1. Describe the pathophysiology of infertility (10 pts)
The inability to conceive a child after 1 year of regular sexual intercourse unprotected by
... [Show More] contraception. Secondary
infertility is the inability to conceive after a previous pregnancy.
Reproduction requires the interaction of the female and the male reproductive tracts, which involves (1) the release
of a normal preovulatory oocyte, (2) the production of adequate spermatozoa, (3) the normal transport of the
gametes to the ampullary portion of the fallopian tube (where fertilization takes place), and (4) the subsequent
transport of the cleaving embryo into the endometrial cavity for implantation and development
2. Discuss the following contraception Methods and provide an example of each: 10pts each = (40 tot pts)
A. Hormonal
These methods of contraception work by altering the hormones within a woman’s body. They rely on estrogen and
progestin or progestin alone to prevent ovulation. When used consistently, these methods are a reliable way to
prevent pregnancy. Hormonal methods include OCs, injectables, implants, vaginal rings, and transdermal patches.
OCs work primarily by suppressing ovulation by adding estrogen and progesterone to a woman’s body, thus
mimicking pregnancy. This hormonal level stifles GnRH, which in turn suppresses FSH and LH and thus inhibits
ovulation. Cervical mucus also thickens, which hinders sperm transport into the uterus. Implantation is inhibited by
suppression of the maturation of the endometrium and alterations of uterine secretions.
Progesterone only pills are appropriate for women who cannot take estrogen in combined OCs, for example, a
woman older than 35 years who smokes cigarettes. They are prescribed for women who cannot take estrogen at all.
These OCs work primarily by thickening the cervical mucus to prevent penetration of the sperm and make the
endometrium unfavorable for implantation.
B. Implantable Devices
The implant is a subdermal time-release method that delivers synthetic progestin that inhibits ovulation. Once in
place, it delivers 3 years of continuous, highly effective contraception. Like progestin-only pills, implants act by
inhibiting ovulation and thickening cervical mucus so sperm cannot penetrate. A single-rod progestin implant
(Nexplanon) is currently available in the United States.
Intrauterine contraceptives are classified as either hormonal or nonhormonal. Both types prevent pregnancy via
inhibition of sperm mobility and sperm viability and change the speed of transport of the ovum in the fallopian tube.
An intrauterine contraceptive (IUC) is a small plastic T-shaped object that is placed inside the uterus to provide
contraception by making the endometrium of the uterus hostile to implantation of a fertilized ovum by causing a
nonspecific inflammatory reaction and inhibiting sperm and ovum from meeting. These include the Mirena, Skyla,
and the Paragard. [Show Less]