Mrs.

Webb- L6

Sexual Reproduction in Humans

✓ In sexual reproduction, the sperm of the male fertilizes the egg of the female.
✓ Humans produce gametes in specialized reproductive organs called gonads.
✓ The male gonads are the testes and the female gonads are the ovaries.
✓ The gonads have cells that aid in the development of the gametes by producing
hormones and supplying nourishment.

✓ Reproduction in humans involves:

▪ Gametogenesis (production of male and female gametes)
▪ Fertilization (fusion of nuclei of a male and a female gamete)
▪ Pregnancy & Birth

Male Reproductive Organs

Organs Function
Testes Produce sperm and sex hormones
Epididymides Maturation and storage of some sperm
Vasa deferentia Conduct and store sperm
Seminal vesicles Contribute fluid to semen
Prostate gland Contributes fluid to semen
Urethra Conducts sperm (and urine)
Bulbourethral gland Contribute fluid to semen
Penis Organ of copulation

Female Reproductive Organs

Organs Function
Ovaries Produce sex hormones
Oviducts Conducts egg; location of fertilisation
Uterus Houses developing embryo
Cervix Contains opening to uterus
Vagina Receives penis during copulation and serves as birth canal.
 Mrs. Webb- L6

The Male Reproductive System

✓ The male gonads consist of paired testes.

✓ The testes are suspended within scrotal sacs which are located inside the scrotum.
✓ The production of sperm requires a slightly cooler temperature than normal body
temperature and so, the scrotum hangs outside the body.
✓ Sperm are produced inside the testes and mature in the epididymides which lie
outside the testes.
✓ Mature sperm are stored in the epididymides and the vasa deferentia.
✓ Muscular contractions help to move the sperm from the testis into the vas deferens.
✓ The penis is a cylindrical organ that hangs outside the body along with the scrotum.
✓ Semen or seminal fluid is a thick, whitish fluid that contains sperm and secretions
from the seminal vesicles, prostate gland and bulbourethral glands (Cowper’s
gland).
✓ Two seminal vesicles are located at the base of the bladder and they join the vas
deferens to form an ejaculatory duct that enters the urethra.
✓ Sperm travel from the vasa deferentia into the ejaculatory duct and the seminal
vesicles secrete a thick viscuous liquid containing nourishment for the sperm.
✓ Semen contains fructose used as an energy source for the sperm.
✓ It also contains prostaglandins and oxytocin which stimulate rhythmic contraction
of the vagina and uterus which draw the sperm towards the ovum.
✓ The prostate gland is located below the bladder and it secretes an alkaline fluid that
increases sperm motility as well as neutralises the acidity of traces of urine in the
male urethra.
✓ It also neutralizes the female’s vaginal secretions which could reduce sperm
motility.
✓ The bulbourethral glands secretes a mucous fluid into the semen that increases
lubrication during intercourse.
✓ The urethra carries semen during copulation.
 Mrs. Webb- L6

The Female Reproductive System

✓ The female gonads are the ovaries. The reproductive organs are the oviducts
(Fallopian tubes), uterus, cervix and the vagina.
✓ Two ovaries are located in the upper pelvic cavity and overall, they produce one
secondary oocyte each month.
✓ An oocyte is an immature egg that is undergoing meiosis and after meiosis is
completed, the oocyte becomes an egg cell.
✓ The oviducts extend from the ovaries to the uterus.
✓ The oviducts are not attached to the ovaries.
✓ The ovaries have fimbriae (finger-like projections) that sweep over the two ovaries.
✓ At ovulation, an oocyte is released from an ovary and it is swept into an oviduct by
the action of the fimbriae and the movement of the cilia that line the oviducts.
✓ Fertilization of the egg cells occurs in the oviduct and this creates a developing egg
cell.
✓ The embryo moves to the uterus by muscle contractions and movement of the cilia
in the oviduct.
✓ The uterus is a thick-walled muscular organ with a narrow end called the cervix.
✓ The lining of the uterus is called the endometrium.
✓ The embryo embeds itself in the endometrium where it can grow.
✓ The vagina is a muscular tube that has folds that can expand and extend.
✓ Contractions of the female reproductive tract help draw the sperm towards the egg.
 Mrs. Webb- L6

Gametogenesis
✓ This is the production of gametes.
✓ It occurs in the testes and ovaries where diploid cells divide by meiosis to produce haploid
cells.

