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Couple in their early 40's would like advice on contraceptives. The…

- - - - It is only about 80% reliable
      - You need to know when you are fertile and may need to abstain for up to 10 days
    - - Condoms can break
      - Spermicidal gels MUST be used correctly to work
      - Must be used with spermacide and not entirely effective
    - - Semen can always exit the penis before ejaculation
      - May not withdraw in enough time
  - - - 99% effective and there is no worrying about it.
    - - Sperm can't reach uterus and they are an older couple that does not plan on having any more kids
    - - No sperm = no babies
- - - - Urethra
    - - Seminal vessicle
      - Vas deferens
      - Prostate gland
      - Bubolurethra gland
      - Penis
      - testes
      - Eipdiymis
      - Glans Penis
      - Fore Skin
    - - Ovary
      - Fallopian tube
      - Fundus
      - Uterus
        
        Endomytreium
        
        Myomytreium
        
        Perimetrium
      - Cervix
      - Vagina
      - Mons Pubis
      - Labia majora
      - Labia minora
      - Hymen
  - - - Male
        
        To deliver sperm to the eggs
      - Female
        
        To prepare for fertilization
        
        provide nutirients to fertilized egg
        
        disposed of non fertilized egg and unused nutrients
    - - Meiotic events
        
        Before Birth
        
        Mitosis
        
        Oogonium
        
        Growth
        
        Infancy and childhood
        
        Ovaries inactive
        
        Cells stop at prophase 1
        
        Each month from puberty to menopause
        
        One primary oocyte released every month
        
        First polar body
        
        Meiosis II may or may not happen
        
        Cell starts to desenagrate
        
        Primary oocyte
        
        Secondary oocyte
        
        stuck in metaphase II
        
        1 more item...
      - Follicle development in ovary
        
        Before birth
        
        Primordial follicle/ oocyte
        
        Infancy and childhood
        
        Primordial follicle/ oocyte
        
        Each month from puberty to menopause
        
        Primary follicle
        
        secondary follicle
        
        Vesicular follicle
        
        ovulated 2ndary oocyte
        
        1 more item...
      - Uterine cycle
        
        Menstrual phase
        
        1-5 Days
        
        Functional layer falls off
        
        Proliferative phase
        
        6-14 Days of cycle
        
        new functional layer develops
        
        overlaps time of follicle growth and ovary estrogen secretion
        
        Secretory phase
        
        15-28 Days
        
        Increase progesterone secretion
        
        Increased vacularization and uterine gland development
        
        if no fertilization then progesterone drops
        
        1 more item...
        
        Corpus luteum degenerates around secondary oocyte
    - - Abstinence
        
        No sex at all
      - Rhythm method
        
        Avoid sex during ovulation time
        
        You absolutely have to know when you are fertile
      - Withdrawal method
        
        Pull out before ejaculation
        
        high failure rate
      - Barrier methods
        
        Prevent sperm from reaching uterine tube
        
        Varying levels of success if used correctly
      - IUD
        
        Structures inserted into uterus
        
        Progesterone to mimic pregnancy
      - Oral contraceptives/ patches
        
        prevent LH spike
        
        stops ovulation
      - Morning after pills
        
        stops ovulation
        
        Need to be taken withing 72 hours of sex
      - Tubal ligation
        
        Cut and tying uterine tubes
        
        sperm cannot reach the egg
      - Vasectomy
        
        Cut ductus deferens
        
        If you cannot ejaculate you cannot have babies