Chapter 13 – Managing Your Fertility
Multiple Choice
1. Which of the following methods is NOT considered contraception?
A) abortion
B)
C)
D) condoms diaphragms birth control pills
2.
A)
B)
C)
D)
Answer:
Page:
A
333
Which of the following BEST describes the use effectiveness of a contraceptive? the projected success rate when used precisely as directed the success rate from clinical trial use of the product the failure rate when used precisely as directed the success rate based on actual use by the general public
3.
4.
5.
6.
Answer:
Page:
D
333
The effectiveness of a contraceptive for women of childbearing age is commonly expressed as
A)
B) the percentage that does not become pregnant while using the method for one year. the percentage risk of failure based on product testing by the manufacturer.
C)
D)
Answer:
Page: the number of failures per 1,000 uses based on user surveys. educated guesses by the sellers of the contraceptive.
A
334
A contraceptive practice in which the penis is removed from the vagina before ejaculation is known as coitus
A)
B) interfereus. interruptus.
C)
D)
Answer:
Page: interposeus. intromitus.
B
336
The human sperm is viable in the female reproductive tract for as long as
A) fifteen to twenty hours.
B)
C) twenty-four to thirty-six hours. two to three days.
D) one week.
Answer:
Page:
D
336
The calendar method, cervical mucus method, and basal body temperature method all attempt to determine
A) time of ovulation.
B)
C)
D) success of a contraceptive. whether a woman is pregnant. whether spermatozoa have reached the egg.

Answer:
Page:
A
337
Cindy and her husband are trying to have a baby. Based on the calendar method of birth control, 7.
8. when is the BEST time (approximately) for them to have intercourse in order to conceive?
A) one week after the beginning of menstruation
B)
C) two weeks after the beginning of menstruation three weeks after the beginning of menstruation
D) four weeks after the beginning of menstruation
Answer:
Page:
B
337
Faye is using the calendar method of contraception. If her menstrual cycle is always 27 days, when should she abstain from intercourse to avoid becoming pregnant?
A) day 1 through day 14
B)
C)
D) day 6 through day 14 day 9 through day 16 day 14 through day 18
9.
Answer:
Page:
C
337
In the temperature method of contraception, the woman should abstain from intercourse
A)
B)
C)
D) as soon as her temperature falls. as soon as her temperature increases. after her temperature falls, then rises. after her temperature rises one degree, then falls.
Answer:
Page:
B
337
10. Spermicides are MOST effective when used
A) with oral contraceptives.
B)
C) one hour after intercourse. with a barrier contraceptive.
D) immediately after intercourse.
Answer:
Page:
C
338
11. What do condoms with spermicides have in common with total abstinence?
A)
B)
They are more popular worldwide than any other contraceptive methods.
They are among the least popular methods of birth control.
C)
D)
Both offer protection against sexually transmitted diseases.
In use, both are 100 percent effective.
Answer:
Pages:
C
334, 335
12. Which of the following is FALSE regarding nonoxynol-9?
A) Nonoxynol-9 decreases the likelihood of disease transmission.
B)
C)
Nonoxynol-9 may cause skin irritations in some individuals.
Nonoxynol-9 may cause skin abrasions in some individuals.
D) Some health centers have stopped distributing condoms with nonoxynol-9.

