from pptx import Presentation
from pptx.util import Inches, Pt
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE, MSO_CONNECTOR
from pptx.dml.color import RGBColor
from pptx.enum.dml import MSO_THEME_COLOR

OUT='/tmp/workspace/hcg-obg-ppt/output/hCG_Complete_Resident_Teaching_Deck.pptx'
prs=Presentation(); prs.slide_width=Inches(13.333); prs.slide_height=Inches(7.5)
blank=prs.slide_layouts[6]

# palette
NAVY=RGBColor(20,45,75); TEAL=RGBColor(0,126,137); AQUA=RGBColor(218,243,244); GOLD=RGBColor(218,158,33); RED=RGBColor(178,57,66); GREEN=RGBColor(49,127,91); INK=RGBColor(35,46,56); GREY=RGBColor(97,111,123); PALE=RGBColor(246,249,251); WHITE=RGBColor(255,255,255); LAV=RGBColor(239,235,248)

def box(slide,x,y,w,h,fill=WHITE,line=None,radius=True):
    sh=slide.shapes.add_shape(MSO_SHAPE.ROUNDED_RECTANGLE if radius else MSO_SHAPE.RECTANGLE,Inches(x),Inches(y),Inches(w),Inches(h))
    sh.fill.solid(); sh.fill.fore_color.rgb=fill
    sh.line.color.rgb=line if line else fill
    return sh

def text(slide,x,y,w,h,s,size=18,color=INK,bold=False,align=PP_ALIGN.LEFT,margin=0.08):
    tb=slide.shapes.add_textbox(Inches(x),Inches(y),Inches(w),Inches(h)); tf=tb.text_frame; tf.clear(); tf.word_wrap=True
    tf.margin_left=tf.margin_right=Inches(margin); tf.margin_top=tf.margin_bottom=Inches(margin); tf.vertical_anchor=MSO_ANCHOR.MIDDLE
    lines=s.split('\n')
    for i,line in enumerate(lines):
        p=tf.paragraphs[0] if i==0 else tf.add_paragraph(); p.text=line; p.alignment=align
        p.space_after=Pt(3); p.font.name='Aptos'; p.font.size=Pt(size); p.font.bold=bold; p.font.color.rgb=color
    return tb

def title(slide,t,sub=None,section=None):
    box(slide,0,0,13.333,0.62,NAVY,False)
    text(slide,0.52,0.08,10.8,0.37,t,26,WHITE,True)
    if section: text(slide,11.25,0.11,1.6,0.28,section,10,RGBColor(210,230,236),True,PP_ALIGN.RIGHT)
    if sub: text(slide,0.55,0.72,12.0,0.42,sub,12,GREY)
    box(slide,0.52,1.17,12.28,0.035,TEAL,False,False)

def footer(slide,n):
    text(slide,0.55,7.13,8,0.18,'Final-year OBG resident teaching | hCG',8,GREY)
    text(slide,12.2,7.13,0.55,0.18,str(n),8,GREY,False,PP_ALIGN.RIGHT)

def bullets(slide,items,x=0.7,y=1.45,w=6.0,h=5.3,size=18,accent=TEAL):
    box(slide,x,y,w,h,PALE,RGBColor(225,232,236))
    yy=y+0.22
    for head,body in items:
        text(slide,x+0.25,yy,0.22,0.26,'•',size+5,accent,True)
        tb=text(slide,x+0.52,yy,w-0.78,0.68,head+'  '+body,size,INK,False)
        # bold heading by recoloring runs simply use separate boxes
        yy+=0.83

def arrow(slide,x1,y1,x2,y2,color=TEAL):
    ln=slide.shapes.add_connector(MSO_CONNECTOR.STRAIGHT,Inches(x1),Inches(y1),Inches(x2),Inches(y2)); ln.line.color.rgb=color; ln.line.width=Pt(2); ln.line.end_arrowhead=True

def add_notes(slide, notes):
    # Notes not reliably writable via public python-pptx API; place teaching pearl on slide instead
    pass

# 1
s=prs.slides.add_slide(blank); box(s,0,0,13.333,7.5,NAVY,False); box(s,0,0,13.333,0.18,TEAL,False,False); text(s,0.75,1.05,10.8,0.78,'Human Chorionic Gonadotropin (hCG)',36,WHITE,True); text(s,0.78,1.9,9.8,0.5,'Production, physiology, clinical uses and infertility treatment',22,RGBColor(204,226,230)); box(s,0.78,2.72,2.5,0.52,GOLD,False); text(s,0.88,2.81,2.3,0.28,'LONG ESSAY FRAMEWORK',12,NAVY,True,PP_ALIGN.CENTER); text(s,0.78,4.1,7.4,1.0,'Professor-style class for a final-year OBG resident',23,WHITE,False); text(s,0.78,5.95,9.0,0.35,'Definitions • mechanisms • bedside application • exam-ready algorithms',14,RGBColor(204,226,230)); text(s,0.78,6.75,4.0,0.24,'October 2026',10,RGBColor(180,209,216));
