REPRODUCTIVE HEALTH

WHAT IS REPRODUCTIVE HEALTH?

World Health Organisation (WHO) defines:

Reproductive health is a total well-being in all aspects of reproduction i.e., physical,
emotional, behavioural & social.

REPRODUCTIVE HEALTH: PROBLEMS AND STRATEGIES

Sa m il y India initiated reproductive health

programmes (family planning) in
1951.
Wider reproduction-related areas
RCH
are in operation under the
Reproductive & Child Health Care
PLANNING (RCH) programmes.

foiology.com
REPRODUCTIVE HEALTH: PROBLEMS AND STRATEGIES
Such programmes deal the
following
Give awareness about reproduction ction c o
organism
related aspects for creating a
reproductively healthy society.
reproduction love
gtion emotional Spen
Educate people about birth control, care
of pregnant mothers, post-natal care of
mother& child, importance of breast
nism
duction
X stdc
tionship female an
feeding, equal opportunities for male & protectionc o
female child etc.

Awareness of problems due to erm

population explosion, social evils like
sex-abuse and sex-related crimes, etc.

www.bankoiajolo9y.com

REPRODUCTIVE HEALTH: PROBLEMS AND STRATEGIES

EducaHOh Aims & needs of sex education in

et schools

T o provide right information about sex-

related aspects. It helps to avoid sex-
related myths and misconceptions.
T o give proper information about
reproductive organs, adolescence and
related changes, safe and hygienic
sexual practices, sexually transmitted
diseases (STD), AIDS etc.

www.bankofbiology.com

PoPULATION EXPLOSION
&BIRTH CONTROL
ww.bankb
POPULATION EXPLOSION & BIRTH CONTROL

In 1900, the world

population was around 2
billion (2000 million). By
2000, it rocketed to about 6
billion.

POPULATION EXPLOSION & BIRTH CONTROL

In India, population was

nearly 350 million at the time
of independence. It reached 1
billion by 2000 and crossed
1.2 billion in May 2011.
It means every sixth person
in the world is an Indian.

POPULATION EXPLOsION & BIRTH CONTROL

According to the 2011

census report, our
population growth rate was
less than 2% (i.e.
20/1000/year), a rate at
which our population could
increase rapidly.

ww
POPULATION EXPLOSION & BIRTH CONTROL

Reasons for population explosion

Increased health facilities and better

living
conditions
Arapid decline in death rate, maternal mortality
rate (MMR) and infant mortality rate (IMR).
Increase in
numberof people in reproducible
age.

POPULATION EXPLOSION & BIRTH CONTROL

Impacts of population explosion

Scarcity of basic requirements (food,

shelter and clothing).

POPULATION EXPLOSION & BIRTH CONTROL

Control measures

Motivate smaller families by using

contraceptive methods
Aware peoples about a slogan Hum Do
Hamare Do (we two, our two). Many
couples have adopted a 'one child norm
Statutory rising of marriageable age of
females (18 years) and males (21 years).
 CONTRACEPTIVE METHODS
Properties of an ideal
contraceptives

User-friendly
Easilyavailable
Effective
GYNOL Ir Reversible
No or least side-effects
Should not interfere with sexual drive,
desire & sexual act.

www.bankotbiolo9y.com

CONTRACEPTIVE METHODS

Natural/ Traditional methods

Barriers

Intra Uterine Devices (IUDs)

Oral contraceptives

Injectables

Surgical methods (sterilization)

www.bankotbiology.com

1. Natural/Traditional methods
Contraceptive
methods
Avoiding chances of ovum and sperms meeting.

LEEDING
Types of
AuLE
INFERTILE
ATS
Natural/Traditional Methods
ERTILE
JATS

Periodic Coitus Lactational

abstinece interruptus amenorrhea

LAUMA bankofhinloCV nom

 1. Natural/Traditional methods
Contraceptive
methods
Periodic abstinence: Avoid coitus from day 10
to 17 of the menstrual cycle (fertile period).

LEEDING Coitus interruptus (Withdrawal):

NFE LE
Withdraw penis from the vagina just before
DAYS NFERTILE
DAYS ejaculation to avoid insemination.
ERTILE
Lactational amenorrhea: It is the absence of
menstrual cycle & ovulation due to intense
lactation after parturition. Fully breastfeeding
increases lactation. This method helps to prevent
conception. This is effective up to 6 months
following parturition.
It has no side effect. But chances of failure are high.
www.bankofbiology.com

2. Barriers
Contraceptive
methods
They prevent physical meeting of sperm & ovum.
E.g. Condoms, Diaphragms, cervical caps & vaults.

