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a healthy, happily married couple in their early 40s has sought your…

- - - - long term and easy to do
    - - relatively short term effects
      - not hormone related
    - - relatively cheap and effective
      - short term effects
  - - - healthy happily married couple
    - - wants to stop taking them
    - - may be tempting but is highly uneffective
- - - - male
        
        testes
        
        seminiferous tubule
        
        primordial germ cells
        
        sustentacular cell
        
        diploid cells
      - female
        
        overies
        
        ovarian follicles consist of
        
        oocyte surrounded by follicle cells
    - - ducts
  - - - male gametes, sperm
      - spermatogenesis
        
        process of sperm development
        
        occurs within seminiferous tubule
        
        spermiogenesis
        
        final stage of spermatogenesis
      - spermatogonia
        
        primordial germ cells from which all sperm develop
        
        diploid cells near base of seminiferous tubule
    - - female gametes, secondary oocytes (“eggs”)
      - single viable secondary oocyte produced in females
      - female oocytes arrested in meiosis prior to birth
      - ovaries
        
        ovarian follicles
        
        support the oocyte
        
        primary follicle
        
        secretes estrogen as it matures
        
        secondary follicle
        
        oocyte forced to one side of follicle
  - - - ovulation
        
        day 14
        
        release of secondary oocyte from mature follicle
        
        induced with peak in LH secretion
      - luteal
        
        days 15—28
        
        remaining follicle cells become corpus luteum
        
        corpus luteum
        
        builds up uterine lining
        
        prepares for fertilized oocyte
        
        corpus luteum regression
        
        sheds lining, menses
      - follicular
        
        days 1–13
        
        ~20 primordial follicles stimulated to mature
        
        primary oocyte finishes meiosis I and forms two cells
    - - cyclical changes in endometrial lining
        
        menstrual phase
        
        sloughing off of the functional layer
      - proliferative phase
        
        development of new functional layer of endometrium
  - - - flexible plastic structures inserted into uterus
      - copper or synthetic progesterone to help prevent implantation
    - - prevent sperm from reaching uterine tubes
      - condoms, spermicidal gels, diaphragms
    - - prevent LH spike and ovulation