Reproductive Health
1. According to the World Health Organisation (WHO), reproductive health means a total well-being
in all aspects of reproduction, i.e., physical, emotional, behavioural and social.
2. India was amongst the first countries in the world to initiate action plans and programmes at a
national level to attain total reproductive health as a social goal.
3. These programmes called ‘family planning’ were initiated in 1951
4. Reproductive and Child Health Care (RCH) programmes’ Creating awareness among people about
various reproduction related aspects and providing facilities and support for building up a
reproductively healthy society
5. Statutory ban on amniocentesis for sex-determination to legally check increasing menace of
female foeticides, massive child immunisation, etc., are some programmes that merit mention in this
connection.
6. In aminocentesis some of the amniotic fluid of the developing foetus is taken to analyse the fetal
cells and dissolved substances.
7. This procedure is used to test for the presence of certain genetic disorders such as, down
syndrome, haemoplilia, sickle-cell anemia, etc., determine the survivability of the foetus.
8. Saheli’–a new oral contraceptive for the females–was developed by scientists at Central Drug
Research Institute (CDRI) in Lucknow, India.
9. The world population which was around 2 billion (2000 million) in 1900 rocketed to about 6 billion
by 2000 and 7.2 billion in 2011.
10. India’s population which was approximately 350 million at the time of our independence reached
close to the billion mark by 2000 and crossed 1.2 billion in May 2011.
11. A rapid decline in death rate, maternal mortality rate (MMR) and infant mortality rate (IMR) as
well as an increase in number of people in reproducible age are probable reasons for this.
12. Through our Reproductive Child Health (RCH) programme, though we could bring down the
population growth rate, it was only marginal.
13. according to the 2011 census report, the population growth rate was less than 2 per cent, i.e.,
20/1000/year, a rate at which our population could increase rapidly.
14. An ideal contraceptive should be user-friendly, easily available, effective and reversible with no
or least side-effects.
15. Natural methods work on the principle of avoiding chances of ovum and sperms meeting.
16. Periodic abstinence is one such method in which the couples avoid or abstain from coitus from
day 10 to 17 of the menstrual cycle when ovulation could be expected.
17. As chances of fertilisation are very high during this period, it is called the fertile period.
18. By abstaining from coitus during this period, conception could be prevented.
19. Withdrawal or coitus interruptus is another method in which the male partner withdraws his
penis from the vagina just before ejaculation so as to avoid insemination.
20. Lactational amenorrhea (absence of menstruation) method is based on the fact that ovulation
and therefore the cycle do not occur during the period of intense lactation following parturition.
21. this method has been reported to be effective only upto a maximum period of six months
following parturition.
22. Chances of failure, though, of this method are also high.
23. In barrier methods, ovum and sperms are prevented from physically meeting with the help of
barriers.
24. Condoms are barriers made of thin rubber/ latex sheath that are used to cover the penis in the
male or vagina and cervix in the female. This can prevent conception.25. ‘Nirodh’ is a popular brand
of condom for the male. Use of condoms has increased in recent years due to its additional benefit
of protecting the user from contracting STIs and AIDS.
26. Diaphragms, cervical caps and vaults are also barriers made of rubber that are inserted into the
female reproductive tract to cover the cervix during coitus.
27. They prevent conception by blocking the entry of sperms through the cervix. They are reusable.
28. Another effective and popular method is the use of Intra Uterine Devices (IUDs).
29. These Intra Uterine Devices are presently available as
1. the non-medicated IUDs (e.g., Lippes loop),
2. copper releasing IUDs (CuT, Cu7, Multiload 375) and
3. the hormone releasing IUDs (Progestasert, LNG-20).
30. IUDs increase phagocytosis of sperms within the uterus and the Cu ions released suppress
sperm motility and the fertilising capacity of sperms.
31. The hormone releasing IUDs, in addition make the uterus unsuitable for implantation and the
cervix hostile to the sperms.
32. It is one of most widely accepted methods of contraception in India.
33. Oral administration of small doses of either progestogens or progestogen–estrogen
combinations is another contraceptive method used by the females.
34. They are used in the form of tablets and hence are popularly called the pills.
35. Pills have to be taken daily for a period of 21 days starting preferably within the first five days
of menstrual cycle.
