Chapter: Reproductive Health

• Introduction & Need for Awareness

  • Definition by WHO: Total well-being in all aspects of reproduction
  • Problems & Strategies: RCH (Reproductive and Child Health care) programmes
  • Amniocentesis: Fetal sex determination test (Misused for female foeticide, legally banned)
  • Population Explosion: Reasons (decline in death rate, maternal mortality, infant mortality)

• Population Control & Birth Control

  • Ideal Contraceptive: User-friendly, easily available, effective, reversible, no side-effects
  • Natural / Traditional Methods
    • Periodic Abstinence (Safe period)
    • Withdrawal / Coitus Interruptus
    • Lactational Amenorrhea (absence of menstruation after parturition)
  • Barrier Methods
    • Condoms (Male and Female - prevent STIs)
    • Diaphragms, Cervical caps, Vaults (Reusable, used with spermicidal creams)
  • Intra Uterine Devices (IUDs)
    • Non-medicated (e.g., Lippes Loop)
    • Copper releasing (e.g., CuT, Cu7, Multiload 375)
    • Hormone releasing (e.g., Progestasert, LNG-20)
  • Oral Contraceptive Pills (OCPs)
    • Mechanism: Inhibit ovulation and implantation
    • Ingredients: Progestogens or Progestogen-Estrogen combinations
    • Examples: Saheli (non-steroidal, once-a-week pill developed in India)
  • Injectables and Implants: Progestogens under skin or as injections
  • Surgical Methods (Sterilization)
    • Vasectomy in males (cutting/tying vas deferens)
    • Tubectomy in females (cutting/tying fallopian tubes)

• Medical Termination of Pregnancy (MTP)

  • Definition: Intentional or voluntary termination of pregnancy before full term
  • Safety: Safe during first trimester (upto 12 weeks); 2nd trimester is more risky
  • Legal status in India: Legalized in 1971 with strict conditions to avoid misuse

• Sexually Transmitted Infections (STIs)

  • Other names: Venereal Diseases (VD) or Reproductive Tract Infections (RTIs)
  • Transmission: Unprotected sex, infected needles, blood transfusion, mother to fetus
  • Curable STIs: Gonorrhoea, Syphilis, Chlamydiasis, Trichomoniasis
  • Incurable STIs: Hepatitis-B, Genital Herpes, HIV/AIDS
  • Prevention: Avoid sex with unknown partners, use condoms, early detection and cure

• Infertility & Assisted Reproductive Technologies (ART)

  • Definition: Inability to produce children despite unprotected coitus
  • Causes: Physical, congenital, diseases, immunological, psychological
  • Test Tube Baby Programme
    • IVF (In Vitro Fertilization) - Fertilization outside the body
    • ET (Embryo Transfer)
  • Specific Techniques
    • ZIFT (Zygote Intra Fallopian Transfer): Zygote/early embryo (< 8 blastomeres) into fallopian tube
    • IUT (Intra Uterine Transfer): Embryo (> 8 blastomeres) into uterus
    • GIFT (Gamete Intra Fallopian Transfer): Transfer of ovum from donor into fallopian tube
    • ICSI (Intra Cytoplasmic Sperm Injection): Laboratory injection of sperm into ovum
    • AI (Artificial Insemination): Semen introduced into vagina or uterus (includes IUI - Intra-Uterine Insemination)