4.5.3.5The use of hormones to treat infertility (HT only)
AQA GCSE Combined Science (8464), Higher tier · Biology › Homeostasis and response › Hormonal coordination in humans
Practise The use of hormones to treat infertility (HT only). 11 exam-style questions plus unlimited generated ones on this subtopic, at up to four difficulty levels, with full mark schemes and a progress tracker. Free, no account needed.
How FSH and LH are used as fertility drugs and in IVF, and the benefits, risks and ethical issues of these treatments. This is Higher tier content: expect 'describe the stages of IVF' questions and 'evaluate' questions from the point of view of patients and doctors.
Grade by grade
What you need to be able to do, from the first marks up to the top grade.
5
Name the hormones in fertility drugsFSH and LH.
5
Describe how a fertility drug worksFSH and LH make eggs mature and be released, so the woman may become pregnant in the normal way.
6
Describe the main stages of IVFGive FSH and LH, collect eggs, fertilise them in the lab, then insert one or two embryos.
7
Give the disadvantages of fertility treatmentIt is emotionally and physically stressful, success rates are not high, and multiple births are risky.
8
Evaluate IVF from different points of viewWeigh benefits against risks for patients and doctors, including ethical issues such as unused embryos.
Notes
Fertility drugs
Some women cannot get pregnant because their eggs do not mature or are not released.
A 'fertility drug' containing FSH and LH can be given. FSH makes eggs mature and LH stimulates their release.
The woman may then become pregnant in the normal way.
IVF (in vitro fertilisation)
1. The mother is given FSH and LH to stimulate the maturation of several eggs.
2. The eggs are collected from the mother.
3. The eggs are fertilised by sperm from the father in the laboratory.
4. The fertilised eggs develop into embryos.
5. When the embryos are tiny balls of cells, one or two are inserted into the mother's uterus (womb).
'In vitro' means 'in glass': fertilisation happens outside the body.
Benefits, problems and ethics
Fertility treatment gives a woman the chance to have a baby of her own.
But it is very emotionally and physically stressful, and the success rates are not high.
It can lead to multiple births, which are a risk to both the babies and the mother. This is why only one or two embryos are inserted.
Ethical issues: unused embryos may be destroyed; treatment is expensive and may not be available to everyone; some people object on religious grounds.
Cheatsheet
Fertility drug: FSH + LH → eggs mature and are released → pregnancy in the normal way
IVF: FSH + LH → several eggs mature → collected → fertilised in the lab → embryos → 1 or 2 inserted into the uterus
In vitro = outside the body
Only 1 or 2 embryos inserted, to reduce the risk of multiple births
Problems: stressful, success rates not high, multiple births
Ethics: unused embryos, cost, religious objections
How to answer each type of question
Describe the stages of IVF
4 to 5 marks6
Start with the hormones and what they do.
Then collection, fertilisation in the lab, and embryo development.
Finish with one or two embryos inserted into the uterus.
Example. Describe how IVF can be used to help a couple have a baby.
Show the model answer
The woman is given FSH and LH (1) so that several eggs mature (1). The eggs are collected and fertilised with the man's sperm in a laboratory (1). The fertilised eggs develop into embryos (1). When they are tiny balls of cells, one or two embryos are inserted into the woman's uterus (1).
Explain why hormones are used
2 marks7
Say what FSH and LH do: stimulate several eggs to mature.
Say why that helps: more eggs to fertilise, so a better chance of a healthy embryo.
Example. Explain why a woman having IVF is given FSH and LH before her eggs are collected.
Show the model answer
To stimulate the maturation of several eggs (1), so that more eggs can be collected and fertilised, increasing the chance of getting a healthy embryo / a pregnancy (1).
Evaluate a fertility treatment decision
4 marks8
Give the benefit for the patient (chance of a baby).
Give the risks (multiple births, stress, cost) and any ethical issues.
Consider the doctor's view (success rates, health of mother and babies).
Finish with a justified conclusion.
Example. During IVF, a doctor must decide how many embryos to insert into the patient's uterus. Evaluate inserting two embryos rather than one.
Show the model answer
Any three from: two embryos increase the chance that at least one will implant, so pregnancy is more likely (1) this matters because success rates are not high and each cycle is stressful and expensive (1) but two embryos increase the chance of twins (1) multiple births are a risk to the babies and to the mother (1) plus a justified conclusion, e.g. one embryo is safer, but two may be justified if earlier attempts have failed (1)
Shortcuts and memory tricks
IVF in five words: stimulate, collect, fertilise, grow, insert.
