married couple in their 40s, concerned about long term affects birth control pills, wants to stop. They don't want any more kids.

Female reproductive system

uterus

fallopian tube

fimbrae

ovarian ligament

ovaries

cervix

endometrium

vagina

Male reproductive system

ureter

vas deferens

seminal vesicle

prostate

bulbourethral gland

erectile tissue

epididymis

testicle

urethra

penile head

Functions of male reproductive organs

Vas Deferens : transports mature sperm to urethra, prep for ejaculation

Seminal Vesicles : produce fructose serving as energy source for sperm. Serves as majority of fluid in ejaculate

Prostate : contributes to fluid in ejaculate, serves as nourishment for sperm

bulbourethral gland : produce clear slippery fluid that empties into urethra. neutralizes acidity associated with residual urine

testes : produces male sperm

erectile tissue : tonically contracted, allowing small amount of arterial flow for nutritional purposes

epididymis : brings sperm to maturity

penile head : opening for urine and semen/fluids

functions of female reproductive organs

uterus : nurturing fertilized ovum that develops into fetus, holding it till baby is mature enough for birth

fallopian tubes: transport ova from ovary to uterus each month

fimbriae : finger like projections activated by hormones to catch released egg and move to fallopian tube

ovaries : produce eggs for fertilization, produce reproductive hormones , oestrogen, progesterone

cervix : allows menstrual blood to flow from uterus into vagina. directs sperm into uterus during intercourse

endometrium: prevent adhesions between opposed walls of myometrium, maintains patency of uterine cavity

events in ovarian cycle

follicular phase : day 1 -13

primodial follicles stimulated to mature by LH & FSH

primary oocyte finishes meiosis I

ovulation : release of secondary oocyte from mature follicle

occurs on day 14 of cycle

luteal phase: days 15-28 of cycle

corpus luteum : temporary endocrine gland, secretes progesterone and estrogen

regression causes shedding of uterine lining during menstruation , marking end of luteal phase

uterine cycle : cyclical changes in endometrial lining

menstrual phase : day 1-5 of cycle, last through period of menstrual bleeding

proliferative phase : days 6 - 14 cycle, development of new functional layer of endometrium,

overlaps time of follicle growth and ovary estrogen secretion

secretory phase : day 15-28, increased progesterone secretion

if fertilization doesn't occur, degeneration happens

Major contraceptive methods

abstinence : 100% way to prevent pregnancy

rhythm method : avoid sex during ovulation time

withdrawal method : pull out before ejaculation/high failure rate

barrier methods : prevent sperm from reaching uterine tubes - condoms, spermicidal gels

IUD: flexible plastic structure inserted into uterus , copper/synthetic progesterone prevents implantation

oral contraceptives or patches : prevent LH spike and ovulation

morning after pills : inhibits ovulation when taken 72 hours after unprotected sex

tubal ligation : surgically cutting uterine tubes and tying off ends. prevents sperm from reaching uterus

vasectomy : ductus deferens cut, segment removed, ends tied. sperm unable to leave testis

history of health before and after the end of birth control pills

health history of husband to see if he's good candidate for vasectomy

overall health of wife

vaginal ring

IUD

hormonal implant

condoms

withdrawal method

tubal litigation

average

good for women with no underlying health problems.

91% - 97% reliable

may make periods more regular, and lessen cramps

best

placed in woman's uterus, prevents sperm from reaching an egg, stops fertilized egg from implanting

99% reliable

may lighten or eliminate periods depending on the material chosen between hormone-free and progestin. may cause acne or ovarian cysts

can be used until they enter menopause

best

matchstick sized rod inserted under skin of upper arm , can remain in arm 3 years

99% reliable

may encounter irregular & unpredictable bleeding/spotting. or no more periods

don't require prescription, widely available. helps protect against STDs

79% - 95% reliable

worst

male withdrawals from the vaginal canal before ejaculation

may cause vaginal dryness, decreases sensation, can be difficult to use correctly

average

about 30% reliable

high chance of getting pregnant

best

most effective / female sterilization

99% reliable

permanent procedure, no reversion

vasectomy

male option

surgical cutting & sealing of part of vas deferens

99% reliable, after 3 months post surgery

overall health of husband