6) ARTIFICIAL METHODS

REPRODUCTIVE HEALTH
The various methods of contraception are enlisted below:
INTRODUCTION

1) DEFINITION 1
3
5 7
Barrier Injections Surgical
methods IUDs & implants methods
According to WHO, reproductive health means a total well being in all aspects of reproduction, i.e. physical, emotional, social and behavioral.
2 6
Spermicidal
4 Emergency
Oral pills contraceptives
jellies

2) REPRODUCTIVE HEALTH : PROBLEMS AND STRATEGIES 3) POPULATION STABILISATION

India was amongst first countries in the world to initiate action plans • According to 2011 census, our population growth rate was less than
to attain reproductive health such as Family Planning Programmes (FPP) in 1951. 2 % i.e. 20/1000/year.
7) ARTIFICIAL METHODS
1 2
Helping adolescents by providing
information about reproductive organs,
hygienic sexual practices and STIs.
Importance of breast feeding.
Year World Population Indian Population
(I) Barrier methods : (b) Diaphragms, cervical caps, vaults :
Creating awareness about Discouraging children from
care of pregnant mother,
postnatal care of mother
& child.
3 4 believing in myths & having
misconceptions about
sex-related aspects.
1900 2 billion 350 million • Prevent ovum and sperm from physically meeting. • Rubber barriers that cover the cervix
• Self inserted and offer privacy to user. during coitus.
TASKS PERFORMED (a) Condoms & its &
(a) Condoms types
its typed • Reusable.
5 6 Introduction of sex
Benefits of massive BY 'REPRODUCTIVE
child immunisation. & CHILD HEALTH CARE (RCH) education in schools. Made up of rubber and thin latex • Do not protect from STIs.
PROGRAMMES'
2000 6 billion 1 billion
• Used by females only.
Role of NGOs, audio-visual
Parameter Male Female
& print media in creating
awareness regarding
sex related aspects.
7 8 Benefits of families
with small size. •
•
Region covered
Provides production
• Penis
• Yes
• Vagina and cervix
• Yes
(II) Spermicidal jellies, foams and creams :
2011 7.2 billion 1.2 billion from STIs • Kill the sperms by creating acidic pH.
• Used along with barrier methods to increase
Awareness regarding social evils such
as sex-abuse and sex related crimes. 9 10 Importance of equal opportunities
for male and female child.
Male condom Female condom their efficiency.
11 (Nirodh)

Educating people about

birth control options.

• REASONS FOR INCREASE IN POPULATION SIZE : (III) Intra-uterine devices (IUDs) : (IV) Oral Contraceptive Pills (OCPs) or tablets :
• Inserted by doctors or expert nurses in uterus.
• Measures Taken By Government To Check Population Growth Rate : • IUDs are one of the most widely accepted method Parameter Non-steroidal Steroidal
• Decline in death rate. • Motivate smaller families by using various contraceptive methods with slogans of contraception in India.
• Rapid decline in maternal mortality rate (MMR). "Hum do Hamare do", advertisements and posters.
• Decrease in infant mortality rate (IMR). • Urban couples adopting : "One child norm". Progestogens (Prg)
Example or
• Increase in number of people in reproducible age. • Statutory raising of marriageable age: Saheli. alone or combination
composition. of Prg and Estrogens (Est).
• Increase in health facilities. • Female to 18 years.
• Male to 21 years.
Types
• Incentives given to couples with small families. Inhibit ovulation
Mode of Interferes & implantation;
• Non medicated IUDs. also alter the quality
• Example:
• Medicated IUDs. action. with implantation. of cervical mucus to

4) BIRTH CONTROL/CONTRACEPTION "Lippe's loop". retard entry of sperms.

Pills have to be taken daily for

Dosage. a period of 21 days starting
'Once a week' pill. preferably within
first 5 days of menstrual cycle.
• Features of an ideal contraceptive:
• User-friendly. • There are two principle methods Parameter Copper coated IUDs
• Easily available. of birth control: • Examples
Hormone releasing IUDs
Progestasert, LNG-20:
Cu7, Multiload 375:
• Increase phagocytosis High contraceptive value Pills are very effective with
• Effective. of sperms within uterus.
Effectiveness. lesser side effects & well
• Natural methods. • Make the uterus unsuitable with very few side effects. accepted by females.
• Reversible.
• No/least side-effects.
• Artificial methods. • Mode of for implantation & cervix
hostile to the sperms.
• Cu ions suppress sperm
motility and fertilising

• No interference with libido or act of coitus. Action capacity of sperms.

CuT Saheli was developed at CDRI, Lucknow, Uttar Pradesh.

