REPRODUCTIVE HEALTH
Introduction
• Family planning initiated in India – 1951
• R.C.H reproductive and child health care
Amniocentesis- technique – amniotic fluid (containing foetal skin cells) is taken out and analysed for chromosomal
and genetic disorders ( down syndrome, sickle cell anemia etc)
• Since it leads to sex identification and female foeticide (banned in India)
Population stabilization and birth control
• 1900 – 2 billion population (world )
• 2000- 7.2 billion
• India -350 million – time of independence
• may- 2011- 1.2 billion
MMR- maternal mortality rate
IMR – Infant mortality rate
Steps taken by government – to control population
Marriageable age- 21 male and 18 female
Incentives – for small family
“Hum do humare do”
Features of ideal contraceptives
• User- friendly
• Easily available
• Effectives
• Reversible and no/least side effects
• Should not interfere with sexual desire
Methods of birth control
1. Natural method
Method of birth control Features Mode of action
1. Natural method • No side effect
• Chances of failure is high
Avoiding coitus/sexual intercourse
a) Periodic Abstinence b/w 10th and 17th day of menstrual Prevent the meeting
cycle (risk, fertile period)during which of sperm and egg
ovulation is expected
• Removal of penis from vagina
before ejaculation
b) withdrawal coitus
interruptus
2. Lactational/ Amenorrhea Period of intense lactation when no
(no menstrual cycle) ovulation and hence no menstrual
cycle occurs
High level of prolactin (PRL)
Artificial method
a) Physical barriers Males- Condoms (disposable)
(they act as contraceptive also prevent Females- Condoms, Diaphragm,
STD/STI Cervical caps, Vaults)
b) IUD (intra- uterine devices) fitted Most popular method in India
into uterus of females by doctors/ (space b/w two children
expert nurses)
types:
1. non-medicated I.U.D Eg- lippes loop Phagocytosis of sperms
2. Copper releasing IUD Eg- cu7, cuT, copper loop, Copper- sperm motility decreases
multiload 375 Sperm fertilization ability decreases
3. Hormone releasing IUD LNG- 20, progestasert Hormone- implantation inhibited
cervix hostile to sperm
c) Oral pills Progesterone or progesterone- • Inhibit ovulation and
(Mala –D- daily pills) estrogen complex (variable implantation
amount) steroidal pills) • Alter mucus quality of cervix to
“Saheli” – non- steroidal drug retard the entry of sperm
developed by CDRI, Lucknow central - Weakly pill
drug research institute( least side
effect)
d) Skin implants Same as pill (effective for Same as pill
longer duration)
e) Surgical method Terminal method to Block gamete transport
(sterilization) most further pregnancy
effective
i) Vasectomy males) vasa-deferens cut/tied Semen will not have
over scrotum sperms
ii) Tubectomy(females) Fallopian tube cut/ sealed Menstrual blood will not
contain egg
MTP (medical termination of pregnancy)
• Induced abortion
• Legal (1971)
• To get rid of unwanted pregnancies
• Generally, it is safe upto 1st Trimester (12 weeks) i.e., 3 months
• MTP ( Amendment act 2017 (12 weeks -24 weeks)
note- 2 medical officer, life threating to mother, child defect.
STI/VD/R.T.I
VD ((Venereal diseases)
R.T.I (reproductive tract infection)
Bacterial S.T.I Viral Protozoans
1. Syphilis, Gonorrhea, AIDS, Hepatitis B, Genital Trichomoniasis
Chlamydiosis Herpes, Genital Warts
Note-
INFERTILITY
if a couple is unable to conceive even after 2 years of sexual- cohabitation; they are said to be infertile.
• Reasons- Physical, disease, congenital disease
• Treatment- A.R.T (Asserted Reproductive technology)
• 1st Test Tube Baby (I.V.F + E.T)
• IVF- In-vitro fertilization (glass/laboratory), ET (embryo transfer)
Husband /donor Wife/donor
In-vitro fertilization(I.V.F)
Zygote
Develop in the laboratory
E.T (embryo transfer)
• Note- zygote upto the 8- blastomere stage is transferred to fallopian tube of surrogated mother
• 2. ZIFT (Zygote intra fallopian transfer)
• Zygote beyond 8-blastomere stage is transferred to uterus of surrogate mother
IUT (Intra-Uterine transfer)
[Link] (Gamete Intra Fallopian Transfer)
-Undertaken for females who cannot produce an egg but provide suitable environment for pregnancy.
-In this technique egg from a donor is transferred into fallopian tube of female
4. I.C.S.I- (Intra Cytoplasm sperm injection)
-in vitro (Laboratory)- Sperm is directly introduced into the cytoplasm of egg
In case of infertility in Males-:
A.I (Artificial Insemination)- sperms from a healthy donor is transfer into female vagina
I.U.I- Intra Uterine insemination- sperms are directly injected into uterus