Notes Chap 04

CHAPTER 4
REPRODUCTIVE HEALTH
Reproductive Health refers to the complete physical, mental, social, and
medical well-being of the people’s reproductive organs in addition to their
mind in terms of reproduction. Thus, reproductive health is very important in
order to reproduce and carry on life. People need to know the correct
methods, tips and ways in order to maintain a healthy sex-related life.
Reproductive health also refers to the absence of any defect and disease in
the human reproductive systems.
Therefore, creating awareness about safe and hygienic sexual practices, family
planning and prevention is essential. Most importantly, the cure for several
kinds of sexually transmitted diseases and maintaining a healthy reproductive
system is an important aspect of life.
WORLD HEALTH ORGANISATION has defined it as a total well-being in all

aspects of reproduction, i.e., physical, emotional, behavioral & social.
Reproductive health – problems and strategy:
 India was among the 1st countries to initiate actions & plans to attain
total reproductive health as social goal.
 These programmes are called as ‘FAMILY PLANNING’
 Improved programmes currently in operation have a popular name
‘Reproductive & Child Health Care Programmes’ (RCH).
HOW HAS THE GOVERNMENT TAKEN MEASURES?
 Through the help of audio-visuals & print media.

 Even family members, close relations are involved in the awareness.
 Sex education was introduced in schools to provide awareness
 Proper information about reproductive organs, adolescence & related
changes, safe & hygienic sexual practices, sexually transmitted
diseases, AIDS etc.
Amniocentesis
It is a technique used to find out chromosomal abnormalities in developing
embryo by using amniotic fluid.
 It is also misused to check foetal sex determination based on the

chromosomal pattern in the amniotic fluid surrounding the
developing embryo.
Population Explosion and Birth Control

Improved quality of life of people, increased health facilities and better
living condition had an explosive impact on explosion of population.
 Rapid decline in death rate, MMR (maternal mortality rate) and IMR
(infant mortality rate) along with increase in population of
reproductive age is the main reason for population explosion.
 Steps to overcome population explosion-
1. Using various contraceptive methods.
2. Educating people about the demerits of large family.
3. Increasing the marriageable age of female and male
4. Providing incentive to parents having 1or 2 children.
 Contraceptive methods are used to prevent the unwanted
pregnancy and modifying the menstrual cycle.
 An ideal contraceptive should be-
1. User friendly
2. Easily available
3. Effective
4. Reversible
5. No side effects
6. No way interferes with sexual desire and sexual act.
Contraceptive methods could be divided into following categories-
a) Natural or traditional methods

b) Barrier methods
c) IUDs
d) Oral contraceptive methods
e) Injectable
f) Implants
g) Surgical methods.
1. Natural Methods:
Avoids meeting of sperm & ovum.
 Periodic Abstinence – Avoid coitus from day 10 – 17 of menstrual

cycle when ovulation is expected. Because chances of fertility is very
high during this period, hence known as fertile period.
 Withdrawal or coitus interuptus – Male partner withdraws his
penis from vagina before ejaculation avoiding insemination of sperms
 Lactational amenorrhea-Absence of menstrual cycle during first six
months of intense lactational period.
2. Barrier Methods:
 Condoms – Thin rubber used to cover penis in male or vagina &

cervix in females.
 Diaphragms, Cervical caps & valuts are all barriers for females to
cover cervix during coitus.
Advantages of barrier methods:

1. They are disposable.
2. They can be self –inserted.
3. They are reusable.
4. Prevents conception by blocking entry of sperm through cervix
3. Intra uterine devices (IUDs):
 Devices inserted by doctors or nurses in uterus thru vagina.
Examples. Cu T, Cu7, Multiload 375, Lippes loop.
 Cu ions released suppress sperm motility & fertilizing capacity of

sperms.
 Hormone releasing IUDs makes the uterus unsuitable for implantation
& cervix hostile to the sperm.
4. Oral pills:
 Pills are taken daily for 21 days.

 They are very effective with less side effects.
 Saheli – new oral contraceptive contains a non-steroidal preparation.
 It is a ‘once a week ‘pill with high contraceptive value.
 Injection or implantation of progesterone /estrogen under the skin.
5. Surgical method:
 This method is also called as STERILISATION.

 It is advisable for male/female partner as a terminal method to
prevent any more pregnancies.
 In male, they’re called vasectomy, where the vas deferens is cut or
tied.
 In female, it is called tubectomy, where a small part of the fallopian
tube is cut or tied up.
 This method is highly effective but their reversibility is very poor.
Side effects of contraceptive method:
• It is very important that the selection of contraceptive method should
be taken under the consultation of the doctors.
• However, their possible ill-effects like nausea, abdominal pain,
breakthrough bleeding, irregular menstrual bleeding or even breast cancer.
• These symptoms SHOULD NOT BE TOTALLY IGNORED.
Medical Termination of Pregnancy
Intentional or voluntary termination of pregnancy before full term is called

Medical Termination of Pregnancy (MTP) or Induced Abortion.
When it is done?
 MTP is done to get rid of unwanted pregnancies due to casual

unprotected intercourse or failure of the contraceptive used during
coitus or rape.
 MTPs are also essential in certain cases where continuation in
pregnancy could be harmful or even fatal to the mother or to the
foetus or both.
MTPs are considered relatively safe during first trimester or up to 12 weeks

of pregnancy. Second trimester MTPs are much more riskier.
Sexually transmitted diseases (STDs)