Structure of a spermatozoon

Structure of an oocyte
 Mrs. Webb- L6

Spermatogenesis

✓ The process of sperm production in the testes is referred to as spermatogenesis.

✓ It usually begins in a boy around the age of 11 and continues through the rest of his life.
✓ The testes are made up of many seminiferous tubules and it is in the walls of these
tubules that spermatogenesis occurs.
1. Spermatogonia are diploid cells which divide by mitosis to form more diploid
cells. Some of these grow into new spermatogonia while others grow and mature
into much larger cells called primary spermatocytes.
2. The primary spermatocytes undergo the first meiotic division (Meiosis I) to form
2 haploid secondary spermatocytes.
3. The secondary spermatocytes undergo the second meiotic division (Meiosis II) to
form 4 haploid spermatids.
4. The spermatids then differentiate into spermatozoa.
✓ Throughout spermatogenesis, large cells called Sertoli cells nourish and protect the
developing cells.
✓ Sertoli cells also help to control and regulate spermatogenesis.
 Mrs. Webb- L6

Oogenesis

✓ The process of oocyte/ova production in the ovaries is referred to as oogenesis.

✓ This process begins in the embryo
1. Germinal epithelial cells in the developing ovaries divide by mitosis to form diploid
oogonia.
2. The oogonia begin to divide by meiosis but only reach Prophase 1. These are called
primary oocytes.
3. At puberty, the primary oocytes continue the first meiotic division to form two
haploid cells of unequal size- the secondary oocyte and the polar body. The polar
body plays no further role in reproduction.
4. The secondary oocyte undergoes the second meiotic division (Meiosis II) but
only till Metaphase II.
5. Each month, a secondary oocyte is released into the oviduct and if fertilized,
will continue its division by meiosis forming an ovum and another polar body.
 Mrs. Webb- L6

Hormonal Control of Gametogenesis

The human male and female reproductive cycles are controlled by the interaction of
hormones from the hypothalamus and anterior pituitary with hormones from
reproductive tissues and organs. In both sexes, the hypothalamus monitors and causes the
release of hormones from the pituitary gland.

When the reproductive hormone is required, the hypothalamus sends a

gonadotropin-releasing hormone (GnRH) to the anterior pituitary. This causes the
release of follicle stimulating hormone (FSH) and luteinizing hormone (LH) from the
anterior pituitary into the blood. Note that the body must reach puberty in order for the
adrenals to release the hormones that must be present for GnRH to be produced.

Although FSH and LH are named after their functions in female reproduction, they
are produced in both sexes and play important roles in controlling reproduction. Other
hormones have specific functions in the male and female reproductive systems.
 Mrs. Webb- L6

Hormonal Control of Spermatogenesis

At the onset of puberty, the hypothalamus causes the release of FSH and LH into the
male system for the first time. FSH enters the testes and stimulates the Sertoli cells to
begin facilitating spermatogenesis using negative feedback. LH also enters the testes and
stimulates the interstitial cells of Leydig to make and release testosterone into the testes
and the blood.
Testosterone, the hormone responsible for the secondary sexual characteristics
that develop in the male during adolescence, stimulates spermatogenesis. These
secondary sex characteristics include a deepening of the voice, the growth of facial,
axillary, and pubic hair, and the beginnings of the sex drive.
A negative feedback system occurs in the male with rising levels of testosterone
acting on the hypothalamus and anterior pituitary to inhibit the release of GnRH, FSH,
and LH. The Sertoli cells produce the hormone inhibin, which is released into the blood
when the sperm count is too high. This inhibits the release of GnRH and FSH, which will
cause spermatogenesis to slow down. If the sperm count reaches 20 million/ml, the
Sertoli cells cease the release of inhibin, and the sperm count increases.
 Mrs. Webb- L6