Answer:
Page:
A
338
13. How do diaphragms, Lea’s Shield, and FemCap work? They
A) cover the cervical opening and keep semen out of the uterus.
B)
C)
D) expel semen from the vagina. kill spermatozoa that enter the cervix. prevent fertilized eggs from implanting in the uterus.
Answer:
Pages:
A
340-341
14. Which of the following is recommended for condom users?
A)
B)
C)
D)
Protect condoms from extreme temperatures.
Slightly inflate the condom before use to check for pinholes.
Maintain an air space at the tip of the condom when putting it on.
If lubrication is needed, use only petroleum jelly in small quantities.
Answer:
Page:
A
339
15. The world’s MOST popular reversible contraceptive device is the
A)
B)
C)
D)
Answer:
Page: condom. diaphragm. intrauterine device. oral contraceptive pill.
C
341
16. A very rare side effect of IUD use is
A) pelvic inflammatory disease.
B)
C) cervical caner. heart disease.
D)
Answer:
Page: stroke.
A
342
17. All of the following statements are TRUE regarding teens who have “pledged virginity until marriage” EXCEPT
A) they are just as likely to have sex as non-pledgers.
B)
C)
D) they are less likely to use contraceptives than non-pledgers. they have similar rates of oral sex as non-pledgers. the vast majority are able to abstain from intercourse until marriage.
Answer: D
Page: 336
18. Research indicates that oral contraceptive use may provide protection against all of the following
EXCEPT
A)
B)
C)
D) pelvic inflammatory disease. breast cancer. ovarian cancer. anemia
Answer: B

Page: 343
19. Sarah has been using the oral contraceptive “Seasonale,” which is designed to prevent her from
A)
B) having any menstrual cycles. having a menstrual cycle every month.
C)
D)
Answer:
Page: transmitting or acquiring any sexually transmitted disease. having menstruation side effects.
B
342
20. Current attempts to create a male contraceptive drug are focusing on
A) killing sperm.
B)
C) stopping the production of sperm. making sperm incapable of fertilization.
“locking” the sperm release mechanism. D)
Answer:
Page:
B
343
21. All of the following are potentially dangerous side effects of the oral contraceptive pill EXCEPT
A)
B)
C)
D) blood clots. strokes. hypotension. heart attacks.
Answer:
Page:
C
343
22. Which of the following BEST summarizes the connection between oral contraceptives and cardiovascular disease?
A)
B)
Oral contraceptives are riskier than either pregnancy or childbirth.
Oral contraceptives double the risk of cardiovascular disease in women under 35.
C)
D)
Answer:
Page:
Research finds no clear connection between oral contraceptive use and heart disease.
Oral contraceptives increase the risk of cardiovascular disease in women over 35.
D
344
23. Which of the following is TRUE about emergency hormonal contraception?
A) Regular oral contraceptives cannot be used for this purpose.
B)
C)
D)
Only Plan B is approved by the FDA.
It is illegal in the United States.
It is usually ineffective.
Answer:
Page:
B
345
24. The difference between the most popular oral contraceptives and the minipill is that minipills
A)
B) contain the same active ingredients, but in lower dosages. are only for use as morning-after pills.
C)
D)
Answer:
Page: contain no estrogen. are more effective.
C
344

25. Depo-Provera is an example of a(n)
A)
B) minipill. contraceptive implant.
C)
D) injectable contraceptive. combined oral contraceptive.
Answer:
Page:
C
344
26. The most common side effect of Depo-Provera is
A) amenorrhea.
B)
C) ectopic pregnancy. fluctuations in sex drive.
D) mild depression.
Answer:
Page:
A
344
27. Which of the following is FALSE regarding the contraceptive ring and contraceptive patch? Both
A)
B) are used for three weeks then removed for one week. contain estrogen and progesterone.
C)
D)
Answer:
Page: work similarly to the oral contraceptive pill. are able to protect against sexually transmitted diseases.
D
344
28. A common male sterilization procedure is called
A) testicular ligation.
B)
C) tubal ligation. cauterization.
D) vasectomy.
Answer:
Page:
D
346
29. What happens to sperm production in men with vasectomies? Sperm
A)
B) continue to be produced, but are destroyed by white blood cells. production ceases within six months to a year after the vasectomy.
C)
D)
Answer:
Page: continue to be produced, but migrate to other tissues where they eventually die. production ceases, and those remaining are absorbed back into testicular tissues.
A
346
30. The MOST common form of female sterilization involves
A) removing the uterus.
B)
C)
D) removing the ovaries. cutting the fallopian tubes. removing the fallopian tubes.
Answer:
Page:
C
346
31. The number of abortions that occur each year in the United States is approximately
A)
B)
1.40 million.
1.20 million.