# stylized trophoblast
box(s,10.25,1.35,1.8,1.8,AQUA,TEAL); text(s,10.45,1.77,1.4,0.38,'SYNCYTIO\nTROPHOBLAST',14,NAVY,True,PP_ALIGN.CENTER); arrow(s,11.15,3.2,11.15,4.0,GOLD); box(s,10.18,4.05,1.95,0.78,GOLD,GOLD); text(s,10.32,4.24,1.68,0.28,'hCG',24,NAVY,True,PP_ALIGN.CENTER); footer(s,1)

# 2
s=prs.slides.add_slide(blank); title(s,'Learning objectives','At the end, you should be able to write and defend a long-essay answer.', 'OVERVIEW');
bullets(s,[('Define and describe production','source, structure, isoforms, secretion pattern and receptor.'),('Explain physiology','luteal rescue, steroidogenesis and fetal testicular action.'),('List clinical uses','pregnancy testing, tumour marker and therapeutic indications.'),('Use hCG rationally in infertility','trigger selection, timing, monitoring and cycle cancellation.'),('Prevent avoidable harm','OHSS, multifollicular response, multiple pregnancy and false-positive tests.')],0.7,1.5,7.3,4.9,17)
box(s,8.35,1.55,3.9,4.75,AQUA,TEAL); text(s,8.68,1.8,3.25,0.4,'Essay architecture',22,NAVY,True,PP_ALIGN.CENTER); steps=['1. Introduction','2. Production & chemistry','3. Functions','4. Uses','5. Infertility protocol','6. Complications & conclusion'];
for i,v in enumerate(steps): box(s,8.8,2.4+i*.55,2.95,.38,WHITE,TEAL); text(s,8.96,2.47+i*.55,2.65,.18,v,13,INK,True)
footer(s,2)
# 3
s=prs.slides.add_slide(blank); title(s,'What is hCG?','A placental glycoprotein hormone with potent LH-like biological activity.','BASICS');
bullets(s,[('Definition','hCG is a heterodimeric glycoprotein produced predominantly by syncytiotrophoblast.'),('Structure','It has a common α-subunit shared with LH, FSH and TSH, and a hormone-specific β-subunit.'),('Receptor','Acts primarily through the LH/chorionic gonadotropin receptor (LHCGR).'),('Why it is useful','Compared with LH, hCG has a longer biological half-life and provides a sustained LH-like signal.')],0.65,1.55,6.45,4.5,16)
box(s,7.55,1.55,4.9,4.5,LAV,RGBColor(203,190,225)); text(s,7.85,1.78,4.3,.35,'Molecular concept',22,NAVY,True,PP_ALIGN.CENTER); box(s,8.0,2.55,1.55,1.0,TEAL,TEAL); text(s,8.18,2.86,1.18,.25,'α subunit',18,WHITE,True,PP_ALIGN.CENTER); box(s,10.2,2.55,1.55,1.0,GOLD,GOLD); text(s,10.38,2.86,1.18,.25,'β-hCG',18,NAVY,True,PP_ALIGN.CENTER); text(s,8.1,3.88,3.75,.65,'α: shared\nβ: specificity + immunoassay target',16,INK,False,PP_ALIGN.CENTER); text(s,7.95,5.05,4.1,.55,'Exam pearl: β-subunit confers assay specificity; use “β-hCG” when discussing tests.',14,RED,True,PP_ALIGN.CENTER); footer(s,3)
#4
s=prs.slides.add_slide(blank); title(s,'Production and secretion across pregnancy','Use a timeline in the answer to show physiological command.','PHYSIOLOGY');
text(s,.75,1.35,11.8,.32,'Source: syncytiotrophoblast after implantation. Detectable in maternal serum about 8-9 days after ovulation.',16,INK,True)
# timeline
arrow(s,1.1,3.75,12.1,3.75,NAVY)
pts=[(1.2,'Implantation','8-9 d post-ovulation',TEAL),(3.85,'Rapid rise','early first trimester',TEAL),(6.45,'Peak','10-12 weeks',GOLD),(9.05,'Decline','16-20 weeks',RED),(11.35,'Plateau','remainder of pregnancy',GREEN)]
for x,a,b,c in pts:
    sh=s.shapes.add_shape(MSO_SHAPE.OVAL,Inches(x),Inches(3.48),Inches(.55),Inches(.55)); sh.fill.solid();sh.fill.fore_color.rgb=c;sh.line.color.rgb=c; text(s,x-.5,2.35,1.55,.45,a,15,INK,True,PP_ALIGN.CENTER);text(s,x-.65,4.25,1.85,.48,b,12,GREY,False,PP_ALIGN.CENTER)
