhibits ovulation (low dose), dependent on cervical mucus thickening preventing sperm reaching egg. Used while breast feeding/ reduce cramp / heavy bleeding– taken by breast cancer risk or high blood pressure Taken same time every day / mood swings/ irregular menstruation / weight gain Chemical Methods

15. Revise & review Complete testing your knowledge pages 130 and 139 Make a flow chart/bullet in sequence of 2 phases in menstruation Use checklist to identify areas for reivison Then use the keywords (and add other key words) from this topic – write definition/explanation underneath in small writing Add an arrow linking to another area – along arrow write the connection

16. The Menstrual Cycle Flow Chart 1.Follicular phase (1 st half of cycle)  before ovulation  Development of Graafian follicle from stimulation of FSH and production of oestrogen  Repair of endometrium  High levels of oestrogen lead to a surge in LH and FSH production at around day 14  OVULATION 2.Luteal phase (2 nd half of cycle)  after ovulation  LH stimulates Graafian follicles to become the corpus luteum which secretes progesterone (vascularisation)  No more FSH or LH is released (due to negative feedback) meaning no new follicles are produced  Lack of LH  degeneration of the corpus luteum (at day 22)  no progesterone released to maintain endometrium  MENSTRUATION (day 28)

17. Mind Map Review FSH Puberty Negative Feedback ICSH Sperm In vitro fertilisation Artificial Insemination Menstrual Cycle Cyclic fertility Testosterone ICSI Endometrium LH Luteal Phase Ovarian hormones Ovulation Chemical methods Physical methods Vascularisation

18. FSH Puberty Negative Feedback ICSH Sperm In vitro fertilisation Artificial Insemination Menstrual Cycle Cyclic fertility Testosterone ICSI Endometrium LH Luteal Phase Ovarian hormones Ovulation Chemical methods Physical methods Vascularisation