Section 10 — Solved Examples
Welcome to the dedicated problem set for Reproductive Health. The 32 worked examples below run in three tiers — concept checks, application & scenarios, and analytical & multi-concept — and deliberately lean towards the scenario and reasoning style that exams reward rather than plain recall (you'll find the straight recall drilled in Sections 11 and 12).
How to use this section
- Concept checks (Q1–Q6): quick "do you really get it" questions. If any trips you up, re-read Sections 3–9.
- Application & scenarios (Q7–Q20): patient-style situations — the same shape as Board 2- and 3-mark questions.
- Analytical & multi-concept (Q21–Q32): multi-step comparison and reasoning problems, NEET-style.
There is no quiz at the end — treat each example as a mini-quiz: cover the answer, attempt it yourself, then verify.
Memory Capsule — Patterns to Master
Lock these high-yield patterns in first — almost every question here is built from one of them:
| # | Pattern / Fact |
|---|---|
| 1 | RCH = Reproductive and Child Health programme; began as Family Planning in 1951, later broadened |
| 2 | Ideal contraceptive: user-friendly, available, effective, reversible, least side-effects, no interference with sexual drive |
| 3 | IUDs — 3 generations: non-medicated (Lippes loop) → copper-releasing (CuT, Cu7, Multiload 375) → hormone-releasing (Progestasert, LNG-20) |
| 4 | Oral pills: Mala-D = combined estrogen-progestogen; Saheli = non-steroidal weekly pill |
| 5 | Emergency contraception: within 72 hours of unprotected coitus |
| 6 | MTP: legalised 1971; NCERT names the MTP (Amendment) Act, 2017. (Beyond NCERT: the 2021 Amendment allows one doctor up to 20 weeks, two doctors for 20–24 weeks, special categories.) |
| 7 | STIs: five curable (gonorrhoea, syphilis, chlamydiasis, trichomoniasis, genital warts); three incurable (genital herpes, hepatitis-B, HIV/AIDS) |
| 8 | ART: IVF-ET, ZIFT (≤8 blastomeres → fallopian tube), IUT (>8 → uterus), GIFT (donor ovum → tube), ICSI (sperm into ovum), IUI/AI |
| 9 | Amniocentesis: legal for detecting genetic disorders; banned for sex determination (PCPNDT Act 1994) |
| 10 | Population: ~1.2 billion (2011); replacement TFR = 2.1; marriage age 18 (female) / 21 (male) |
Concept Checks (Q1–Q6)
Q1. Why does "reproductive health" mean more than just having disease-free reproductive organs?
Answer: The WHO defines it as total well-being in all aspects of reproduction — physical, emotional, behavioural and social. So it also covers safe practices, awareness and freedom from stigma, not just healthy organs.
Q2. What is the difference between an STI and an STD?
Answer: STI (sexually transmitted infection) is the broader, now-preferred term and includes symptomless infections; STD traditionally meant those with visible symptoms. Since many infections are asymptomatic, "STI" is used.
Q3. Why is a condom the one contraceptive a doctor would recommend to someone also at risk of STIs?
Answer: Condoms have a dual benefit — they prevent pregnancy and also block transmission of STIs and AIDS. Pills, IUDs and sterilisation give no protection against STIs.
Q4. In the periodic abstinence (rhythm) method, why is roughly day 10–17 of the cycle avoided?
Answer: Ovulation occurs around day 14; with the released egg viable ~24 hours and sperm surviving ~3–5 days, days 10–17 form the fertile window when fertilisation is most likely.
Q5. Which assisted reproductive techniques transfer an embryo rather than gametes?
Answer: IVF-ET (embryo into the female tract) and ZIFT (a zygote/early embryo of ≤8 blastomeres into the fallopian tube). GIFT transfers gametes, and AI/IUI transfer only sperm.
Q6. Why is surgical sterilisation called a "terminal" method?
Answer: Vasectomy and tubectomy permanently block gamete transport, ending fertility. They are very effective but their reversibility is very poor, so couples are counselled before choosing them.