C)
D)
Answer:
Page:
2.20 million.
2.49 million.
B
347
32. Rebecca is having an abortion in the eighth week of her pregnancy. Which procedure will MOST likely be used?
A) saline injection
B)
C)
D) vacuum aspiration menstrual extraction dilation and curettage
Answer:
Pages:
B
347-348
33. The Mifeprex abortion pill, formerly known as RU-486, works by
A)
B)
C)
D) denying nourishment to the embryo. blocking estrogen’s role in supporting the endometrium. causing uterine contractions that detach the endometrium. blocking progesterone’s role in supporting the endometrium.
Answer:
Page:
D
443
34. Which of the following is currently used to induce a medication abortion during the first trimester of pregnancy?
A)
B) mifepristone nonoxynol-9
C)
D)
Answer: rifampin
Lybrel
Page:
A
443
35. Which of the following methods of birth control has the LOWEST use effectiveness?
A) IUD
B)
C) contraceptive implant contraceptive patch
D) diaphragm
Answer:
Pages:
D
334-335
36. If possible, which of the following would NOT be a procedure within the process of cloning of a human?
A) Doctors surgically retrieve an egg from the female donor.
B)
C)
D)
The nucleus of the egg is removed.
A cell is taken from a cloning subject.
The clonal embryo is implanted in the female donor.
Answer:
Pages:
D
356-357
37. The type of cells that have the potential of developing into tissues or organs that would match the tissues or organs in the person who donated the genetic material are referred to as ________ cells.
A) cloning

B)
C)
D)
Answer: stem embryonic clonal
B
Page: 357
38. Sexually active women of childbearing age who do not use contraception stand about a(n) ____ percent chance of becoming pregnant within a year.
A)
B)
C)
D)
40
55
70
85
Answer:
Page:
D
349
39. In which part of the female reproductive tract is the environment hostile to sperm?
A) fallopian tube
B)
C) vagina uterus
D)
Answer:
Page: ovum
B
349
40. If a fertile couple has intercourse at the time of ovulation, why is the chance of conception not
100 percent?
A) The female reproductive tract contains natural barriers to sperm.
B)
C)
The semen may contain no sperm at times.
Most sperm live for too short a time.
D) The cervix may be closed.
Answer:
Page:
A
349
41. On average, between _____ million and ____ million sperm cells are deposited during ejaculation.
A) 100; 150
B)
C)
D)
Answer:
Page:
200; 500
500; 750
800; 950
B
349
42. All of the following are considered “aids to fertilization” EXCEPT
A)
B)
C)
D) sperm deposits near the cervical opening. uterine contractions. the speed of the sperm. the contoured shape of the fallopian tubes.
Answer:
Pages:
D
349-350
43. On average, most sperm will survive in the woman’s reproductive tract for __________ day(s) following intercourse.

A)
B)
C)
D) one two to three four to five six to seven
Answer:
Page:
B
350
44. All of the following are presumptive signs of pregnancy EXCEPT
A)
B)
C)
D) a missed period after unprotected intercourse. nausea upon awakening. a decrease in size and tenderness of breasts. a darkening of the areolar tissue surrounding the nipples.
Answer:
Page:
C
350
45. The name of the structure that is created when the sperm and egg first unite is referred to as a(n)
A) blastocyst.
B)
C) zygote. embryo.
D)
Answer:
Page: fetus.
B
351
46. The third trimester of pregnancy is characterized by
A)
B)
C)
D) fetal growth. development of organs. fetal cell differentiation. the appearance of a heartbeat.
Answer:
Page:
A
352
47. Most spontaneous abortions are believed to occur because of
A)
B)
C) maternal stress. the mother’s activities. the mother’s substance use. genetic or developmental problems. D)
Answer:
Pages:
D
351-352
48. Which of the following is a sign late in pregnancy that labor will happen soon? The
A) baby’s heart rate will increase by 15 percent.
B) mother will experience unusual food cravings.
C)
D)
Answer:
Page: position of the baby will suddenly be lower. baby can be felt to kick inside the womb.
C
352
49. What is the best way to recognize true labor pains? The
A) pains are mild and irregular.
B)
C) uterus can be felt to contract. pelvic cavity feels heavy