Hormonal Control of Oogenesis

The control of reproduction in females is more complex. As with the male, the
anterior pituitary hormones cause the release of the hormones FSH and LH. In
addition, oestrogens and progesterone are released from the developing follicles.
Oestrogen is the reproductive hormone in females that assists in endometrial
regrowth, ovulation, and calcium absorption; it is also responsible for the secondary sexual
characteristics of females. These include breast development, flaring of the hips, and a
shorter period necessary for bone maturation.
Progesterone assists in endometrial re-growth and inhibition of FSH and LH
release.
In females, FSH stimulates development of egg cells, called ova, which develop in
structures called follicles. Follicle cells produce the hormone inhibin, which inhibits FSH
production.
LH also plays a role in the development of ova, induction of ovulation, and
stimulation of estradiol and progesterone production by the ovaries. Estradiol and
progesterone are steroid hormones that prepare the body for pregnancy. Estradiol
produces secondary sex characteristics in females, while both estradiol and
progesterone regulate the menstrual cycle.
 Mrs. Webb- L6

The Menstrual Cycle

The ovarian cycle governs the preparation of endocrine tissues and release of eggs,
while the uterine cycle governs the preparation and maintenance of the uterine lining.
These cycles occur concurrently and are coordinated over a 22–32-day cycle, with an
average length of 28 days.
Slowly rising levels of FSH and LH cause the growth of follicles on the surface of
the ovary. This process prepares the egg for ovulation. As the follicles grow, they begin
releasing oestrogens and a low level of progesterone. Progesterone maintains the
endometrium to help ensure pregnancy. The trip through the fallopian tube takes about
seven days. At this stage of development, called the morula, there are 30-60 cells. If
pregnancy implantation does not occur, the lining is sloughed off. After about five days,
oestrogen levels rise and the uterine cycle enters the proliferative phase. The
endometrium begins to regrow, replacing the blood vessels and glands that deteriorated
during the end of the last cycle.
Just prior to the middle of the cycle (approximately day 14), the high level of
oestrogen causes FSH and especially LH to rise rapidly, then fall. The spike in LH
causes ovulation in which the most mature follicle ruptures and releases its egg.
The follicles that did not rupture degenerate and their eggs are lost. The level of
oestrogen decreases when the extra follicles degenerate.
Following ovulation, the ovarian cycle enters its luteal phase and the uterine cycle
enters its secretory phase, both of which run from about day 15 to 28. The luteal phase
refers to the changes in the ruptured follicle. The cells in the follicle undergo physical
changes and produce a structure called a corpus luteum. The corpus luteum produces
oestrogen and progesterone. The progesterone facilitates the regrowth of the uterine
lining and inhibits the release of further FSH and LH. The secretory phase refers to the
maturation of the uterine glands causing them to produce a thick mucoid secretion to aid
in implantation. The uterus is being prepared to accept a fertilized egg, should it occur
during this cycle. The inhibition of FSH and LH prevents any further eggs and follicles from
developing, while the progesterone is elevated. The level of oestrogen produced by the
corpus luteum increases to a steady level for the next few days.
If no fertilized egg is implanted into the uterus, the corpus luteum degenerates and
the levels of oestrogen and progesterone decrease. The endometrium begins to degenerate
as the progesterone levels drop, initiating the next menstrual cycle. The decrease in
progesterone also allows the hypothalamus to send GnRH to the anterior pituitary,
releasing FSH and LH and starting the cycles again.
Mrs. Webb- L6
Mrs. Webb- L6
Mrs. Webb- L6
 Mrs. Webb- L6

Fertilization & Implantation

Copulation
✓ If sexual intercourse occurs around the time of ovulation, there is a chance
that fertilization will occur.
✓ Fertilization takes place when the nucleus of a sperm fuses with the nucleus
of a female gamete.
✓ During sexual activity, the male inserts his penis into the female’s vagina and
the resulting stimulation causes impulses to be sent from the brain via the
parasympathetic nerve cells to an artery and its arterioles branches in the penis.
✓ These dilate to allow the blood to fill the spaces in the erectile tissue, causing
the penis to become hard and erect.
✓ Additional stimulation causes impulses to be sent to the vas deferens of each testis
via the sympathetic nerve cells.
✓ As a result, the sperm are moved to the urethra by peristalsis.
✓ The seminal vesicles and prostate gland release fluids that combine with the sperm
to produce semen.
✓ These fluids contain mucus, fructose, vitamin C, citric acid, prostaglandins and
various clotting enzymes which help to increase the normally acidic pH of the vagina
to 6-6.5, which is the optimum pH for sperm motility following ejaculation.
✓ It also helps to provide the sperm with energy to swim to the female gamete in the
oviduct.
✓ During the fertile period, the cervical mucus forms channels which the groups
of sperm can swim through.
 Mrs. Webb- L6

