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Concept Tutorial
Chapter 4 | Reproductive Health
Reproductive Health Artificial Methods
Reproductive and Child Healthcare  Barrier Method
Indicators of Improved Reproductive Health  Hormonal Method
Amniocentesis  Intrauterine Devices (IUDs)
Population Explosion  Surgical Method
Contraception Sexually Transmitted Diseases (STDs)
Natural methods Infertility and its causes
 Periodic Abstinence Assisted Reproductive Techniques (ART)
 Coitus Interrupts IVF-ET, GIFT, ICSI, Artificial Insemination
 Lactational Amenorrhea
Reproductive Health
Reproductive health means a total well-being in all aspects of
reproduction. i.e.; physical, emotional, behavioral and social.
A reproductively healthy society includes people with:
 Physically and functionally normal reproductive organs.
 Normal emotional and behavioral interactions in all sex related
aspects.
India was amongst the first countries in the world to initiate “family
planning” programs at national level in 1951.
Presently these programs are in operation under the name
“Reproductive and Child Healthcare” (RCH) programs.
 Major Tasks of
RCH
Create awareness among people
about various reproduction
related issues.
Provide medical facilities and
support to build reproductively
healthy society.
Importance of Sex Education
1. Provide proper information about: [Link] people about:
Reproductive organs. Correct marriageable age.
Adolescence and related changes. Available birth control measures.
Safe and hygienic sexual practices. Prenatal care of pregnant women.
Sexually transmitted diseases Benefits of breast feeding.
(STDs)
Equal opportunities for male and
2. Discourages: female children.
Beliefs in myths and Sex abuse and sex related crimes.
misconceptions about sex.
Child abuse.
Indicators of Improved Reproductive
Health
 Better awareness about sex related issues.
 Better prenatal care of mother and increase in number of medically
assisted deliveries.
 Better post natal care of mother and child.
 Decreased rate of Infant Mortality Rate (IMR) and Maternal
Mortality Rate (MMR).
 Increase in number of small families.
 Better detection and cure of Sexually Transmitted Diseases (STDs).
 Decreased incidences of sex related crime.
 Balanced sex ratio.
Medical Termination of Pregnancy
(MTP)
Voluntary termination of pregnancy before full term is called medical terminal of
pregnancy (MTP).
About 45 to 50 million MTPs are performed in a year all over the world which
accounts to 1/5th of the total number of conceived pregnancies in a year.
Note: Though MTP has significant role in decreasing the population, it is not meant
for that purpose.
Reasons for MTP:
Casual or unprotected intercourse.
Ineffective contraceptive.
Abnormal fetus.
Risk to mother or fetus or both.
Amniocentesis

Note: Ultrasonography and amniocentesis are misused to determine

the sex of unborn child. Frequently, if the fetus is found to be female,
it is followed by MTP.
 Population
Explosion
Rapid expansion of population resulting from decreased
death rate and increase in longevity, is called
population explosion.
Improved healthcare and better living conditions have
led to rapid growth of world populations.
Reasons for population explosion:
A rapid decline in death rate, maternal mortality rate
and infant mortality rate (IMR).
Increased number of people reaching reproductive age.
Advancement in healthcare facilities.
Contraception
Prevention of unwanted pregnancy is called contraception.

An ideal contraceptive should be:

 User friendly
 Easily available
 Effective and reversible with least side–effects.
 Should not interfere with sexual drive.
Natural Methods

Artificial Methods
Natural Methods
1. Periodic abstinence:
 The couples avoid coitus from 10th to 17th day of
menstrual cycle when ovulation is expected.
 As chance of fertilization are very high during this period
(10th to 17th day of menstrual cycle), it is called fertile
period.
2. Withdrawal method or coitus interruptus: The male
partner withdraws his penis from vagina just before
ejaculation so as to avoid insemination.
Natural Methods…
3. Lactational amenorrhea:
 Ovulation does not occur during period of
intense lactation following parturition due
to high level of prolactin hormone in
mother’s blood.
 Therefore, as long as the mother breast
feeds child fully, chances of conception are
almost nil.
 This method has been reported to be
effective only up to a maximum period of
six months.
Natural Methods…
 Advantages of natural methods: As no medicines or
devices are used in these methods, side effects are
almost nil.