Condoms
Condom for male Made ofrubber/latex sheat
Condoms for male: Cover the penis.
Condoms for female: Cover the vagina & cervix.
Condoms are used just before coitus. They
prevent the entry of semen into female
reproductive tract.
Nirodh': Popular condoms for males.
Condom for female
www.bankofbiology.com

2. Barriers
Contraceptive
methods
They prevent physical meeting of sperm & ovum.
E.g. Condoms, Diaphragms, cervical caps & vaults.

Condoms

Why Condoms are very popular?

It protects the user from STDs and AlDS.

It is disposable.

It can be self-inserted and thereby give

privacy to user.

www.bankofbiology.com
 2. Barriers
Contraceptive
methods

Diaphragms, cervical caps &vaults

a Made of rubber and are inserted into the female
reproductive tract to cover the cervix during
coitus.

They block the entry of sperms through the cervix.

They are reusable.
GYNOL I Spermicidal creams, jellies & foams are used along
with these barriers to increase their contraceptive
efficiency.

www.bankotbiology. com

3. Intra Uterine Devices (IUDs)

Contraceptive
methods
These are inserted by doctors or nurses in the
uterus through vagina.
They increase phagocytosis of sperms.
IUDs are ideal method to delay pregnancy or
space children.

Types of IUDs

Non-medicated
TUDs
CopperIUDs
releasing Hormone
releasing IUDs

www.bankofbiology.com

Contraceptive 3. Intra Uterine Devices (IUDs)

methods Types of IUDs

Non-medicated IUDs:
They retard sperm motility.
Also have spermicidal effect. E.g. Lippes loop.

www.hankofninlngY GAm
 Contraceptive 3. Intra Uterine Devices (IUDs)
methods
Types of IUDs

Copper releasing IUDs: Cu ions suppress

motility and fertilising capacity of sperms. E.g.
CuT, Cu7, Multiload375.

Cu T Cu 7 Multiload375

www.bankofbiology.com

Contraceptive 3. Intra Uterine Devices (IUDs)

methods
Types of IUDs

Hormone releasing IUDs:

They make the uterus unsuitable for
implantation and the cervix hostile to the
sperms. E.g. Progestasert, LNG-20.

LNg Reservoir
********* Vertical Stem
**
Membrane

******-****
www.bankofbiology.com

4. Oral contraceptives
Contraceptive
methods
Oral administration of progestogens or
progestogen-estrogen combinations in the
Tdiol28 form of tablets (pills).
idiol Pills are taken daily for 21 days starting within
the first five days of menstrual cycle. After a gap
of 7 days (menstruation period), it should be
repeated in the same pattern till the female
desires to prevent conception.
They inhibit ovulation & implantation and
thicken cervical mucus to prevent entry of
sperms.
Pills are very effective with lesser side effects.

www.bankofbiology.com
 4. Oral contraceptives
Contraceptive
methods

Saheli
New oral cont1 eptive for the females
AA
It is developed by Central Drug Research
Institute (CDR) in Lucknow.
Saheli It contains a non-steroidal preparation.
It is a 'once a week' pill with very few side
effects and high contraceptive value.

www.b fbic

5. Injectables
Contraceptive
methods
Progestogens or Progestogens-oestrogen
combination are used by females as injections or
implants under skin.
Their mode of action is Hike that of pills and their
effective periods are much longer.

Progestogens or progestogen-oestrogen
combinations& IUDs are used as emergency
contraceptives within 72 hours of coitus.
ubde
It avoids pregnancy due to rape or casual
Inmplant is P
of arm intercourse.

www.bankotbiology.com

6. Surgical methods (Sterilization)

Contraceptive
methods
It helps to block gamete transport and thereby
prevents conception.
It is very effective but reversibility is poor.

Types of surgical methods

Vasectomy Tubecto y

www bankofbioloOv.com
 Surgical methods (Sterilization)
Contraceptive
methods
Vasectomny
inal ve

Vas deferens
/tied and cut

Sterilization procedure in males.