D) pains are regular and more intense.
Answer: D
Page: 352
50. In the United States, the birth process for a first-time mother averages about _________ hours.
A) two to three
B)
C) ten to twelve twelve to sixteen
D) eighteen to twenty-four
Answer:
Pages:
C
352-353
51. Effacement of the cervix during labor refers to
A)
B) opening. thinning.
C)
D)
Answer:
Page: tightening. lubricating.
B
353
52. The end of the first stage of labor, when the cervix has fully dilated, is called
A) transition.
B)
C) afterbirth. delivery.
D)
Answer:
Page: vernix.
A
353
53. During labor, the cervix will dilate from zero to ____ centimeters.
A)
B)
C)
D)
Answer:
Page: four six eight ten
D
353
54. For most women, the strongest labor pains occur during
A) transition.
B)
C) delivery of the baby. delivery of the afterbirth.
D) the first stage of labor.
Answer:
Page:
A
353
55. By the time labor reaches the transition phase, the pattern of the contractions are
A)
B)
C)
D) constant. up to ninety seconds with up to a minute between contractions. up to sixty seconds with five minutes between contractions. twenty seconds with about two minutes between contractions.
Answer: B

Page: 353
56. Gail’s doctor says she might require a C-section at delivery time. This will involve
A)
B) removing the baby through an incision in the abdomen. surgically removing the uterus after birth.
C)
D)
Answer:
Page: surgically widening the perineum. surgically widening the vagina.
A
353
57. Home pregnancy tests detect levels of which substance?
A) human chorionic gonadotropin
B)
C) prostaglandins oxytocin
D) luteinizing hormone
Answer:
Page:
A
350
58. Each year in the United States, about _____________ children spend time in foster homes.
A)
B)
100,000
200,000
C)
D)
Answer:
300,000
500,000
Page:
D
356
59. At the beginning of the third trimester, the fetus generally weighs from
A) one to two pounds.
B)
C) two to three pounds. three to four pounds.
D) five to six pounds.
Answer:
Page:
B
352
60. It is possible for a woman to develop which condition if she does not maintain sound nutritional habits during her pregnancy?
A) lupus
B)
C)
D) osteoporosis gestational diabetes anemia
Answer:
Page:
D
352
61. The percentage of American couples that have problems with infertility is estimated at
A)
B)
3 percent.
4 percent.
C)
D)
Answer:
Page:
6 percent.
10 percent.
D
354

62. The MOST common cause of infertility in men is
A)
B) impotence. mutated sperm.
C)
D) congenital sterility. insufficient sperm delivery.
Answer:
Page:
D
354
63. How is artificial insemination of humans usually done?
A) Sperm are placed near the cervix.
B)
C)
Sperm are placed into each fallopian tube.
Ova are fertilized in test tubes and then placed in the uterus.
D) Sperm are placed into the fallopian tube where ovulation occurs.
Answer:
Page:
A
354
64. Transcervical balloon tuboplasty is used to clear blockages of the
A)
B) uterus. cervix.
C)
D)
Answer:
Page: fimbriae. fallopian tubes.
D
355
65. Fertility drugs are usually prescribed when a woman has
A) structural abnormalities that block the passage of sperm.
B)
C) a highly acidic vaginal environment. problems with ovulation.
D) endometriosis.
Answer:
Page:
C
355
66.
Which of the following is an advantage of “test tube” methods of fertilization over drugs or artificial insemination?
A) The fertilized eggs that result are more viable.
B)
C)
The fertilization process is more controllable.
The child’s gender can be selected.
D) Pregnancy is guaranteed.
Answer:
Page:
B
355
67. The major unresolved controversy surrounding surrogate parenting is
A)
B)
C)
D)
Answer:
Page: whether the process increases the risk of birth defects. whether the practice breaks state or federal laws. whether rich people are exploiting poor women. to whom the child belongs.
D
356