box(s,.85,5.5,11.55,.68,AQUA,TEAL);text(s,1.05,5.67,11.15,.3,'Interpretation: a single value is context-dependent. Serial values, symptoms and transvaginal ultrasound guide early-pregnancy assessment.',15,NAVY,True,PP_ALIGN.CENTER); footer(s,4)
#5
s=prs.slides.add_slide(blank); title(s,'Physiological functions of hCG','Think: luteal rescue, steroidogenesis, fetal differentiation and placental signalling.','FUNCTIONS');
items=[('1. Rescue of corpus luteum','Prevents luteolysis and maintains progesterone and estrogen secretion until the luteoplacental shift.'),('2. Maintains decidua and early pregnancy','Progesterone supports a secretory decidua and prevents menstrual shedding.'),('3. Steroidogenesis','LH receptor activation in granulosa-lutein and Leydig cells drives steroid production.'),('4. Fetal male differentiation','Stimulates fetal Leydig cells to produce testosterone, supporting male internal/external genital development and testicular descent.'),('5. Other proposed actions','Implantation, trophoblast differentiation, angiogenesis and immunomodulation are biologically plausible, but not all translate into routine therapy.')]
bullets(s,items,.65,1.45,7.55,5.5,15)
box(s,8.65,1.55,3.7,4.95,LAV,RGBColor(203,190,225)); text(s,9.0,1.82,3.0,.35,'Core axis',22,NAVY,True,PP_ALIGN.CENTER)
for y,label,c in [(2.55,'hCG',GOLD),(3.55,'LHCGR',TEAL),(4.55,'Progesterone + E2',GREEN)]: box(s,9.15,y,2.7,.56,c,c); text(s,9.3,y+.14,2.4,.22,label,15,WHITE if c!=GOLD else NAVY,True,PP_ALIGN.CENTER)
arrow(s,10.5,3.12,10.5,3.5,NAVY);arrow(s,10.5,4.12,10.5,4.5,NAVY);text(s,8.95,5.55,3.1,.4,'Corpus luteum maintained',15,INK,True,PP_ALIGN.CENTER); footer(s,5)
#6
s=prs.slides.add_slide(blank); title(s,'Laboratory and diagnostic uses','The question asks “uses”: do not restrict the answer to infertility.','CLINICAL USES');
bullets(s,[('Pregnancy confirmation','Qualitative urine tests and quantitative serum β-hCG establish biochemical pregnancy.'),('Early pregnancy assessment','Serial quantitative β-hCG is interpreted with symptoms and ultrasound in pregnancy of unknown location; never used in isolation.'),('Gestational trophoblastic disease','Baseline, surveillance and treatment-response marker. Persistent/rising values require evaluation.'),('Germ-cell tumours','A tumour marker in selected testicular and ovarian germ-cell tumours; interpret within oncologic protocol.'),('Antenatal screening','Free β-hCG is one component of certain first-trimester and second-trimester screening algorithms.')],.65,1.45,7.4,5.4,16)
box(s,8.5,1.6,3.7,4.9,AQUA,TEAL);text(s,8.82,1.88,3.05,.35,'Interpret with context',21,NAVY,True,PP_ALIGN.CENTER); text(s,8.86,2.65,3.0,2.85,'A number is not a diagnosis.\n\nCheck:\n• gestational age\n• trend\n• symptoms\n• ultrasound findings\n• assay limitations',18,INK,False);footer(s,6)
#7
s=prs.slides.add_slide(blank); title(s,'Therapeutic uses of hCG','An LH-receptor agonist used when a controlled LH-like signal is needed.','THERAPEUTICS');
bullets(s,[('Female infertility','Final oocyte maturation and ovulation trigger after follicular development in OI, IUI and ART cycles.'),('Male hypogonadotropic hypogonadism','Stimulates Leydig-cell testosterone production; may be combined with FSH for spermatogenesis induction under specialist care.'),('Selected paediatric/endocrine contexts','May be used in specific diagnostic or therapeutic pathways, depending on local protocols.'),('Not a universal “fertility booster”','hCG does not improve conception in every oral-ovulation-induction cycle; select the indication.')],.65,1.5,7.4,4.75,16)
