PRAMATI PU COLLEGE

II PUC BIOLOGY
REPRODUCTIVE HEALTH
Reproductive health Population explosion and birth control MTP STD
Infertility
Reproductive Health: It refers to the total wellbeing in all aspects of reproduction, i.e.,
physical, behavioural, emotional, and social.
In India, as early as in1951, family planning programmes were initiated. This programme is
currently under the name, Reproductive and Child Health Care (RCH) programmes. This
aims at creating awareness among the people regarding reproductive wellbeing and provides
facilities for the same.

Government organizations, NGOs, print media, Audio-Visual media play an important role in
creating awareness regarding reproductive health. Parents, teachers, friends and relatives also
have a responsible role in this regard.

People have to be educated about the hygiene, STDs, and misconceptions have to be
discouraged. Couple or marriageable group have to be counselled regarding conceptions,
prenatal care, post-natal care, gestation, lactation and vaccination. Sex- related crimes have to
be dealt with.

Amniocentesis: It is a test based on the chromosomal pattern in the amniotic fluid

surrounding the embryo. This can be used to find out chromosomal aberration if any. This
procedure is used to test for the presence of certain genetic disorders like Down syndrome,
haemophilia and sickle-cell anaemia. But it is exploited to determine the foetal sex. This is
increasing the cases of female foeticides. Hence there is a statutory ban on the test.

Saheli: It is a new oral contraceptive for females. Developed by Central Drug Research
Institute, Lucknow, it is non- steroidal, once -a-week pill. It has few side effects and high
contraceptive value.

Population explosion and birth control: The quality of life has significantly improved in
the last century. Better medical facilities, better living conditions, rapid decline is the Infant
Mortality Rate (IMR) and Maternal Mortality Rate (MMR) are the probable reasons for
increase in population. Also, there is an increase in the number of people in the reproducible
age. This has resulted in population explosion

World population Population in India

1990-2 billion 1947-350 million

2000-6 billion 2000-billion

2011-7.2 billion 2011- 1.2 billion

The Government is forced to take up some measures to check the population growth rate. The
most important step is to motivate the use of contraceptives. Advertisements in media and as
posters, showing a happy family with two children, statutory raising of marriageable age of
female to 18 years and males to 21 years, incentives given to couples with small families are
some of the measures taken.

An ideal contraceptive must be user-friendly, easily available have least side effects and
reversible. They are classified into natural methods, barrier methods, IUCDs, implants, oral
contraceptives and surgical methods. Some contraceptive methods are-

Natural methods: These work on the principle of avoiding chances of ovum and sperm
meeting

1. Periodic abstinence: Abstaining from coitus around the ovulation period, between
10th to 17th day of menstrual cycle. This is also known as rhythm method.
2. Coitus interruptus: The male partner withdrawing from the coitus before ejaculation,
hence preventing insemination. This is also known as withdrawal method.
3. Lactational amenorrhea: Absence of menstrual cycle during intense lactation
period, that is for initial 6 months after parturition.
Since no medicines are used in these methods, side effects are almost nil but
chances of failure are high.

Barrier methods:

1. Condoms: These are barriers made of thin rubber of latex sheath which are used to
cover the penis in male and vagina and cervix in female (Femidom). The ejaculated
semen will not enter into the reproductive tract and hence prevents conception. It is
one use only. It also protects the user from contracting STIs and AIDS. Nirodh is a
popular condom used in India.
2. Diaphragms, cervical caps and vaults are other barrier methods made of rubber
and inserted into the female. They are reusable.