True/False
68. Birth control and contraception are similar terms, but birth control is a broader concept.
Answer: True
Pages: 332-333
69. The behavior termed outercourse is sexual gratification that does not involve coitus.
Answer:
Page:
True
333
70. Cost is rarely an issue in selecting a method of birth control.
Answer:
Page:
False
335
71. The use effectiveness of a contraceptive is almost always lower than the theoretical effectiveness.
Answer:
Page:
72. Periodic abstinence methods of contraception are based on avoiding intercourse near the time of ovulation.
True
334
Answer:
Page:
True
336
73. Periodic abstinence is an acceptable birth control method for practicing Catholics.
Answer:
Page:
True
337
74. Spermicides are moderately effective for occasional use without other forms of contraception.
Answer:
Page:
True
338
75. Nonoxynol-9 is very effective in decreasing the likelihood of disease transmission.
Answer:
Page:
False
338
76. Current recommendations are to use dry or lubricated condoms without spermicide.
Answer:
Page:
True
339
77. Diaphragms can typically be purchased over the counter wherever condoms are sold.
Answer:
Page:
False
340
78. Those who choose to use the diaphragm should consult their physician regarding which spermicide to use.
Answer: True

Page: 340
79. A Lea’s Shield is similar to a diaphragm but has a central air valve that permits air to move out from beneath the shield to allow a closer fit.
Answer:
Page:
True
341
80. The way in which IUDs prevent pregnancy is not fully understood.
Answer:
Pages:
81. The only method of reversible contraception that is more effective than the oral contraceptive is the diaphragm.
False
341-342
Answer:
Page:
False
341
82. Unlike other contraceptive methods, oral contraceptives have no side effects.
Answer:
Pages:
82. Injectable contraceptives and subdermal contraceptive implants are as effective as oral contraceptives.
False
342-343
Answer:
Page:
True
344
83. After a vasectomy, men can no longer produce sex hormones.
Answer:
Page:
False
346
84. Most vasectomies can be reversed.
Answer:
Page:
False
346
85. During a tubal ligation, the vas deferens is removed.
Answer:
Page:
False
346
86. An abortion by Mifeprex (RU-486) can only be performed very early in the pregnancy.
Answer:
Page:
True
348
87. The most commonly used abortion procedure is vacuum aspiration.
Answer:
Page:
True
348
88. Human cloning has been accomplished numerous times in the United States.

Answer: False
Page: 357
89.
A woman’s reproductive tract is a supportive environment for sperm.
Answer:
Page:
False
349
90. Once the sperm has entered the fallopian tube, its journey to the egg is guaranteed.
Answer:
Page:
False
349
91.
During ovulation, the cervical mucus is thicker in order to prevent the passage of sperm through the cervical opening.
Answer:
Page:
False
349
92. One missed menstrual period is a confirmation of pregnancy.
Answer:
Page:
False
350
93. Diagnostic medical X-rays are not a threat to developing fetuses.
Answer:
Page:
94. The prescription anti-acne medication Accutane has been found to be harmful to developing fetuses.
False
351
Answer:
Page:
True
351
95. Home pregnancy tests are highly accurate.
Answer:
Page:
True
350
96. False labor pains are not caused by true contractions of the uterus.
Answer:
Page:
False
352
97. The average labor for a first-time pregnancy lasts from twelve to sixteen hours.
Answer:
Pages:
True
352-353
98. The first stage of labor is usually the longest.
Answer:
Page:
True
353
99. The stage of labor when contractions are most intense is transition .

