Reproductive Health is a high-yield chapter because it links core concepts of contraception, infertility management (including assisted reproductive technologies), and sexually transmitted infection (STI) prevention with real-life decision making. Board exams and competitive tests frequently ask numericals (failure rates, risk calculations, indices like Pearl Index), and concept-based MCQs on mechanisms of contraception and emergency contraception—so a strong understanding here directly boosts scoring.
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10
Questions
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Marking
Q1. A couple uses a contraceptive method that reduces the probability of conception per ovulatory cycle by . If the baseline probability of conception in a normal ovulatory cycle is , what is the probability that they will conceive in a given cycle while using this method?
Q2. In a fertile cycle the probability of conception without contraception is . A couple uses two methods simultaneously: an oral contraceptive with per‑cycle efficacy and condoms with per‑cycle efficacy. Assuming the two methods act independently, the probability of conception in that cycle is closest to:
Q3. A contraceptive method X has a perfect‑use failure rate of per year and a typical‑use failure rate of per year. In a cohort of women using X for one year, what percentage of the observed pregnancies are attributable to imperfect use (user error)?
Q4. Assertion (A): Use of a copper intrauterine device (Cu‑IUD) increases the absolute (per‑woman per‑year) risk of ectopic pregnancy compared to women not using any contraception.
Reason (R): Among pregnancies that occur with a Cu‑IUD in situ, the probability that the pregnancy is ectopic is higher than among pregnancies in non‑users.
Both A and R are true and R explains A
Both A and R are true but R does not explain A
A is true but R is false
A is false but R is true
Q5. In a population, the annual pregnancy rate among Cu‑IUD users is and, among those pregnancies, are ectopic. Among women not using any contraception the annual pregnancy rate is and, among those pregnancies, are ectopic. Based on these data, which of the following is correct about the absolute (per‑woman per‑year) risk of ectopic pregnancy?
Absolute risk is higher in Cu‑IUD users than in non‑users
Absolute risk is lower in Cu‑IUD users than in non‑users
Absolute risk is equal in both groups
Cannot be determined from the given information
Q6. Pearl Index (per 100 women per year) can be calculated as . Method A was used by 400 women for 12 months and resulted in 2 pregnancies. Method B was used by 900 women for 12 months and resulted in 5 pregnancies. Which statement is correct?
Method B has a lower Pearl index (≈ 0.56) and is therefore more effective than Method A (≈ 0.50).
Both methods have equal Pearl index (≈ 0.50).
Pearl index for Method A ≈ and for Method B ≈ ; Method A is slightly more effective.
Pearl indices are approximately for A and for B (both extremely low).
Q7. A 27-year-old woman on a combined oral contraceptive (ethinylestradiol + progestin) is to start rifampicin for pulmonary tuberculosis. Which contraceptive method would have been the most appropriate recommendation before initiating rifampicin to avoid loss of contraceptive efficacy caused by hepatic enzyme induction?
Copper-bearing intrauterine device (Cu‑T), non-hormonal method not affected by enzyme induction.
Switch to progestin-only oral pills (mini‑pill).
Switch to etonogestrel subdermal implant (systemic progestin), which can have reduced effectiveness with rifampicin.
Switch to combined hormonal transdermal patch (systemic hormones may be reduced with rifampicin).
Q8. During an IVF cycle a patient develops severe ovarian hyperstimulation syndrome (OHSS) after oocyte retrieval; oocytes have been fertilized and several good‑quality embryos are available. To minimize maternal risk while preserving her chance of pregnancy, the most appropriate immediate management is:
Proceed with fresh embryo transfer in the same stimulated cycle with luteal support.
Cancel the cycle and discard all embryos to prevent further risk.
Administer an additional hCG bolus to stabilise luteal phase and then transfer embryos.
Cryopreserve (freeze) all embryos and postpone embryo transfer to a subsequent cycle after OHSS resolves.
Q9. Assertion (A): A copper IUD inserted within 120 hours after unprotected intercourse is a more reliable emergency contraceptive than levonorgestrel if ovulation has already occurred.
Reason (R): Copper IUDs create a local environment that is spermicidal and interferes with fertilisation and implantation, so their efficacy is less dependent on whether ovulation has already taken place.
Both A and R are true but R is not the correct explanation of A.
Both A and R are true and R is the correct explanation of A.
A is true but R is false.
A is false but R is true.
Q10. Both partners are heterozygous carriers (Aa × Aa) for an autosomal recessive disease. They opt for IVF with preimplantation genetic diagnosis (PGD) and obtain 6 embryos. Each embryo independently has probability of being homozygous normal (AA), of being a carrier (Aa) and affected (aa). If they will transfer only homozygous normal embryos (AA), what is the probability that at least one of the 6 embryos is homozygous normal?
Probability exactly one AA =
Probability at least one unaffected (AA or Aa) =