Capacitation
✓ Sperm cells are only able to fertilize the oocyte after spending about 7 hours in the
female genital tract and during that time, they undergo a process known as
capacitation.
✓ Capacitation involves a change in the properties of the membrane covering the
acrosome and enables fertilization to occur.
✓ In this process, a layer of glycoprotein is removed via hydrolysis from the
outer surface of the sperm.
✓ Cholesterol is lost from the cell surface of the sperm which weakens the membrane.
✓ Also, the plasma proteins in the seminal fluid are hydrolysed by enzymes in
the uterus which enable the tail to lash more strongly.
✓ The cell membranes also become more permeable to calcium ions which increase
the sperm motility and help the release of enzymes from the acrosome.

Acrosome Reaction
✓ On contact with follicle cells, the receptors on the sperm’s plasma membrane bind
to the proteins in the zona pellucida surrounding the secondary oocyte.
✓ This stimulates the sperm cells to release the enzymes in the acrosome and this is
known as the acrosome reaction.
✓ The acrosome swells and enzymes are released to digest a pathway through the
zona pellucida to the cell surface membrane of the oocyte.
✓ Hyaluronidase digests hyaluronic acid between follicle cells and proteases digest the
proteins in the zona pellucida.
 Mrs. Webb- L6

Fertilisation
✓ Only about 0.025% of the sperm will complete the journey to the egg and enter
the oviduct. If an oocyte is present, the sperm cells will cluster around the oocyte.
✓ Fertilization usually occurs high up in the fallopian tube.
✓ Hydrolytic enzymes such as Hyaluronidase, digests a path through the hyaluronic
acid that holds the granulose cells together.
✓ The sperm reach the outer surface of the zona pellucida which has receptors
that sperm heads can bind to.
✓ Proteases digest a path though the zona pellucida which sperm can reach the
secondary oocyte’s surface.
✓ The head of the spermatozoon will fuse with the microvilli surrounding the
secondary oocyte and penetrate the cytoplasm.
✓ As soon as the sperm penetrates the oocyte, the cortical reaction occurs.
❖ The membranes of the two cells fuse and the oocyte immediately releases
lysosomes (cortical granules).
❖ The cortical granules release enzymes.
❖ Enzymes cause zona pellucida to thicken and harden and also destroy
the sperm receptor sites on zona pellucida.
❖ The zona pellucida is now an impenetrable barrier called the fertilization
membrane.
❖ This prevents polyspermy which is the entry of more than one sperm
into the egg.
✓ Fertilization stimulates the final division of meiosis in the secondary oocyte to
form the ovum and the second polar body.
✓ The second polar body degenerates and the tail of the sperm is lost in the cytoplasm
of the ovum.
✓ The sperm nucleus swells due to the uncoiling of chromatin.
✓ The pronuclei of the sperm and ovum are drawn together and the nuclear
membranes of the two pronuclei break down.
 Mrs. Webb- L6

✓ The chromosomes assemble on the equatorial plate at metaphase of the first

mitosis of the diploid cell.
✓ This fusion restores the diploid number of the chromosomes and the fertilised
ovum is known as the zygote.

Implantation

✓ As the zygote travels down the fallopian tube, it divides into two cells to form a two celled
embryo then the two nuclei divide again to form a four-celled embryo.
✓ This mitosis continues and forms a ball of cells.
✓ At this stage, cleavage occurs but does not increase the size of the blastula because the
cells continue to be retained within the zona pellucida.
✓ The cleaved cells are known as blastomeres and they form a hollow ball of cells, called the
blastula, which encloses the central cavity called the blastocoel which is filled with liquid
from the oviduct.
✓ Further growth results in the formation of the outer layer of the blastomeres forming the
trophoblast [which later forms the placenta] and the inner cell mass [that grows into
the embryo and then into the foetus].
 Mrs. Webb- L6