Condoms Copper T Implants Vasectomy Tubectomy

3. IUDs: Intra Uterine Contraceptive Devices are another popular and effective method.
These devices are inserted by the doctors or expert nurses in the uterus through the
vagina. The following are types of IUDs based on their nature.
a. Non-medicated IUDs. Eg: Lippe’s loop
b. Copper releasing IUDs. Eg: Cu-T, Cu-7, Multiload 375.
c. Hormone releasing IUDs: Progestasert, LNG- 20
IUDs increase phagocytosis of sperms within the uterus. The Cu ions suppress
sperm motility and fertilizing capacity of sperms. The hormone releasing IUDs in
addition, make the uterus unsuitable for implantation and cervix hostile to the
sperms.
Pills:
 These are combinations of oestrogen and progestogens These come in the form of
tablets, administered orally. Pills have to be taken daily for a period of 21 days
starting within the first 5 days of menstruation. Then a gap of say 7-8 days are given
(during which menstruation occurs). The cycle has to be repeated till contraception is
needed.
Saheli is a new contraceptive developed at Central Drug Research Centre at Lucknow
and is found to be very effective. It is once- a week pill with very few side effects and
high contraceptive value.
Implants:
Long term contraceptive method. A contraceptive implant is a flexible plastic rod
inserted beneath the skin in the upper arm. The implants releases slow and steady
dose of progestins.
The ill effects of contraceptive methods include nausea, abdominal pain, breakthrough
bleeding, irregular menstrual bleeding, breast cancer.
Surgical methods:
These methods block the transport of gametes thus prevents conception. In males, it
is called vasectomy wherein the vas deferens are cut and tied. In females, the fallopian
tubes are cut and tied and is called tubectomy. These techniques are highly effective
but the reversibility is poor.
Medical Termination of Pregnancy (MTP): This refers to voluntary termination of
pregnancy or induced abortion. Government of India legalised MTP in 1971.
MTPs are relatively safe during the first trimester. MTPs are conducted to get rid of
unwanted pregnancies either due to casual unprotected intercourse, or failure of
contraceptives or rapes. MTPs are carried out after amniocentesis, if the foetus is
found to be female. This is illegal and has to be banned. Such practices are dangerous
both for the young mother and the foetus.
Sexually Transmitted Diseases (STDs): Infections transmitted through sexual
intercourse are called STDs or venereal diseases. Some of the infections can also be
transmitted by sharing of injection needles, surgical instruments etc with infected
persons, transfusion of blood or from infected mother to the foetus.
Some common STDs and the causative organism are given in the following table:
Disease Causative organism Type
Syphilis Treponema pallidum Bacteria
Gonorrhoea Neisseria gonorrhoeae Bacteria
Chancroid Haemophilus ducreyi Bacteria
AIDS HIV Virus
Hepatitis B Hepatitis B Virus Virus
Genital warts Human Papilloma virus Virus
Genital herpes Herpes Simplex Virus Virus
Chlamydiasis Chlamydia trachomatis Bacteria
Trichomoniasis Trichomonas vaginalis Protozoa
Giardiasis Giardia lamblia Protozoa
Candidiasis Candida albicans Fungus

For prevention of STDs,

i. Avoid sex with unknown partners/multiple partners
 ii. Always try to used condoms during coitus
iii. In case of doubt, one should go to a qualified doctor for early detection and
treatment
Early symptoms of STDs include itching, fluid discharge, slight pain,
swellings. Later complications include abortions, still births, pelvic
inflammatory disease (PID), ectopic pregnancies, infertility and cancer
Infertility: Inability to conceive even after two years of co- habitation is called
infertility. The causes of infertility are many- abnormalities in the reproductive
processes, infections, diseases, drugs, immunological, stress, smoking, alcoholism,
etc.
Infertility in men: Oligospermia is low sperm count, azoospermia is absence of
sperm in semen, cryptorchidism is when the testes does not descend into the scrotum,
low fructose content, ADAM (Androgen Deficiency in Aging Males) etc.
Infertility in women: Irregular menstrual cycles, blocked oviducts, damaged uterus,
diseases, presence of cysts and fibroids, PIDs etc.,
ARTs: Special techniques to assist the couple to have children are known as assisted
reproductive technologies.
1. IVF-ET: Invitro fertilization and Embryo Transfer. This is commonly known as
test tube baby. The ova and the sperms from the couple are collected and induced
to form the zygote in the laboratory. The zygote or embryo up to eight
blastomeres transferred into the fallopian tube. If the embryo is of more than 8
blastomeres then it is transferred into uterus (IUT) This is called the ZIFT-Zygote
Intra Fallopian Transfer. The zygote gets implanted and further development
occurs.
2. GIFT: Gamete Intra Fallopian Transfer. This method is used in females who
cannot produce ova but can provide suitable environment for fertilization and
further development of embryo.
In this technique both sperms and unfertilized oocytes are transferred into
fallopian tubes of female and fertilization takes place inside the body of the
female involves the transfer of ovum collected from a donor into the fallopian
tube of another female who cannot produce the egg, but can give right condition
for fertilization and implantation.
3. ICSI: Intra Cytoplasmic Sperm Injection. The sperm is directly injected into the
cytoplasm by micro-puncture of zona pellucida of an ovum of to form an embryo
in the laboratory.
4. AI-Artificial Insemination: This technique is used in cases of infertility of male
partner, where the husband is either unable to inseminate the female or has a very
low sperm count in the ejaculation. The semen collected either from the husband
or a healthy donor is artificially introduced into the vagina or uterus of the female
(IUI-intra uterine insemination).
All these techniques need expensive instruments, specialised doctors, asepsis and
cooperation from the couple
Legal adoption is permitted by our laws and this also can be the best methods for
attaining parenthood.
MORE.
1. HIV, Genital Herpes and Hepatitis B are non-curable STDs
2. Lactational amenorrhoea- During intense lactation, prolactin
is released which is antagonistic to FSH
3. Pills contain a combination of progesterone and oestrogen,
while mini pill contains only progesterone. Saheli is a mini pill
4. Implants are long lasting. But they do not provide any
protection against STIs
5. Oligospermia is also called oligozoospermia
6. IUI-Intra Uterine Insemination- fertilization is in vivo; IUT-
Intra Uterine Transfer- fertilization is in vitro
7. Surrogacy- a woman carries and delivers a child for a couple
or individual (through IVF)
8. Amniotic fluid contains fetal skin cells and cells from
respiratory system