Married couple in their 40's come in for contraceptive advice. Female PT is worried about the long term effects of birth control and is seeking advice on what to do, to avoid pregnancy.

Upstream

Ovarian Cycle

Downstream

Ovulation

Follicular

Luteal

Follicle cells

Secondary

Primary

Finishes Meiosis I

Forming 2 cells

Reaches Metaphase II

If fertilized, completes meiosis

corpus luteum

secretes progesterone & estrogen

Temporary endocrine gland

corpus luteum regression

Release of Secondary oocyte

drops secretion of progesterone & estogen

Menstration

menses

Uterine Cycle

Menstrual phase

28 day cycle

Estrogen

Progesterone

Proliferative phase

Secretory phase

Menstrual bleeding

follicle growth

ovary estrogen secretion

Increased progesterone secretion

Increases vascularization

& uterine gland development

Contraceptive Methods

Morning after pills

Barrier methods

IUD

Vasectomy

Copper/synthetic progesterone preventing implantation

Inhibit ovulation

Prevents sperm from reaching uterine tubes

Sperm unable to leave testis

Female Reproductive system

Ovaries in Females

Gametogenesis

Secondary oocytes

XX Sex chromosomes

Males Reproductive system

Gametes

testes

XY sex chromosomes

Spermatogenesis

spermatogonia

Secondary spermatocyte

spermatid

Primary spermatocyte

Menopause

3 Best choices

3 Worst choices

Female PT gets a hysterectomy

advice to use no precaution if still having intercourse

Tubal ligation

Male PT get a Vasectomy

Ductus deferen cut

uterus removed

segment removed

ends tied

cutting uterine tubes

tying off ends

Wait until female pt undergoes menopause

Withdraw method

high failure rate

menopause

At risk for child w/ Down syndrome

progesterone and estrogen no longer secreted

Uterine line no longer growing

ovarian follicles no longer remain

Trisomy 21

intellectual disability

due to nondisjunction on oocyte/sperm

due to mother's age