✓ This stage is known as the blastocyst which is formed about 4-5 days after
fertilization.
✓ The first sign that fertilization has occurred is the secretion of a glycoprotein
hormone called human chorionic gonadotrophin (hCG).
✓ This is produced by the blastocyst and has similar effects to LH.
✓ It stimulates the corpus luteum to keep on secreting oestrogen and progesterone
which in turn, stimulate the endometrium so its rich supply of blood vessels is
maintained.
✓ This stops menstruation from occurring.
✓ The blastocyst arrives in the uterus, spends about 2 days in the lumen, during which the
zona pellucida disappears allowing the cells of the trophoblast to make contact with the
endometrium.
✓ The trophoblast invades the uterus wall and gains nutrients from the endometrium
causing it to grow.
✓ At about 6 to 9 days after fertilization, the blastula embeds into the lining of the
endometrium and cells of the trophoblast form projections into the endometrium to
increase the surface area for absorption of nutrients, water and oxygen called
trophoblastic villi.
✓ These trophoblastic villi protrude into the small blood spaces or lacunae in the
endometrium and their function is later taken over by the placenta.
 Mrs. Webb- L6

Extra-embryonic Membranes
✓ The outer cells of the blastocyst (the trophoblast) form an outer membrane known as
the chorion which serves to nourish and remove waste from the developing embryo.
✓ Two cavities appear within the inner cell mass and the cells lining these give rise to two
membranes, the amnion and the yolk sac.
✓ The yolk sac plays no major role in human embryonic development but is important in
reptiles and birds for food absorption.

Amnion
✓ The amnion is a thin but tough transparent sheet of tissue which covers the embryo.
✓ The cells of the amnion secrete a fluid called amniotic fluid which fills the amniotic cavity
between the amnion and the embryo.
✓ The amniotic fluid provides a sterile environment for the embryo and protects it
from mechanical damage.
✓ The foetus moves around within the amniotic fluid which helps in the development of
the skeletal and muscular systems.
✓ It also absorbs some of the liquid through its skin which does not become tough
and impermeable until about 20 weeks.
✓ The swallowing reflex of the foetus is developed by it drinking some of the amniotic fluid
which then passes through the foetal gut and is absorbed.
✓ Some of it is urinated into the amniotic fluid.
✓ The amnion breaks during the early stage of birth.
 Mrs. Webb- L6

Placenta

✓ The placenta is a point of close association between the maternal and foetal circulations and
aids in the transfer of nutrients, oxygen and metabolic waste between them.
✓ It is a disc-shaped structure located in one region of the uterus wall and as it develops, it
takes over the function of the trophoblastic villi as the principal gas exchange site after
about 12 weeks.
✓ It is a temporary organ found only in eutherian mammals and is the only organ made up of
cells from two different organisms; the mother and the foetus.
✓ The foetal part of the placenta is composed of connective tissue cells from the
chorion which invade the trophoblastic villi in one region of the uterus wall to form
larger projections called chorionic villi.
✓ The inner regions of the chorionic villi contain looped capillary networks derived from two
blood vessels of the foetus: the umbilical artery and the umbilical vein.
✓ These two blood vessels are derived from the allantois and run between the foetus and
uterus wall in the umbilical cord which is a tough structure about 40 cm in length, and
is covered by cells from the chorion and the amnion.
✓ The maternal part of the placenta is composed of the outward projections of the outer
layer of the endometrium (decidua).
✓ The lacunae, located between the deciduas and the chorionic villi, are supplied with arterial
blood from the uterine vein.
✓ The direction of blood flow the lacunae is determined by the difference in pressure
between the arterial and venous vessels.
 Mrs. Webb- L6

