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40 y/o patient presents to physician office concerned about contraception …
40 y/o patient presents to physician office concerned about contraception
Female Reproductive System
Uterine Tube
Ampulla
Fertilization
Infundibulum
Catches and releases egg
Fimibriae
Finger like projections that help pass the egg along
Ovaries
Primary Follicles
Supports granulose cell
Secondary Follicle
Production of estrogen
Ovarian Ligament
Holds ovaries in place
Beginning establishment of pregnancy
Vesicular Follicle
Releases egg
Uterus
Endometrium
Lining of uterus
Myometrium
Muscle layer/contracts during menstruation
Round ligament
attaches labia majora and fundus
Internal Os
opening of uterus
Male Reproductive System
Scrotum
Sac that contains testis
Cremaster Muscles
Contracts to lift testis closer to body in cold temperature
Dartos Muscles
relaxes to let scrotum cool away from body
Testis
Sperm production
Primary Spermatocytes
Diploid 1/meiosis 1
Rete Testis
Connect Seminiferious tubules and efferent duct
Secondary Spermatocytes
Haploid/Meiosis 1 undergoing spermatogenesis
Sustentacular Cells
Blood testi barrier
Seminiferous Tubules
production of germ cells
Interstitial Cells
Produce testosterone
Ducts
Ejaculatory Duct
Recieves semen to ejaculate
Epididymis
Maturation of sperm/storage
Ductus Van Deferens
Transport/Storage of semen
Penis
Prepuce
Foreskin
Corpus Cavernosum
Contracts to help with erection
Urethra
Expels urine
Corpus Spongiosum
Contracts so urethra doesnt pinch
Glands
Prostate Gland
Gives semen more fluid to reach egg/has sugar properties
Cowper's gland
Neutralizes acid in vagina to reach egg
Seminal Vesicle
produce fluid that attributes too large amounts of semen
The best options for the couple would be possibly an IUD or sterilization of some sort for either of the couple. Vasectomy/Hysterectomy/Tubal Ligation (tubes tied) are very common procedures with higher success rates. All three have success rates higher than 90%
The worst options for the couple would probably be the old trusty dusty "pull out method" being #1- for many reasons! The cervical cup would be a close second with a 40% success rate (what in the world) and the pill would be the third option for me. It can be something you easily forget to take and then well you have a nice new miracle to take care of for the next 18 years.
This couple is a little different because "if" the wife was to end up pregnant she would be considered "high risk" and a "geriatric pregnancy" because she is over the age of 35. It's something to consider getting permanently taken care of due to the fact you are at a higher likely hood of having complications with the pregnancy and/or labor. The male would have a decreased sperm count by this age (compared to a 21 year old) and quite possibly low testosterone. It would be wise to consider ways that his hormone levels would still benefit his 40 year old decisions with his partner.