In this, a small part of the vas deferens is
removed or tied up through a small incision on
the scrotum.

www.bankofbiology.com

6. Surgical methods (Sterilization)

Contraceptive
methods
Tubectomy
Cautertzation of

fallopian tubes
Falloplan tubes Cautery-
ued and cut

Fallopian tubes
sealed shut

Sterilization procedure in females.

In this, a small part of the fallopian tube is
removed or tied up through a small incision in
the abdomen or through vagina.

bankofbiology.com

Side-effects of anti-natural
Contraceptive Contraceptive methods
methods
Nausea

Abdominal pain

Breakthrough bleeding

Irregular menstrual bleeding

Breast cancer

www.bankofbiology.com
 MEDICAL TERMINATION
OF PREGNANCY (MTP)
www.bankofbiology.comn

MEDICAL TERMINATION OF PREGNANCY (MTP)

Intentional or voluntary termination of

pregnancy before full term is called MTP or
induced abortion.
4 5 to 50 million MTPs are performed in a year
all over the world (i.e. 1/5th of total number of
conceived pregnancies).
MTP helps to decrease
thepopulation.
Many countries have not legalised MTP due to
emotional, ethical, religious and social issues.
Government of India legalised MTP in 1971
with some strict conditions to check illegal
female foeticides.
Owww.medind
www.bankoftbiólogycom

MEDICAL TERMINATION OF PREGNANCY (MTP)

A. A speculum is placed in the
is
clamped to
Amnion enoculum
Dterus
is Inserted into the uteru Importance of MTP
Placenta To avoid unwanted pregnancies due to
fenaculum
9 week
fetus
casual intercourse or failure of the
Cannula contraceptive used during coitus or
rapes.
I t is essential in cases where continuation
Speculum

ofpregnancy could be harmful to the

mother or to the foetus or both.
Cut-away view of mothers pelvis

MTPs are safe during the first trimester, (up to 12 weeks of

pregnanc), 2d trimester abortions are very risky.
 MEDICALTERMINATION OF PREGNANCY (MTP)

Problems related with MTPs

Majority of the MTPS are performed
illegally.
Utrasound
Misuse of amniocentesis test for foetal
transducer
sex determination. If the foetus is

adde
female, it is followed by MTR Such
empty practices are dangerous for the young
mother and foetus.
cIvty

Amnio ntesis: In this, some amniotic fluid of the

foetus is taken to analyse the fetal cells & dissolved
substances. It is used to test the presence of genetic
Amniocentes is disorders, survivability of the foetus etc.

MEDICAL TERMINATION OF PREGNANCY (MTP)

Government of India enacted The

Medical Termination of Pregnancy
(Amendment) Act, 2017 to reduce
illegal abortion and consequent
Ultasound
maternal mortality and morbidity.
ansauce
Fascia
According to this Act, a pregnancy
BAadder
empiy
may be terminated within the first
wa
12 weeks on the opinion of a
registered medical practitioner.
cvity

fthe pregnancy is between 12-24

weeks, two registered medical
practitioners must be of the opinion.
Amniocentesis

www.bankofbiology.com

SEXUALLY TRANSMITTED DiSEASES www.bankofbiology.com

 SEXUALLY TRANSMITTED DISEASES (STDs)

Diseases transmitted through sexual intercourse are called Sexually

transmitted diseases /infections (STDs or STIs)/ Venereal diseases (VD) or
Reproductive tract infections (RT)
E.g. Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts,
trichomoniasis, hepatitis-B & HIV leading to AIDS.

Gonorrhea Genital
herpes Genital warts

www.bankofbiology.com

SEXUALLY TRANSMITTED DISEASES (STDs)

Hepatitis-B & HIV are also

Unprotected Sharing transmitted
sex with an
needles o By sharing of injection needles,
infected with
partner infected surgical instruments etc.
person
o
By transfusion of blood.
o From infected mother to
foetus
Except hepatitis-B, genital herpes &
Transmission Infection HIV, other diseases are completely
from infected from blood
mother to products curable if detected early and
fetus
treated properly.

www.bankofbiology.com

SEXUALLY TRANSMITTED DISEASES (STDs)

NORMAL PREGNANCY ECTOPIC PREGNANCY
ndoteroa

ay
Ulerus

Uterus Ovary
Fallopian tube
Endometr

Pelvicinlammatory disease

Symptomns
Early symptoms: Itching, Nuid discharge, slight pain, swellings, etc, in genital region.
Absence or less significant early symptoms and the social stigma deter the infected
persons to consult a doctor.
This leads to complications such as pelvic inflammatory diseases (PID), abortions, still
births, ectopic pregnancies, infertility or cancer of the reproductive tract.

www.bankofbiology.com
 SEXUALLY TRANSMITTED DISEASES (STDs
Prevention
1. Avoid sex with unknown partners/multiple
2. Always use condoms during coitus.
partners
3. In case of doubt, go to a qualified doctor for early detection and get complete
treatment.