✓ Cell membranes in the wall of the chorionic villi which are covered in maternal blood bear
microvilli which increase the surface area for the exchange of substances by diffusion and
other modes of transport.
✓ A number of uptake mechanisms are necessary as the distance between foetal and
maternal blood is large.
o Water, glucose, amino acids, simple proteins, lipids, mineral salts, vitamins,
hormones, antibodies and oxygen pass from mother to foetus while water, urea
and other nitrogenous waste materials, hormones and carbon dioxide pass from
the foetus to the mother across the placental barrier.
o Harmful substances such as bacteria, viruses, toxins and drugs can be passed to the
foetus but this is offset by certain antibodies, globulins, antibiotics and antitoxins
which pass in the same direction. This allows the baby to be born with a passive
immunity to certain diseases.
o The placental barrier does not only protect the foetus from various harmful
situations which may occur to the mother but also shields the foetal circulation
from the higher pressure of the maternal circulation.
o However, it doesn’t function as an immunological barrier. The foetus carries
paternal genes and so produces antigens foreign to the mother who
produces antibodies against them.
o The continual passage of oxygen from mother to foetus is vital to the life and
development of the foetus and this is ensured by the difference in affinity for
oxygen between foetal and maternal haemoglobins.
✓ The placenta is an endocrine organ. From the third month of pregnancy, the placenta takes
over completely from the corpus luteum as the main source of oestrogen and progesterone.
✓ Throughout pregnancy, oestrogen and progesterone are secreted in progressively
greater amounts, first by the corpus luteum and then by the placenta. Its major secretions
are chorionic gonadotrophin, oestrogens, progesterone and human placental lactogen.
✓ Human placental lactogen stimulates the mammary development in preparation for
lactation. The site of secretion of all of these hormones is the connective tissue of the
chorion.
 Mrs. Webb- L6

Birth Control
Birth Control is used in order to allow persons to be able to control how many children they
have. Contraception means preventing conception and refers to methods that prevent fertilization
when sexual intercourse takes place. Other birth control methods include anti-implantation
methods which prevent the embryo from implanting into the lining of the uterus.

Methods of Contraception
Birth Control Pill

The pill contains steroid hormones such as progesterone and oestrogen, which mimic the
changes in hormone levels that occur when a woman is pregnant. When a woman is pregnant, the
hormone levels prevent the ovaries from releasing any ova while she is pregnant and for a short
period of time after birth. However, without a real pregnancy the cycle of hormones in the pill
has to allow for menstruation so that the endometrium remains healthy.
Synthetic hormones are used instead of the natural ones because they break down at a
slower rate in the body and thus work for a longer period of time.
The progesterone-only pill, also known as the ‘mini pill’ prevents ovulation as it contains
progesterone and it also thickens the cervical mucus to reduce the chances of sperm entering the
uterus. The more effective ‘combined birth control pill’ contains both oestrogen and progesterone
and acts by preventing the ovarian cycle from occurring by exerting negative feedback control on
the hypothalamus and anterior pituitary to inhibit the secretion of GnRH, FSH and the mid cycle
surge of LH.

Spermicide

This is a chemical which kills sperm. It is normally placed in the vagina to cover
the lining of the vagina and cervix. It is usually effective for about 1 hour. It is very
effective when used with a condom or diaphragm.
 Mrs. Webb- L6

Condoms

This is a widely used method and is considered a mechanical or barrier method of

contraception in which a physical barrier is placed between the sperm and ova. The barrier is a
thin, strong rubber sheath. It is cheap, readily available and is composed of a material which also
prevents the passage of viruses and bacteria. Thus, they also serve as a method of prevention of the
transmission of HIV/AIDS and STIs. Condom usage is the only other method of birth control
besides sterilization that is used by men.
Femidoms, female condoms, are also an impermeable barrier to sperm which is placed
inside the vagina instead of on the penis. It is a thin rubber or polyurethane tube with a closed end
which fits inside the vagina. It has 2 flexible rings to keep it in place. The effectiveness of these
methods is increased by use with spermicidal cream placed inside of the vagina.

Diaphragm

This is a flexible device that is inserted into the vagina so that is sits over the cervix. It
provides a physical barrier, similar to the condom, to prevent the sperm from reaching the egg by
blocking the entrance of the sperm to the uterus. To increase the effectiveness of this method, it
should be used with spermicidal cream to ensure that no sperm can get through.
The diaphragm is not to be worn at all times but is inserted when it is expected to be
needed and left in for about 6 hours after intercourse. Initially, it should be fitted by a doctor for a
snug and comfortable fit but after that, the woman can place it in herself. It may occasionally cause
abdominal pain.
 Mrs. Webb- L6

DMPA (Depo-Provera®)
Depo-Provera® contains non-cyclic medroxyprogesterone acetate (DMPA) which
is a synthetic hormone similar to progesterone that prevents ovulation. It is injected into a
woman’s body every 12 weeks to prevent conception.