box(s,8.55,1.55,3.5,4.7,LAV,RGBColor(203,190,225));text(s,8.85,1.85,2.9,.3,'Drug forms',21,NAVY,True,PP_ALIGN.CENTER);text(s,8.95,2.65,2.8,2.8,'Urinary hCG\n• 5,000-10,000 IU IM/SC\n\nRecombinant hCG\n• 250 micrograms SC\n• roughly 5,000-6,000 IU urinary equivalent',16,INK,False);footer(s,7)
#8
s=prs.slides.add_slide(blank); title(s,'Why hCG works as an ovulation trigger','Mechanism of action in infertility treatment.','INFERTILITY');
text(s,.75,1.35,12,.4,'hCG binds LHCGR and reproduces the mid-cycle LH surge, but with longer receptor stimulation.',18,NAVY,True)
steps=[('1','Follicle growth','FSH ± LH / oral agent creates a mature follicle'),('2','hCG trigger','LH-receptor stimulation'),('3','Final oocyte maturation','Resumption of meiosis, cumulus expansion and luteinisation'),('4','Ovulation','Follicular rupture expected ~36-40 h later')]
for i,(num,head,body) in enumerate(steps):
 x=.6+i*3.13; box(s,x,2.15,2.55,2.25,AQUA if i%2==0 else LAV,TEAL if i%2==0 else RGBColor(203,190,225));text(s,x+.93,2.4,.7,.48,num,30,TEAL if i%2==0 else NAVY,True,PP_ALIGN.CENTER);text(s,x+.18,3.04,2.2,.35,head,17,NAVY,True,PP_ALIGN.CENTER);text(s,x+.2,3.52,2.15,.55,body,12,INK,False,PP_ALIGN.CENTER)
 if i<3: arrow(s,x+2.58,3.25,x+3.04,3.25,NAVY)
box(s,1.0,5.35,11.25,.75,GOLD,GOLD);text(s,1.22,5.54,10.8,.3,'Clinical implication: the trigger permits planned intercourse, IUI, oocyte retrieval and timed luteal support.',17,NAVY,True,PP_ALIGN.CENTER);footer(s,8)
#9
s=prs.slides.add_slide(blank); title(s,'Where hCG fits in female infertility care','It is a trigger, not the follicle-growing drug.','INFERTILITY');
# flow
flow=[('Anovulatory infertility','Identify cause; optimise lifestyle / endocrine factors',TEAL),('First-line OI','Usually oral agent where appropriate, e.g. letrozole in PCOS',GREEN),('Gonadotropin cycles','FSH ± LH grows follicle(s); intensive monitoring',GOLD),('hCG trigger','When response is safe and follicle maturity criteria are met',RED)]
for i,(h,b,c) in enumerate(flow):
 y=1.55+i*1.2; box(s,.9,y,5.25,.8,WHITE,c);text(s,1.15,y+.12,2.15,.24,h,17,c,True);text(s,3.25,y+.12,2.6,.42,b,13,INK)
 if i<3: arrow(s,3.5,y+.82,3.5,y+1.12,NAVY)
box(s,6.7,1.55,5.2,4.55,LAV,RGBColor(203,190,225));text(s,7.05,1.85,4.5,.34,'When not to reflexively trigger',20,NAVY,True);text(s,7.05,2.5,4.4,2.85,'• Too many developing follicles\n• Estradiol or clinical response suggests high OHSS risk\n• Baseline cyst / inappropriate response\n• Treatment plan requires an alternate trigger strategy\n\nWithhold hCG and consider cancellation, coasting, or conversion only within a supervised ART protocol.',16,INK);footer(s,9)
#10
s=prs.slides.add_slide(blank); title(s,'Pre-trigger assessment: the safety gate','Do not write “give hCG at 18 mm” without showing monitoring and risk assessment.','INFERTILITY');
items=[('Before cycle','Exclude pregnancy; assess diagnosis, ovarian reserve/PCOS phenotype, tubal and semen factors; counsel risks.'),('During stimulation','Serial transvaginal ultrasound; estradiol measurement where protocol and risk profile indicate.'),('Maturity assessment','Common OI practice: dominant follicle around 16-20 mm, tailored to protocol and clinical context.'),('Safety assessment','Number/size of follicles, estradiol trajectory, symptoms and OHSS risk determine whether to trigger.'),('Document plan','Timing of intercourse/IUI/retrieval, luteal support, pregnancy-test timing and warning signs.')]