Application & Scenarios (Q7–Q20)
Q7. A 28-year-old woman with two children wants a long-term, reversible method that needs no daily attention. What would you suggest, and why?
Answer: An IUD — copper (CuT/Multiload 375) or hormonal (LNG-20). It is long-acting, highly effective, reversible on removal, and needs no daily action — ideal for spacing children.
Q8. How do copper-releasing IUDs prevent pregnancy?
Answer: The released Cu²⁺ ions suppress sperm motility and fertilising capacity, and the device increases phagocytosis of sperms in the uterus — making it hostile to sperm and to implantation.
Q9. Why is a hormone-releasing IUD (LNG-20) often better than a copper IUD for a woman with heavy menstrual bleeding?
Answer: Copper IUDs can increase menstrual flow, whereas LNG-20 releases a progestogen that thins the endometrium and lightens periods — handling both contraception and the heavy bleeding.
Q10. A woman had unprotected intercourse 36 hours ago and wants to avoid pregnancy. What can she use, and within what window?
Answer: Emergency contraception — progestogen (or progestogen-estrogen) pills, or a Cu-IUD — within 72 hours of coitus, and the sooner the better.
Q11. A couple has normal sperm and regular ovulation, but both fallopian tubes are blocked. Which ART suits them, and why?
Answer: IVF-ET — the egg and sperm are fertilised in the lab and the embryo is placed in the uterus, bypassing the blocked tubes. GIFT/ZIFT won't work because they need a healthy tube.
Q12. Parents ask a doctor to do amniocentesis to find the foetus's sex before deciding to continue the pregnancy. Is this allowed?
Answer: No — using amniocentesis for sex determination is illegal under the PCPNDT Act 1994, which targets female foeticide. It is permitted only to detect genetic disorders or abnormalities.
Q13. A man has a normal sperm count but very poor sperm motility. Which ART is most appropriate?
Answer: ICSI — a single sperm is injected directly into the ovum, bypassing the motility problem; the embryo is then transferred like IVF.
Q14. Match the major causes of female infertility to their ART solution.
Answer: Blocked/damaged tubes → IVF-ET (bypasses the tubes); failure to ovulate (e.g., PCOS) → ovulation-inducing drugs then IUI/IVF; inability to produce eggs → GIFT or donor-egg IVF.
Q15. Why is lactational amenorrhea unreliable beyond about 6 months postpartum?
Answer: Intense breastfeeding keeps prolactin high and suppresses ovulation, but as feeds reduce after ~6 months prolactin falls and ovulation can resume — often before the first period — so pregnancy can occur unnoticed.
Q16. A couple relies on the "safe period" but the wife conceives. Why does the rhythm method fail so often?
Answer: Cycle length and ovulation timing vary month to month, and sperm survive ~3–5 days, so the fertile window is hard to predict — giving the method a high failure rate.
Q17. A woman on combination pills forgets them for two days mid-cycle. Why does her pregnancy risk rise, and what should she do?
Answer: Pills work mainly by suppressing ovulation; missing them lets FSH/LH rise so ovulation can occur. She should resume the pills and use a backup barrier method (and consider emergency contraception if she had unprotected sex).
Q18. A man avoids vasectomy fearing it will reduce his masculinity. Reassure him biologically.
Answer: Vasectomy only blocks the vas deferens, keeping sperm out of the semen. The testes still produce testosterone, so libido, erection and secondary sexual characters are unaffected.
Q19. After IVF, the lab has an early embryo with 6 blastomeres. Where is it transferred and what is the technique called?
Answer: An embryo with up to 8 blastomeres is placed in the fallopian tube — this is ZIFT. Embryos with more than 8 blastomeres go to the uterus (IUT).
Q20. A person with multiple partners uses oral pills and assumes they're protected from STIs. Is that correct?
Answer: No — oral pills only prevent pregnancy and give no STI protection. Condoms should also be used, since they are the only method that also blocks STI transmission.
Analytical & Multi-Concept (Q21–Q32)
Q21. Three statements: (1) Copper IUDs act mainly by impairing sperm; (2) Hormonal IUDs act mainly by thinning the endometrium and thickening cervical mucus; (3) Both need daily user action. Which are correct?
