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

- - - - least effective
- - - - Penis
        
        deposits sperms in female
      - Scrotum
        
        a layer of skin that holds the testis
      - Testis
        
        produces male sex hormones and sperms in puberty
      - Sex glands
        
        release fluids which protect the sperm and provide the energy for them to swim
      - Urethra
        
        tube that carries sperm and urine outside if the body
      - Epididymis
        
        where sperm is stored after leaving testis
      - Sperm duct
        
        carries sperm from epididymis to urethra
    - - Vagina
        
        where sperm is deposited during sexual intercourse
      - Cervix
        
        the neck of the uterus which widens during child birth
      - Ovary
        
        produces female sex hormones
      - Uterus
        
        a muscular pear-shaped structure where the embryo develops during pregnancy
      - Fallopian tube
        
        carries the mature egg from the ovary to the uterus
  - - - 3 phases
      - Follicular
        
        Days 1-13
        
        20 primordial follicles stimulated to mature by LH and FSH
      - Ovulation
        
        Day 14
        
        Release of secondary oocyte from mature follicle
      - Luteal
        
        Days 15- 28
        
        Remaining cells become corpus luteum
        
        Corpus luteum
        
        temporary endocrine gland
        
        builds up uterine lining, prepares for fertilization
        
        lifespan of 10 to 13 days if not fertilized
        
        Corpus luteum regression
        
        shedding of uterine lining, menstruation
        
        sheds lining, menses
        
        ends luteal phase
    - - Menstrual phase
        
        Days 1-5 of cycle
        
        Sloughing off the functional layer
        
        Lasts through period of menstrual bleeding
      - Proliferative phase
        
        Days 6-14 of cycle
        
        Development of new functional layer of endometrium
        
        Overlaps time of follicle growth and ovary estrogen secretion
      - Secretory phase
        
        Days 15-28 of cycle
        
        Increased progesterone secretion from corpus luteum
        
        Increases vascularization and uterine gland development
        
        If fertilization does not occur
        
        Degeneration of corpus luteum and dramatic drop of progesterone
        
        Without progesterone, sloughs off functional layer
  - - - avoid sex entirely
      - 100% prevents pregnancy
    - - avoiding sex during ovulation time
    - - pull out before ejaculation
      - high failure rate
    - - prevent sperm from reaching tubes
      - condoms, spermicidal gels etc.
    - - flexible plastic structures inserted into uterus
      - copper or synthetic progesterone to help prevent implantation
    - - prevent LH spike and ovulation
    - - inhibit ovulation
    - - surgically cutting uterine tubes and tying off ends
    - - Ductus deferens cut, segment removed, ends tied