All persons are vulnerable to STDs.

These are very high among persons in the age group of 15-24 years.

www.bankofbiology.com

bankofbio LNFERTILITY
INFERTILITY

it is the inability to conceive or produce

children even after 2 years of unprotected
sexual cohabitation.
The reasons for this may be physical,
congenital, diseases, drugs, immunological
or even psychological.
These disorders can be treated in infertility
clinics using Assisted Reproductive
Technologies (ART).

t0u hankofhi
 Assisted Reproductive Technologies (ART)
The technologies used to Gamete Intra
Fallopian
correct the infertility problems. Transfer
(GIFT)
In vitro Intra
fertilisation cytoplasmic
(VF-test
tube baby
Sperm
injection
programme) (ICSI)
ART

Artificial
Surrogacy insemination
(AI)

Assisted Reproductive Technologjes (ART)

1. In vitro fertilisation (IVF- test tube baby programme)

In this method, ova from the wife/donor and

Collection of sperms from the husband/donor are collected
Collectionof
from sperms from and are induced to form zygote under
female donor male donor
simulated conditions in the
laboratory
Pog production sbimulated This is followed by Embryo transfer (ET).
y hormone unerap

EGG RETRIEVAL

Types of Embryo Transfer

FERTILIZATION

EMBRYO
RANSFER
Zygoteintrafallopian Intra uterine transfer
transfer (ZIFT) (UT)
EMBRYOS

Assisted Reproductive Technologies (ART)

1. In vitro fertilisation (IVF- test tube baby programme)

Collection of Collection of Embryo Transfer (ET)

Pgg from sperms from
female donor male donor Zygote Intra Fallopian Transfer (ZIFT):
Transfer of zygote or early embryos (with up to
gg production stimulabed
Dy hormone therapy
8 blastomeres) into fallopian tube
Intra Uterine Transfer (UT): Transfer of
GG RETREvAL embryos with more than 8 blastomeres into
the uterusS

FERTILIZATION
Embryos formed by in vivo fertilisation (fertilisation
EMBRYO within the female) is also used for such transfer to
TRANSPER

assist those females who cannot conceive.

EMBRYOS

www.bankofbiology.com
 Assisted Reproductive Technologies (ART
2. Gamete Intra Fallopian Transfer (GIFT)

Catheter
Transfer of an ovum from a donor into the
fallopian tube of another female who cannot
produce ovum, but can provide suitable
environment for fertilization and
Fallopian development.
Tube

Ovary

www.bankotbiology.com

Assisted Reproductive Technologies (ART)

3. Intra cytoplasmic sperm injection (IcSI)

A laboratory procedure in which a

single sperm (from male partner) is
injected directly into an egg (from
female partner). After the fertilization,
the embryo is implanted into the
woman's uterus.

www.bankofbiology.com

Assisted Reproductive Technologies (ART)

4. Artificial insemination (Al) technique

Injected
Sperm
Washed
Sperm

The semen collected from husband or a donor is artificially introduced into the
vagina or the uterus of the female.
Artificial insemination into the uterus is known as intra-uterine insemination (IU).
This technique is useful for the male partner having inability to inseminate female
or low sperm counts etc.

www.bankofbiology.ci
Assisted Reproductive Technologies (ART)
5. Surrogacy

Here, a woman (surrogate mother) bears

a child for a couple unable to produce

children, because the wife is infertile or

unable to carry.
The surrogate is impregnated through
artificial insemination or implantation of
an embryo produced by IVE.

Assisted Reproductive Technologies (ART)

Problems of ART

V FC R A M B E
I t requires high precision handling
by specialized professionals and
expensive instrumentation.
Therefore, these facilities are
available only in very few centres.
Emotional, religious and social
problems.
RENT

www.banKOIDiology.com

Legal adoption is one

of the best methods
for couples looking
for parenthood

www.bankofbiology.com