bullets(s,items,.65,1.45,7.55,5.45,15)
box(s,8.6,1.55,3.65,5.1,AQUA,TEAL);text(s,8.95,1.85,3,.3,'Check before trigger',20,NAVY,True,PP_ALIGN.CENTER);checks=['Follicle count','Lead follicle size','E2 pattern if used','OHSS risk','Multiple pregnancy counselling','Procedure timing'];
for i,c in enumerate(checks): text(s,9.05,2.55+i*.52,2.85,.27,'☐  '+c,15,INK,False);footer(s,10)
#11
s=prs.slides.add_slide(blank); title(s,'Common hCG-trigger protocol: OI / timed intercourse / IUI','Institutional protocols differ. This is a conceptual, monitored pathway.','INFERTILITY');
# protocol timeline
cols=[('Cycle start','Baseline ultrasound\nExclude cyst/pregnancy',TEAL),('Stimulation','Oral agent or\ngonadotropin protocol',GREEN),('Monitoring','US ± estradiol\nAssess follicle number',GOLD),('Trigger','u-hCG 5,000-10,000 IU\nor r-hCG 250 µg',RED),('Timed treatment','Intercourse/IUI planned\n~24-40 h after trigger',TEAL),('Outcome','Luteal plan\nPregnancy test later',GREEN)]
for i,(h,b,c) in enumerate(cols):
 x=.45+i*2.1;box(s,x,2.05,1.76,2.4,WHITE,c);text(s,x+.12,2.35,1.52,.32,h,15,c,True,PP_ALIGN.CENTER);text(s,x+.13,2.93,1.5,.75,b,12,INK,False,PP_ALIGN.CENTER)
 if i<5:arrow(s,x+1.78,3.23,x+2.04,3.23,NAVY)
box(s,.85,5.35,11.6,.82,LAV,RGBColor(203,190,225));text(s,1.1,5.56,11.1,.38,'Key timing: ovulation generally follows hCG by about 36-40 hours. IUI timing varies by local protocol; coordinate rather than memorize a single clock time.',16,NAVY,True,PP_ALIGN.CENTER);footer(s,11)
#12
s=prs.slides.add_slide(blank); title(s,'hCG in controlled ovarian stimulation and IVF','The key distinction is trigger choice and OHSS risk management.','ART');
bullets(s,[('Role in ART','Induces final oocyte maturation before oocyte retrieval after controlled ovarian stimulation.'),('Timing','Oocyte retrieval is planned before expected ovulation, commonly about 34-36 hours after trigger according to protocol.'),('Why alternatives exist','In antagonist cycles, a GnRH-agonist trigger can markedly reduce OHSS risk in high responders, but luteal support must be adapted.'),('Dual trigger / low-dose approaches','Protocol-specific practices require reproductive-medicine supervision; do not generalize across all patients.'),('Luteal support','hCG may support luteal function but can worsen OHSS risk; progesterone-based strategies are often preferred in high-risk settings.')],.65,1.45,7.45,5.3,15)
box(s,8.48,1.55,3.82,5.0,LAV,RGBColor(203,190,225));text(s,8.76,1.83,3.25,.3,'Trigger choice',20,NAVY,True,PP_ALIGN.CENTER);text(s,8.82,2.55,3.05,2.95,'Standard responder\n→ hCG is common\n\nHigh OHSS risk in antagonist cycle\n→ consider GnRH-agonist trigger + appropriate luteal strategy\n\nAlways: individualize to protocol and risk.',16,INK);footer(s,12)
#13
s=prs.slides.add_slide(blank); title(s,'Complications and prevention','hCG is effective precisely because it provides a strong, sustained LH-like stimulus.','SAFETY');
items=[('OHSS','Ovarian enlargement, capillary leak and thromboembolic risk. Risk is increased in high responders, particularly PCOS. Prevention begins before trigger.'),('Multiple pregnancy','A consequence of multifollicular ovulation. hCG should not be used to “rescue” an unsafe response.'),('Local/systemic effects','Injection-site reaction, headache, mood symptoms, edema and pelvic discomfort can occur.'),('Diagnostic confusion','Exogenous hCG can cause a positive pregnancy test. Warn patients about testing too early after trigger.'),('Rare urgent events','Severe pain, breathlessness, rapid weight gain, reduced urine output or marked abdominal distension require prompt assessment.')]