Sterilization

This method of birth control is 100% effective and it is not easily reversed.
Sterilization in women is done by a process referred to as tubal ligation. This involves the tying of
the oviducts and is performed under general anaesthesia. A Filshie clip which clips across the
oviduct, can also be used to sterilize women and it is a more reversible procedure.
Sterilization in males is performed by vasectomy which is performed under local anaesthesia. The
vasa differentia leading from both testes are cut and tied to prevent sperm from entering the
urethra.

Implanted Contraceptives

These are implanted into the woman’s body to deliver contraceptive hormones which give
the female protection over a long period of time. For example, a small plastic rod containing
progesterone can be implanted beneath the skin. The hormone slowly diffuses out of the rod and
prevents ovulation. This allows for a continuous steady dose of progesterone to be in the blood for
up to 3 years. The disadvantage of this method is that it does not provide protection against the
transmission of bacteria and viruses.

Coitus interuptus
In this method, the penis is withdrawn before ejaculation which serves to prevent sperm from
entering the vagina. This procedure is about 75% effective. The disadvantage of this method is that
it does not provide protection against the transmission of bacteria and viruses.
 Mrs. Webb- L6

Anti-Implantation Methods
There are 2 widely used birth control methods that have their effect after fertilization.
However, the effect takes place so early after conception that the woman is not aware that it
has occurred. It should be noted that these methods may play a minor role in preventing
conception.

1. Intra-uterine Device
This is a small folded piece of plastic and copper that fits inside the uterus. The
uterus responds to the IUD as it would to a slight bacterial infection. Leucocytes congregate
in the uterus lining and cytokines are secreted to cause a low-level immune response. This
aids in preventing sperm from passing through and stops a blastocyst from implanting into
the uterus lining. Also, the copper present in the IUD can have toxic effects on both the egg
and early embryo.
This device must be placed in the uterus by a doctor or specialist nurse and once it
has been put in, it is left there. The disadvantages of the method are that it may cause
discomfort and it holds a small risk of infection. It is not recommended for young people
who may want to have children later.

2. Morning-After Pill
This type of birth control is used after unprotected sexual intercourse when the
female thinks that she might be pregnant. The pill contains a synthetic progesterone-like
hormone which lowers the chances of sperm reaching and fertilizing the egg & prevents
the embryo from implanting into the nucleus. The effects of this pill work up to 72 hours
after being taken. The modes of action of these types of medications are:
✓ Disruption of the uterine cycle so it is difficult for the embryo to implant.
✓ Blocking progesterone receptors in endometrial cells so the endometrium
disintegrates giving a menstrual flow which removes the implanted embryo.
✓ Inducing uterine contractions through prostaglandin.
 Mrs. Webb- L6

The Effect of Maternal Behaviour on Foetal Development

Maternal behaviour can have a significant effect on the development of the foetus.
The foetus is interacting with the surrounding world via the placenta and as a result,
mothers should maintain a good diet, stay healthy and avoid abusive drug use. The care
that a prospective mother should take of herself and her growing foetus is known as
antenatal care.

Preconceptual Care
As the health of the mother impacts on the health of the foetus, it is important the
she be healthy even before conception. Woman are advised to take approximately 400µg
of folic acid per day for at least one month before becoming pregnant and for the first
twelve weeks of pregnancy to reduce the risk of giving birth to a child without neural
defects. The neural tube is the part of the embryo that develops into the spinal cord and
the brain and if it is not properly developed various defects of the central nervous system
can occur. Spinal bifida is a condition where the neural tube does not close properly and is
exposed at the body surface at birth. Dark green vegetables, milk products and bananas
are a good source of this B vitamin.

In addition to the use of folic acid in the diet, a woman should find out if she is
immune to Rubella (German measles) or not. While this disease is not generally dangerous
to children and adults, in can be fatal to a developing foetus. Rubella is caused by a virus
and its symptoms are fever, fatigue and red spots covering the skin. If the virus crosses the
placenta and gets into the foetus’ blood it can prevent the proper development of the eyes,
ears, heart and brain of the foetus. Babies exposed to Rubella may be born deaf or may
have heart and brain defects. If the mother is immune to the virus then she is fine,
however, if she is not, she will need to be vaccinated. As the vaccine can be potentially
harmful to the foetus, she should do this before becoming pregnant.
 Mrs. Webb- L6

Postconceptual Care

Nutrition

As a woman’s metabolism undergoes various changes when she is pregnant, there

is an increased demand for energy and nutrients to support the growth and metabolism of
the uterus, placenta, foetus and breasts. During the first six months of pregnancy, the
mother does not require any additional dietary requirements because that is provided by
her stored fat and stores of iron and calcium. Also, she becomes more efficient at taking in
nutrients from her diet. Also, it is not necessary to increase the food intake by significant
amounts during the last three months of pregnancy to gain sufficient energy. Ideally, a
woman’s body mass should increase by 11-15kg during pregnancy.

