Reproductive Health Set-1

Q1. If contraceptive method X has annual effectiveness $98\%$ and method Y has annual effectiveness $92\%$, and the probabilities of their failure are independent, the combined annual effectiveness when both are used simultaneously is approximately:

Q2. A couple with 3 years of infertility has the following findings: husband's semen concentration $1\times10^{6}\ /\text{mL}$ and total motility $5\%$, wife's hysterosalpingography shows bilateral tubal block. Which assisted reproductive technique is most appropriate for this couple?

Q3. After implantation maternal serum hCG is $2\ \text{mIU/mL}$ and doubles every $48\ \text{h}$. A home urine pregnancy kit becomes positive at $\ge 25\ \text{mIU/mL}$. Approximately how many days after implantation will the urine test become positive?

Q4. Assertion (A): Levonorgestrel emergency contraception (LNG‑EC) taken within $72\ \text{h}$ after unprotected intercourse is ineffective in preventing pregnancy if ovulation has already occurred.
Reason (R): LNG‑EC mainly acts by delaying or inhibiting ovulation and does not terminate an established pregnancy.
Which of the following is correct?

Q5. HPV types 16 and 18 account for $70\%$ of cervical cancers. An HPV vaccine is $95\%$ effective against these types and achieves $60\%$ coverage in adolescent girls. Assuming no herd immunity or cross‑protection, the maximum proportional reduction in cervical cancer incidence expected in the vaccinated cohort is closest to:

Q6. In a woman with a regular 28‑day cycle ovulating on day $14$, sperm can survive in the female tract up to $72\ \text{h}$ and an ovum remains viable for $24\ \text{h}$ after ovulation. Intercourse on which of the following day ranges (counting from day $1$) corresponds to the full fertile window with the highest probability of conception?

Q7. A woman with a 28‑day cycle expects ovulation on day $14$. She had unprotected intercourse on day $11$ and again on day $15$, and takes a levonorgestrel emergency contraceptive within $24\ \text{h}$ after the second exposure (i.e., on day $16$). Considering sperm viability up to $72\ \text{h}$ and ovum viability $24\ \text{h}$ after ovulation, which of the following is the most likely outcome?

Q8. In a regional family‑planning program $8000$ men underwent vasectomy (failure rate $0.15\%$) and $12000$ women underwent tubectomy (failure rate $0.5\%$). Assuming each procedural failure leads to one unintended pregnancy, the expected total number of unintended pregnancies from these sterilizations is closest to:

Q9. In an IVF clinic the probability of implantation for a single day‑3 embryo is $p_3=0.20$ and for a single day‑5 blastocyst is $p_5=0.45$. Compare two strategies: (I) transferring two day‑3 embryos simultaneously, (II) transferring a single day‑5 blastocyst. Which statement is correct regarding probability of at least one implantation and risk of multiple pregnancy?

Q10. In a population of $1000$ sexually active women, the annual pregnancy rate without contraception is $85\%$ and $2\%$ of those pregnancies are ectopic. With an intrauterine device (IUD) the annual pregnancy rate is $1\%$, but among pregnancies that occur with an IUD, $25\%$ are ectopic. Which conclusion follows from these figures?