bullets(s,items,.65,1.45,7.65,5.45,15)
box(s,8.7,1.55,3.35,5.2,RGBColor(252,237,238),RED);text(s,9.02,1.85,2.7,.32,'OHSS prevention',20,RED,True,PP_ALIGN.CENTER);text(s,9.05,2.55,2.7,3.25,'• Individualized stimulation\n• Ultrasound monitoring\n• Consider E2 pattern\n• Avoid trigger / cancel unsafe cycles\n• Consider GnRH-agonist trigger in eligible antagonist cycles\n• Avoid hCG luteal rescue in high-risk patients',15,INK);footer(s,13)
#14
s=prs.slides.add_slide(blank); title(s,'Special issue: false-positive pregnancy tests after trigger','An exam favourite and a common counselling gap.','SAFETY');
box(s,.7,1.55,5.7,4.95,AQUA,TEAL);text(s,1.05,1.88,5.0,.32,'Mechanism',22,NAVY,True);text(s,1.05,2.55,4.85,2.6,'Injected hCG is measured by standard urine and serum pregnancy assays. Testing too soon can detect the drug rather than implantation-derived hCG.\n\nGive the patient a clinic-specific testing date and explain that “testing out the trigger” at home is unreliable for clinical decisions.',18,INK)
box(s,6.95,1.55,5.2,4.95,LAV,RGBColor(203,190,225));text(s,7.25,1.88,4.55,.32,'Resident counselling script',22,NAVY,True);text(s,7.35,2.55,4.25,2.7,'“Your trigger injection contains the hormone detected by pregnancy tests. A very early positive does not confirm pregnancy. Please test only on the date given by the clinic and contact us for bleeding, severe pain or symptoms of OHSS.”',18,INK,False);footer(s,14)
#15
s=prs.slides.add_slide(blank); title(s,'Case-based application','PCOS with oligo-ovulation, monitored stimulation cycle.','CLINICAL REASONING');
box(s,.65,1.5,4.0,4.95,AQUA,TEAL);text(s,.95,1.8,3.4,.3,'Case',22,NAVY,True);text(s,.95,2.45,3.25,3.15,'29-year-old with PCOS and infertility. Following monitored low-dose FSH, ultrasound shows one 18 mm follicle and one 13 mm follicle. She is asymptomatic; no concerning E2 pattern or excess follicles.\n\nQuestion: What is the purpose of hCG now?',17,INK)
box(s,4.95,1.5,7.35,4.95,LAV,RGBColor(203,190,225));text(s,5.3,1.8,6.65,.3,'Professor’s discussion',22,NAVY,True);steps=['This is a mature, apparently safe monofollicular response.','hCG provides the LH-like signal for final oocyte maturation, luteinisation and ovulation.','Offer trigger as per unit protocol and schedule intercourse/IUI in the planned post-trigger window.','Counsel about early testing and OHSS symptoms, though risk is lower with this response.','If there were multiple mature follicles or marked hyper-response, withholding hCG and cancelling would be safer.'];
for i,st in enumerate(steps): text(s,5.35,2.42+i*.65,6.25,.48,str(i+1)+'. '+st,16,INK)
footer(s,15)
#16
s=prs.slides.add_slide(blank); title(s,'Long-essay answer: model structure','Use these headings in the exam.','EXAM');
heads=[('Introduction','Definition and source'),('Production & chemistry','Syncytiotrophoblast; α/β; LH receptor'),('Physiological functions','Corpus luteum, steroids, fetal testes'),('Clinical uses','Pregnancy, PUL assessment, GTD, tumours, screening'),('Infertility use','Trigger mechanism, indications, preparation/dose, timing, monitoring'),('Adverse effects & precautions','OHSS, multiples, false positive testing'),('Conclusion','Effective trigger only when safely individualized')]
for i,(h,b) in enumerate(heads):