36. After a gap of 7 days (during which menstruation occurs) it has to be repeated in the same
pattern till the female desires to prevent conception.
37. They inhibit ovulation and implantation as well as alter the quality of cervical mucus to
prevent/retard entry of sperms.
38. Saheli–the new oral contraceptive for the females contains a non-steroidal preparation.
39. It is a ‘once a week’ pill with very few side effects and high contraceptive value.
40. Progestogens alone or in combination with estrogen can also be used by females as injections or
implants under the skin.
41. Their mode of action is similar to that of pills and their effective periods are much longer.
42. Administration of progestogens or progestogen-estrogen combinations or IUDs within 72 hours
of coitus have been found to be very effective as emergency contraceptives
43. Surgical methods, also called sterilisation, are generally advised for the male/female partner as
a terminal method to prevent any more pregnancies.
44. Sterilisation procedure in the male is called ‘vasectomy’ and that in the female, ‘tubectomy’.
45. In vasectomy, a small part of the vas deferens is removed or tied up through a small incision on
the scrotum.
46. whereas in tubectomy, a small part of the fallopian tube is removed or tied up through a small
incision in the abdomen or through vagina.
47. their possible ill-effects like nausea, abdominal pain, breakthrough bleeding, irregular menstrual
bleeding or even breast cancer.
48. Intentional or voluntary termination of pregnancy before full term is called medical termination
of pregnancy (MTP) or induced abortion.
49. Nearly 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.
50. Government of India legalised MTP in 1971 with some strict conditions to avoid its misuse.
51. MTPs are considered relatively safe during the first trimester, i.e., upto 12 weeks of pregnancy.
Second trimester abortions are much more riskier.
52. Infections or diseases which are transmitted through sexual intercourse are collectively called
sexually transmitted infections (STI) or venereal diseases (VD) or reproductive tract infections
(RTI).
53. Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and
of course, the most discussed infection in the recent years,
54. HIV leading to AIDS are some of the common STIs.
55. Some of these infections like hepatitis–B and HIV can also be transmitted by sharing of
injection needles, surgical instruments, etc., with infected persons, transfusion of blood, or from an
infected mother to the foetus too.
56. Except for hepatitis-B, genital herpes and HIV infections, other diseases are completely
curable if detected early and treated properly.
57. complications or STI include pelvic inflammatory diseases (PID), abortions, still births, ectopic
pregnancies, infertility or even cancer of the reproductive tract.
58. their incidences are reported to be very high among persons in the age group of 15-24 years.
59. One could be free of these infections by
(i) Avoid sex with unknown partners/multiple partners.
(ii) Always try to use condoms during coitus.
(iii) go to qualified doctor for early detection.
60. A large number of couples all over the world including India are infertile,
61. the couples could be assisted to have children through certain special techniques commonly
known as assisted reproductive technologies (ART).
62. In vitro fertilisation (IVF–fertilisation outside the body in almost similar conditions as that in
the body) followed by embryo transfer (ET) is one of such methods.
63. In this method, popularly known as test tube baby programme, ova from the wife/donor
(female) and sperms from the husband/donor (male) are collected and are induced to form zygote
under simulated conditions in the laboratory.
64. The zygote or early embryos (with upto 8 blastomeres) could then be transferred into the
fallopian tube (ZIFT–zygote intra fallopian transfer).
65. the embryos with more than 8 blastomeres, into the uterus (IUT – intra uterine transfer), to
complete its further development.
66. Embryos formed by in-vivo fertilisation (fusion of gametes within the female) also could be used
for such transfer to assist those females who cannot conceive.
67. Transfer of an ovum collected from a donor into the fallopian tube (GIFT – gamete intra
fallopian transfer) of another female who cannot produce one, but can provide suitable environment
for fertilisation and further development
68. Intra cytoplasmic sperm injection (ICSI) is another specialised procedure to form an embryo in
the laboratory in which a sperm is directly injected into the ovum.
69. Infertility cases either due to inability of the male partner to inseminate the female or due to
very low sperm counts in the ejaculates, could be corrected by artificial insemination (AI)
technique.
70. In this technique, the semen collected either from the husband or a healthy donor is artificially
introduced either into the vagina or into the uterus (IUI – intra-uterine insemination) of the
female.
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