Fertility drug = FSH + LH, pregnancy the normal way. IVF = FSH + LH, fertilisation in the lab.
Three problems: stress, low success rate, several babies at once.
Where marks are lost
Saying fertilisation happens inside the woman in IVF. It happens in the laboratory; only the embryos are put back.
Saying fertility drugs contain oestrogen or progesterone. They contain FSH and LH.
Saying lots of embryos are inserted to raise the chance of success. Only one or two are, because multiple births are risky.
Giving only biological facts in 'evaluate' questions, with no ethical or personal points and no conclusion.
Exam technique
Learn the IVF stages in order: each stage is usually worth a mark.
For 'evaluate', think about the patient (chance of a baby, stress, cost, multiple births) and the doctor (success rates, health risks, ethics).
Always say what FSH and LH do, not just their names.
Sample questions
Written for this site in the style of AQA exam questions. They are not taken from real past papers.
Question 1Easy5 marks
Some women cannot become pregnant because the eggs in their ovaries do not mature. They can be treated with a 'fertility drug'.
(a) Which two hormones are given in a fertility drug? Tick (✓) two boxes.[2]
FSH
Insulin
LH
Progesterone
Testosterone
(b) The stages of IVF treatment are shown below, but they are in the wrong order. A Eggs are collected from the woman. B The woman is given FSH and LH. C One or two embryos are inserted into the woman's uterus. D The eggs are fertilised by sperm in the laboratory. E The fertilised eggs develop into tiny balls of cells (embryos). Write the letters in the correct order.[2]
(c) Give one disadvantage of IVF treatment.[1]
Show the answer and mark scheme
(a)Answer: FSH; LH
(b)Answer: B, A, D, E, C
B first and C last
A, D, E in this order (between B and C)
(c)Answer: It is emotionally and physically stressful / success rates are not high / it can lead to multiple births
emotionally / physically stressful / success rates are low / can lead to multiple births (which are a risk to mother and babies) / expensive
Question 2Medium8 marks
In vitro fertilisation (IVF) can help some couples to have a baby.
(a) Describe how IVF is carried out.[4]
(b) Explain why the woman is given FSH and LH before the eggs are collected.[2]
(c) Doctors usually insert only one or two embryos into the uterus. Explain why.[2]
Show the answer and mark scheme
(a)Answer: The mother is given FSH and LH so several eggs mature; the eggs are collected and fertilised by the father's sperm in the laboratory; the fertilised eggs develop into embryos; one or two tiny balls of cells are inserted into the mother's uterus
the mother is given FSH and LH
(to stimulate) the maturation of several eggs
the eggs are collected (from the mother)
the eggs are fertilised by sperm (from the father) in the laboratory
the fertilised eggs develop into embryos
one or two embryos / tiny balls of cells are inserted into the mother's uterus
(b)Answer: To make several eggs mature at the same time, so more embryos can be produced and the chance of success is greater
so that several eggs mature (at the same time)
(so) more embryos can be produced / greater chance that at least one embryo develops successfully
(c)Answer: Inserting more embryos could lead to multiple births, which are a risk to both the babies and the mother
to reduce the chance of multiple births (e.g. triplets)
which are a risk to the health of the mother and the babies
Question 3Hard7 marks
A health service has £1 200 000 each year to spend on IVF. One cycle of IVF costs £4000. At this clinic, the chance of a live birth from one cycle is 30% for women under 40, and 10% for women aged 40 to 42.
(a) Calculate the number of IVF cycles the health service can pay for each year.[1]
(b) Calculate how many more live births would be expected if all of these cycles were given to women under 40, rather than to women aged 40 to 42.[2]
(c) The health service decides to pay for IVF only for women under 40. Evaluate this decision.[4]
Show the answer and mark scheme
(a)Answer: 300
1 200 000 ÷ 4000 = 300
(b)Answer: 60
under 40: 300 × 0.30 = 90 and aged 40 to 42: 300 × 0.10 = 30
90 − 30 = 60
(c)Answer: It gives more live births for the same money and fewer unsuccessful, stressful cycles, but it is unfair to women aged 40 to 42, who still have a chance of a baby and must pay privately, which not everyone can afford; a justified conclusion
(for) more live births for the same money (90 rather than 30 from 300 cycles)
(for) the money is used where it is most likely to succeed / fewer unsuccessful cycles, which are emotionally and physically stressful
(against) it is unfair to women aged 40 to 42, who still have a chance (10%) of a live birth
(against) older women must pay privately, which not everyone can afford, so access depends on income