 Disadvantages of natural methods: Chances of

failure are high.
 Artificial Methods
1. Barrier methods:
 Ovum and sperms are prevented from
physically meeting with the help of barriers.
 Condoms are barriers made of thin rubber or
latex sheath that are used to cover penis in the
male or vagina in the female just before
intercourse so that ejaculated semen would not
enter the female reproductive tract.
 Diaphragms and cervical caps are also barriers
made of rubber that are inserted into the female
reproductive tract to cover cervix during coitus.
Barrier Methods for Females
Popularity of Condoms
 No medical help is required to use them.
 Easily disposable.
 Easily available
 Protect from STDs such as AIDS.
Intra-Uterine Devices (IUDs)
Mechanisms of Action of IUDs
Cu ions released from CuT
suppress sperm motility
and fertilizing capacity of
sperms.

IUDs increase tubal

motility resulting in
premature arrival of early
embryo into uterus before it
is ready for implantation.
 Oral Pills
These contain small doses of
either progesterone or
progesterone–estrogen
combination.
They inhibit ovulation by
exerting negative feedback on
FSH and LH.
Hormone Releasing Implant
 Implants are available under the
brand name “Norplant”.
 These are surgically implanted
under the skin of female.
 Mode of action is similar to that
of pills and their effective periods
are much longer (about 5 years).
 Hormonal
Method
Advantage: Convenient method of contraception for females.

Disadvantage: Increase risk of intravascular clotting. Therefore

they are not recommended for women with history of disorders
of blood clotting, hypertension, liver dysfunction, heart diseases
and breast cancer.
 Saheli
It is a new oral contraceptive for
females, developed by scientists at
Central Drug Research Institute
(CDRI), Lucknow.
It contains a non–steroidal
preparation called centchroman
which suppresses functioning of
corpus luteum.
It is a “once a week” pill with little
side effects and high contraceptive
value.
 Surgical Methods/Sterilization
Terminal method to prevent
any more pregnancy.
Advantage: Highly effective.
Disadvantage: Reversibility is
very poor.
 Sexually Transmitted Diseases
(STDs)
Infections that are transmitted through sexual intercourse are
called sexually transmitted diseases (STDs) or Reproductive Tract
Infections (RTIs).
Bacterial infections are gonorrhea, syphilis and chlamydiasis etc.
Protozoan infections is trichomoniasis.
Viral infections are genital herpes, genital warts, hepatitis B and
HIV (AIDS).
 Important
Note
Hepatitis B and AIDS can also be transmitted by:
Sharing of infectious needles, surgical instruments etc. with
infected person.
Transfusion of blood.
From infected mother to fetus.
Except for hepatitis B, genital herpes and AIDS other diseases are
completely curable if detected early and treated properly.
 Sexually Transmitted Diseases
(STDs)…
Early symptoms: Itching, slight pain, swelling etc. in genital region.
Later complications due to lack of treatment:
Pelvic Inflammatory Disease (PID)
Abortions
Still births (birth of dead baby)
Ectopic pregnancies (implantation of early embryo in fallopian tube or
cervix).
Infertility
Cancer of reproductive tract
Infertility: Failure to conceive in spite of unprotected sexual co–
habitation. 
Reasons of infertility in male:
 Cryptorchidism: Failure of testes to descend into scrotum during
fetal development.
 Note: The defect can be corrected surgically after birth.
 Absence or blockage of vas deferens.
 Hyperthermia of scrotum (exposure to high temperature as in case
of mine workers).
 Excessive exposure to radiations.
 Alcohol inhibits spermatogenesis.
Reasons of infertility in females:
 Anovulation (absence of ovulation) due to deficiency of
gonadotropins.
 Luteal phase defect: Inadequate growth and functioning of
corpus luteum leads to inadequate growth of endometrium. Due
to this implantation of early embryo fails.
 Lactational amenorrhea: It leads to temporary infertility.
 Blockage in fallopian tube.
Assisted Reproductive Technologies
(ART)

Test Tube Baby

1. IVF–ET (In vitro Fertilization and Embryo
Transfer)
 Assisted Reproductive Technologies
(ART)…
2. Gamete Intra Fallopian Transfer
(GIFT): Transfer of an ovum collected from
a donor into fallopian tube of another
infertile female, but she can provide
suitable environment for fertilization and
embryonic development. 
Assisted Reproductive Technologies
(ART)…
3. Intra Cytoplasmic Sperm
Injection (ICSI): A sperm is
directly injected into ovum with
the help of a microscopic needle.
Fertilized egg is then placed in
uterus.
 Assisted Reproductive Technologies
(ART)…
4. Artificial insemination (AI):
Semen is collected from either
husband or a healthy donor, is
introduced into the vagina.