Answer: 1 and 2 are correct; 3 is wrong — IUDs are insert-and-forget for years. Daily action applies to pills, not IUDs.
Q22. Why does having another STI increase the risk of HIV transmission, even though HIV is itself an STI?
Answer: Other STIs cause genital ulcers and inflammation that breach the mucosal barrier and draw in CD4+ T-cells (HIV's target cells), giving the virus an easier route of entry and raising transmission risk per exposure.
Q23. A woman with uncontrolled diabetes and a history of deep vein thrombosis wants oral contraception. Why avoid combination estrogen-progestogen pills, and what's safer?
Answer: The estrogen raises the risk of blood clots and worsens insulin resistance — risky given her DVT and diabetes. Safer options are progestogen-only pills, an IUD (CuT/LNG-20), or barrier methods.
Q24. A mother breastfeeding a 4-month-old wants a reversible method that won't affect her milk. Which are safe and which to avoid?
Answer: Safe: copper IUD, progestogen-only pill, LNG-20 IUD and barrier methods. Avoid combination estrogen-progestogen pills, since estrogen can reduce milk supply.
Q25. Why is HIV called an STI but also a bloodborne and vertically transmitted infection? Give the three routes.
Answer: HIV spreads by (1) sexual contact, (2) blood — shared needles, unscreened transfusion, needle-stick injury, and (3) mother-to-child — in the womb, during delivery, or via breast milk.
Q26. Compare IUI, IVF and ICSI, and match each to: (a) mild male-factor infertility, (b) very low sperm count, (c) blocked tubes with normal sperm.
Answer: IUI places sperm in the uterus (fertilisation in the tube, simplest); IVF fertilises in a dish; ICSI injects one sperm into the egg (most complex). Match: (a) → IUI, (b) → ICSI, (c) → IVF.
Q27. An unmarried woman seeks an MTP at 18 weeks after her contraceptive failed. Is it allowed, and what is required?
Answer: Yes — contraceptive failure is a valid ground and the law applies to any woman. At 18 weeks, one registered medical practitioner's opinion suffices under the current law; two RMPs are needed only for 20-24 weeks, special categories (MTP (Amendment) Act, 2021 — beyond NCERT depth).
Q28. Why does an untreated STI in a woman often go unnoticed until it has already caused infertility?
Answer: STIs are frequently asymptomatic in females, so they stay undetected; meanwhile the infection can ascend and cause pelvic inflammatory disease and tubal damage, leading to ectopic pregnancy or infertility.
Q29. Why is an MTP much safer in the first trimester than in the second?
Answer: Up to 12 weeks the foetus and uterus are small, so the procedure is simpler with less bleeding and risk; second-trimester abortions are technically harder and much riskier.
Q30. One patient's gonorrhoea is caught early and cured; another ignores HIV symptoms. Why do the outcomes differ so much?
Answer: Gonorrhoea is curable with early antibiotic treatment, allowing full recovery. HIV is one of the three incurable STIs (with hepatitis-B and genital herpes) — it can only be managed lifelong, not cured.
Q31. How does widespread contraceptive use connect to population stabilisation and to better reproductive-health indicators?
Answer: Contraceptives cut unwanted pregnancies and lower the birth rate and TFR toward the replacement level of 2.1, helping stabilise the population; together with falling maternal and infant mortality and better awareness, this reflects improved reproductive health of society.
Q32. Master integrative: India targets a replacement TFR of 2.1. (a) What does TFR 2.1 mean, (b) why hasn't every state reached it, and (c) which interventions help most?
Answer: (a) Each woman has on average ~2.1 children — just enough to replace both parents (the extra 0.1 offsets child mortality), so the population stabilises. (b) Southern states are at or below replacement, while states with low female literacy, early marriage and poor contraceptive access remain higher. (c) Female education, a higher age of marriage, and accessible contraception are the most impactful.
End of Section 10
That's 32 worked examples spanning the whole chapter — programmes, contraception, MTP law, STIs, ART, and population. For the same concepts in exam phrasing, work through Section 11 (Board questions) and Section 12 (NEET practice) next.