Towards the end of pregnancy, a woman should increase the following things:

1. Energy: This is needed for growth and metabolism and should only increase by
800kJ a day during the last 3 months of pregnancy.
2. Protein: This is required for the growth of tissues such as blood in the mother and
foetus and uterus and foetal muscle. An additional 6g a day should be added to the
diet throughout pregnancy.
3. Calcium: This is necessary for the growth of foetal bones.
4. Iron: This is required for haemoglobin in both the mother and foetus.
Iron supplements with Vitamin C are recommended.
Reference: Table 12.1 Pg.244 Unit 1
 Mrs. Webb- L6

Drugs

The term can be defined as any substance taken into the body that affects or changes
chemical reactions in the body. This includes both legal drugs such as medicine,
nicotine and alcohol, as well as illegal drugs like cocaine and heroin.

The foetus is most sensitive to damage by any drugs during the phase of
organ development which begins in the 3rd week of pregnancy.

• Alcohol
✓ Alcohol crosses the placenta and enters the foetal blood circulation and
is distributed all around the foetus.
✓ The foetus is not yet able to metabolize alcohol and thus is more strongly
affected by this drug.
✓ Consumption of alcohol increases the risk of premature delivery. It also affects
development of nervous system and the brain does not develop adequately.
✓ Foetal Alcohol Syndrome (FAS) is a rare condition caused by a high consumption
rate of alcohol and its symptoms include mental retardation, microcephaly (small
head), hyperactivity, poor concentration, poor muscle tone, reduced growth rate,
abnormal limbs and heart defects.

• Cigarette Smoking
✓ The carbon monoxide in cigarette smoke combines irreversibly with haemoglobin
to form carboxyhaemoglobin which decreases its ability to combine with oxygen
by 10% and affects both the maternal and foetal blood.
✓ Nicotine is found in tobacco products such as cigarettes and it also crosses the
placenta and enters the foetal circulation to affect the foetus. It reduces the blood
flow through the umbilical arteries through the placenta and serves to increase
heart rate, blood pressure and the stickiness of platelets resulting in increased
risk of blood clots. In addition, it restricts blood flow to the extremities.
 Mrs. Webb- L6

• Combined effects of carbon monoxide and cigarette smoke lead to the following:
✓ Narrow umbilical blood vessels
✓ Decreased placenta size
✓ Increased placental heart rate
✓ Increased risk of miscarriage of premature birth
✓ Increased death rate of foetus and infant
✓ Low birth weight as a result of intra-uterine growth retardation (IUGR)
✓ Decreased immunity to infection

• Heroin, Cocaine and Marijuana

✓ Heroin and cocaine also pose various detrimental health effects to the foetus.
✓ Its crosses the placenta and leads to the child becoming dependent on these drugs.
✓ As a result, after birth, the child shows withdrawal symptoms such as
severe shaking and chills and it increases the risk of cot deaths in babies.
✓ The babies may have a higher rate of jaundice, congenital abnormalities, five
times the risk of growth retardation and twice the risk of being born prematurely.
✓ Both cocaine and heroin can damage the nervous system.
✓ Smoking of marijuana increases the risk of the baby being born with low
birth weights and may reduce the length of gestation by about 1 week.

• Pharmaceutical Products
✓ These will usually cross the placenta and may have harmful effects on the foetus.
✓ It is a wise precaution to not use drugs, especially early in pregnancy.
✓ Example: Thalidomide was a drug introduced in the early 1960’s and was
prescribed to pregnant women to help with ‘morning sickness’. This resulted in
an increase in the numbers of deformed babies with the main characteristic
deformities being missing or very stunted limbs. It also causes defects of the gut,
heart, eyes and ears.

• Rhesus Factor [Reference Pg 242 Unit 1]