5) NATURALTRADITIONAL METHODS
• Principle of avoiding physical meeting of the egg and sperms.
(V) Implants :
• Chances of failure are high. • Placed under skin.
• Effective periods are much longer.
Method Mode of Action (MoA) • Composition: Progestagens alone/Combination of Progestagens and Estrogens.
Couples abstain from coitus from day 10 to 17 of the menstrual cycle i.e. fertile period.
Periodic abstinence :
• Mode of Action (MoA).
Insemination is avoided as the male partner, Coitus interruptus, withdraws his penis from
Withdrawal method : the vagina just prior to ejaculation.
• Inhibit ovulation and implantation.
Lactational amenorrhea :
Absence of menstruation upto 6 months during period of intense lactation • Alter the quality of cervical mucus to retard entry of sperms.
following parturition.
• Injections usually share similar MoA and composition as implants.
(VI) Emergency contraceptives : (VII) Surgical/Sterilisation methods :
• Poor reversibility but highly effective.
11) INFERTILITY
• Mode of action
Blocks gamete transport. • Infertile couple : Unable to produce children inspite of 2 years of unprotected sexual co-habitation.

Types Charateristics Types

• Progestogens. • Effective within 72 hrs of coitus.
• Used to prevent contraception
• Combination of Prg + Est.
resulting from rape or Tubectomy Vasectomy Psychological
• IUDs. unprotected intercourse.

• In females: • In males:
• Cut and tie • Cut and tie Physical Congenital
fallopian tubes. vas deferens.
• Incision in • Small incision
abdomen or on the scrotum. Reasons
8) MEDICAL TERMINATION OF PREGNANCY through vagina. Diseases for infertility
Immunological
(MTP)/INDUCED ABORTION :

• MTP : Intentional or voluntary termination of

pregnancy before full term. • Permission of how many medical practitioners is
• MTP was legalized in India in 1971 . needed for MTP depending on duration of gestation?
Help for infertile couples comes in the form of
• When can MTP be performed? ASSISTED REPRODUCTIVE TECHNOLOGIES (ART).
• Unwanted pregnancy due to rape, failure of
contraception, casual unprotected intercourse.
less than/upto
• If continuation of pregnancy could harm the
12 weeks. More than 12 but In-vitro fertilisation :
mother of foetus or both. Parameter : in-vivo fertilisation:
less than • Outside the body in simulated • In the female
24 weeks. (i) Site of fertilisation conditions in laboratory reproductive tract
(ii) Can female produce ova ? • Yes • No
(iii) Embryo transfer. • Yes • No
(iv) Example of techniques. • ZIFT, IUT, ICSI • GIFT, Al, IUI

• Intention behind MTP amendment 9) AMNIOCENTESIS :

act 2017 : • Analyse foetal cells and dissolved substances from
• Reduction in the incidence of illegal abortion. amniotic fluids. Site of Embryo Transfer (ET)
• Decrease consequent maternal mortality and morbidity. • Technique used to check for genetic disorders such as based on number of blastomeres :
• MTPs are safe upto 12 weeks but riskier in 2nd trimester Down’s syndrome, hemophilia, sickle-cell anemia etc.
yet both are legal. • Statutory ben on this technique in India to prevent
• Amniocentesis and MTPs have been misused in context female foeticide.
of female foeticide.

10) SEXUALLY TRANSMITTED INFECTIONS (STIS) : • Symptoms and complications of STIs : Parameter : Upto 8 blastomeres : More than 8 blastomeres:
• Location. In fallopian tube.
• Alternately named: Venereal diseases (VD) or In uterus.
• Technique. • ZIFT: zygote Intra
reproductive tract infections (RTls). • IUT: Intra uterine
fallopian transfer. transfer fallopian
• High vulnerability/risk group: 15-24 years.
• Mode of transmission (MoT): Sexual intercouse. 1 Early detection
2 Late detection
transfer.

Category Disease Symptoms Complications

Pelvic inflammatory
1 Bacterial Gonorrhea, Syphilis, Chlamydiasis. Itching, fluid discharge, diseases (PIDs),
slight pain, swellings abortions, still births,
ectopic pregnancies, • Other details of ART involved :
2 Protozoan Trichomoniasis. in the genital region.
infertility, cancer of
reproductive tract. (i) ICSI : Intra cytoplasmic sperm injection :
Genital herpes, Hepatitis-B, Genital warts, AIDS.
3 Viral
• Sperm injected directly into the egg.

• Bacterial and protozoan diseases are completely

• Preventive measures to avoid STIs: (ii) Artificial Insemination (AI):
• Semen introduced in vagina or uterus.
curable if detected early and treated properly. • Avoid sex with unknown partners/multiple
• Low sperm count or inability of male to inseminate female.
• Other MoT for hepatitis-B virus and HIV infection include: partners. • IUI : Intra uterine insemination.
• Sharing of injection needles, surgical instruments with infected persons. • Always try to use condoms during coitus. (iii) GIFT : Gamete intra fallopian transfer:
• Transfusion of blood.
• From infected mother to foetus. • Female can provide conditions for fertilisation and further development.