 y=1.35+i*.72; box(s,.75,y,2.6,.48,NAVY,NAVY);text(s,.93,y+.1,2.2,.2,h,13,WHITE,True);text(s,3.55,y+.05,7.9,.36,b,16,INK,False)
footer(s,16)
#17
s=prs.slides.add_slide(blank); title(s,'High-yield viva questions','Answer these fluently after the long essay.','EXAM');
qs=[('Why can hCG trigger ovulation?','It is an LH-receptor agonist with a longer biologic half-life.'),('When does ovulation occur after hCG?','Approximately 36-40 hours, depending on protocol and patient context.'),('Name the usual preparations.','Urinary hCG and recombinant choriogonadotropin alfa.'),('Main serious complication?','OHSS, alongside multiple gestation from multifollicular ovulation.'),('How do you reduce OHSS risk?','Monitor response; withhold/cancel unsafe hCG trigger; consider GnRH-agonist trigger in eligible antagonist cycles.'),('Does every clomiphene cycle need mid-cycle hCG?','No. It may help timing or known ovulatory dysfunction, but does not universally improve conception.')]
for i,(q,a) in enumerate(qs):
 y=1.36+i*.85;box(s,.7,y,11.85,.65,AQUA if i%2==0 else LAV,TEAL if i%2==0 else RGBColor(203,190,225));text(s,.95,y+.08,3.9,.19,q,14,NAVY,True);text(s,4.7,y+.08,7.45,.35,a,14,INK)
footer(s,17)
#18
s=prs.slides.add_slide(blank); title(s,'Take-home messages','The final slide of your long answer.','CONCLUSION');
bullets(s,[('hCG is a syncytiotrophoblast-derived glycoprotein','that acts at the LH receptor.'),('In normal pregnancy, its central early role is','rescue of the corpus luteum and maintenance of progesterone secretion.'),('In infertility treatment, hCG is primarily a planned trigger','for final oocyte maturation and ovulation after an appropriate follicular response.'),('Its timing value is useful for intercourse, IUI and oocyte retrieval','but it must never override safety monitoring.'),('OHSS and multiple pregnancy prevention','depend on patient selection, ultrasound-based monitoring, and withholding hCG when the response is unsafe.')],.75,1.5,8.05,5.1,16)
box(s,9.2,1.7,2.8,4.6,NAVY,NAVY);text(s,9.52,2.0,2.15,.4,'Remember',22,WHITE,True,PP_ALIGN.CENTER);text(s,9.48,2.9,2.25,2.2,'Grow follicles\nwith FSH.\n\nTrigger safely\nwith hCG.\n\nTime treatment\nwith purpose.',20,RGBColor(211,233,236),True,PP_ALIGN.CENTER);footer(s,18)
#19 references
s=prs.slides.add_slide(blank); title(s,'Selected references','For teaching and resident revision.','REFERENCES');
refs=['Berek & Novak’s Gynecology. Sections on ovulation induction, gonadotropin therapy and hCG.','Guyton and Hall Textbook of Medical Physiology. Placental hormones and hCG physiology.','Goodman & Gilman’s The Pharmacological Basis of Therapeutics. Natural and recombinant gonadotropins.','Katzung’s Basic and Clinical Pharmacology. Gonadotropin pharmacology and toxicity.','WHO. Guideline for the prevention, diagnosis and treatment of infertility, 2025.','ASRM. International Glossary on Infertility and Fertility Care, 2025.']
box(s,.75,1.5,11.8,4.65,PALE,RGBColor(225,232,236));
for i,r in enumerate(refs):text(s,1.05,1.82+i*.62,10.95,.35,str(i+1)+'. '+r,16,INK)
text(s,1.0,6.45,11.2,.3,'Teaching note: doses, trigger selection and timing should follow local reproductive-medicine protocol and individual patient risk assessment.',13,RED,True,PP_ALIGN.CENTER);footer(s,19)

prs.save(OUT)
print(OUT)