Diseases or infections which are transmitted sexually through sexual
intercourse are called as Sexually Transmitted Diseases (STDs) or Venereal
Diseases (VDs) or reproductive tract infections. STDs can be classified as
viral, bacterial, protozoan, fungal, etc.
Various types of Sexually Transmitted Diseases:
The various types of sexually transmitted diseases include gonorrhoea,

syphilis, genital herpes, and of course the most common HIV leading to
AIDS.
Prevention
STDs are a major threat to a healthy society. Therefore early detection or
prevention and cure of these Diseases are given prime consideration under
Reproductive health-care programmes though all person are vulnerable to
these infections, their incidences are reported to be very high among the
age group of 15-24years.
Infections of STDs can be prevented by-

a) Avoid sex with unknown partners/multiple partners.
b) Always use condoms during coitus.
c) Go to a qualified doctor in case of doubt for early detection and get

complete treatment if diagnosed.
INFERTILITY
A large no of couples all over India are infertile, i.e., they are unable to
produce children in spite of Unprotected sexual co-habitation. The reasons
for this could be many-physical, congenital, diseases, drugs, Immunological
or even Psychological.
Assisted Reproductive Technologies (ART) are special techniques that

assist couples to have children.
VARIOUS TYPES OF ASSISTED REPRODUCTIVE TECHNOLOGIES
(ART) INCLUDE:
· In-vitro fertilization (IVF)
· Zygote intra fallopian transfer (ZIFT)
· Intra cytoplasmic sperm injection(ICSI)
· Gamete intra fallopian transfer(GIFT)
· Artificial insemination (AI)
1) In Vitro Fertilization (IVF)

It is the fertilization outside the body in almost similar conditions as that in
the body. In this method, popularly known as test tube baby programme,
ova from the wife / donor (female) and sperms from the husband / donor
(male) are collected and are induced to form the zygote under simulated
conditions in the lab. The zygote or early embryos could then be
transferred into the fallopian tube (ZIFT -zygote intra fallopian transfer)
2) Zygote intra fallopian transfer (ZIFT)

The zygote with 8 blastomeres can be transferred into the fallopian tube.
3) Intra cytoplasmic sperm injection (ICSI)

Intra cytoplasmic sperm injection (ICSI) is another specialized procedure to
form an embryo in the lab in which a sperm is directly injected into the
ovum.
4) Gamete intra fallopian tube (GIFT)

Transfer of an ovum collected from a donor into the fallopian tube of
another female who cannot produce one, but can provide suitable
environment for fertilisation and further development is another method
attempted.
5) Artificial Insemination (AI)

Infertility cases either due to inability of the male partner to inseminate the
female or due to very low sperms counts in the ejaculates could be
corrected by artificial insemination.
In the technique, the semen collected either from the husband or a healthy
donor is artificially introduced into the vagina or into the uterus (IUI – Intra
Uterine Insemination) of the female.
6) Adoption – can be done from orphanage / relatives.
All these techniques require extremely high precision handling by

specialized professional and expensive instruments. . Therefore, their
benefits are limited to certain countries and people.
Emotional, religious and social factors also prevent the adoption of these
methods.
Counseling and information on infertility
It is important to involve both partners in all aspects of management.

Discussions of wishes, plans, beliefs and motives are important.
“IF YOU HAVE ANY QUESTIONS, PLEASE REMEMBER I AM HERE TO

HELP. REACH OUT TO ME FROM 9:00 AM TO 12:00 AM SUNDAY TO
THURSDAY SO THAT I CAN SUPPORT YOUR SUCCESS.”
Dr. NAZIA SIRAJ

(BIOLOGY TEACHER)

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CHAPTER 4

WORLD HEALTH ORGANISATION has defined it as a total well-being in all

Reproductive health – problems and strategy:

HOW HAS THE GOVERNMENT TAKEN MEASURES?

 Through the help of audio-visuals & print media.

 It is also misused to check foetal sex determination based on the

Population Explosion and Birth Control

Contraceptive methods could be divided into following categories-

a) Natural or traditional methods

 Periodic Abstinence – Avoid coitus from day 10 – 17 of menstrual

 Condoms – Thin rubber used to cover penis in male or vagina &

Advantages of barrier methods:

3. Intra uterine devices (IUDs):

 Devices inserted by doctors or nurses in uterus thru vagina.

Examples. Cu T, Cu7, Multiload 375, Lippes loop.

 Cu ions released suppress sperm motility & fertilizing capacity of

 Pills are taken daily for 21 days.

 This method is also called as STERILISATION.

Medical Termination of Pregnancy

Intentional or voluntary termination of pregnancy before full term is called

 MTP is done to get rid of unwanted pregnancies due to casual

MTPs are considered relatively safe during first trimester or up to 12 weeks

Sexually transmitted diseases (STDs)

The various types of sexually transmitted diseases include gonorrhoea,

Infections of STDs can be prevented by-

b) Always use condoms during coitus.

c) Go to a qualified doctor in case of doubt for early detection and get

Assisted Reproductive Technologies (ART) are special techniques that

VARIOUS TYPES OF ASSISTED REPRODUCTIVE TECHNOLOGIES

1) In Vitro Fertilization (IVF)

2) Zygote intra fallopian transfer (ZIFT)

3) Intra cytoplasmic sperm injection (ICSI)

4) Gamete intra fallopian tube (GIFT)

5) Artificial Insemination (AI)

All these techniques require extremely high precision handling by

Counseling and information on infertility

It is important to involve both partners in all aspects of management.

“IF YOU HAVE ANY QUESTIONS, PLEASE REMEMBER I AM HERE TO

Dr. NAZIA SIRAJ

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