Answer: True
Page: 353
100.
A woman in labor must not “push” the baby with her abdominal muscles until the cervix is fully dilated.
Answer:
Page:
True
353
101. Crowning is said to occur when the baby’s head clears the cervical opening.
Answer:
Page:
False
353
102. Uterine contractions end immediately after a baby is born.
Answer:
Page:
103. A cesarean delivery is commonly performed when the health of either the baby or the mother is at risk.
False
353
Answer:
Page:
True
354
104. The biggest challenge with extreme multiple births is the health of the mother.
Answer:
Page:
False
355
105. According to the guidelines of the American Society for Reproductive Medicine, no more than three embryos should be implanted in a woman under the age of 35 who is receiving IVF-ET.
Answer: False
355 Page:
106. In early 2007, the FDA approved the first human trials of embryonic stem cells.
Answer:
Page:
False
357
107. Frequent intercourse tends to increase sperm counts.
Answer:
Page:
False
354
108. One treatment for male infertility is regularly placing a cold pack on the scrotum.
Answer:
Page:
True
354
109.
Contracting sexually transmitted illnesses such as chlamydia and/or gonorrhea have no impact on a woman’s fertility.
False
354
Answer:
Page:

Essay
110. Explain the difference between birth control and contraception
Answer: Birth control is a broader term that refers to all possible methods of preventing the birth of a child, including both contraception and abortion. Contraception refers to measures that prevent conception.
Pages: 332-333
111. List the considerations for selecting a method of contraception.
Answer: It must be safe, reliable, and affordable. It must be easy to use so that its effectiveness will not be diminished by complicated procedures that lead to mistakes. It should be reversible in the event the couple wants to have children. It should also not interfere with a couple’s sexual expression.
Page: 335
112. Choose three of the following reversible birth control methods, and briefly discuss two advantages and disadvantages for each method. Your choices include: withdrawal; periodic abstinence; the male condom; the female condom; Lea’s Shield; diaphragm; and spermicide.
Answer:
Pages:
Refer to Table 13.1
334-335
113. Describe the sterilization procedures for men and women.
Answer:
Men: The procedure for men is vasectomy. In this procedure, each vas deferens, the tubes that connect the testes to the urethra, is cut and closed off so that sperm can no longer be ejaculated.
This is typically done under local anesthetic in a doctor’s office.
Women: Sterilization is accomplished by tubal ligation, in which the fallopian tubes are cut and tied back so that ova cannot pass down the tubes and sperm can never reach them. This procedure is now typically done via laparoscopy under general or local anesthetic. A new method of nonsurgical female sterilization involves insertion of the Essure coil into the fallopian tubes by a physician. After three months, the physician checks to see that adequate scar tissue has formed to block the fallopian tubes.
Pages: 346-347
114.
If human cloning were to occur, what procedures would be involved in the process?
Answer: The steps would include the following:
1)
2)
3)
4) doctors would surgically retrieve an egg from the female donor; the nucleus of the egg would be removed; a cell is then taken from a cloning subject; through an electrical jolt, the cloning subject’s cell is fused with the enucleated egg;
5)
6)
Pages: the clonal embryo is then implanted in the womb of the surrogate mother; and after nine months, a genetically matched reproduction of the cloning subject is born.
356-357
115. List the early signs of pregnancy.

Answer: Most notably, a missed menstrual period the month after unprotected sexual intercourse can signal the possibility that the endometrium is not being ejected because it harbors an embryo. The woman may also experience the nausea of morning sickness and changes in the breasts.
Page: 350
116. Describe the stages of labor and delivery.
Answer:
1) Effacement and dilation of the cervix: Typically the longest stage, during which contractions begin and gradually become more intense as the cervix dilates. This first
2)
3) stage ends at transition, when the cervix dilates fully and the baby moves into the birth canal.
Delivery of fetus: The baby is pushed out through the vaginal opening and delivered.
This stage ends when delivery is complete.
Delivery of placenta: Uterine contractions continue until the placenta has been expelled.
Continuing mild contractions help to stop bleeding and help the uterus begin to return to normal size.
Pages: 352-353
117. Describe advantages and disadvantages of “test tube” methods of fertilization.
Answer: One advantage is the fact that fertilization and implantation are more controllable in a “test tube” situation than they are in a woman’s body. Also, this type of assisted pregnancy is the only option for women whose fallopian tubes are totally blocked. On the other hand, fertility services make the process of getting pregnant much more involved and expensive, and there is no guarantee of success. An unusually large percentage of assisted pregnancies result in more than one conception.
Page: 355