Learning Objectives
- Understand reproductive health and related programmes
- Learn about various contraceptive methods
- Study sexually transmitted diseases (STDs)
- Understand infertility and assisted reproductive technologies (ART)
Key Concepts
Reproductive Health
According to WHO, reproductive health means total well-being in all aspects of reproduction — physical, emotional, behavioural, and social. India launched Family Planning Programme in 1951 (first country to do so). RCH (Reproductive and Child Health) programmes focus on awareness about reproduction, creating healthy society. Problems: population explosion, STDs, infertility.
Population Control and Contraception
Natural methods: Periodic abstinence (avoiding coitus during ovulation period — Day 10-17), Coitus interruptus (withdrawal), Lactational amenorrhea (no menstruation during intensive breastfeeding up to 6 months).
Barrier methods: Condoms (male and female — also prevent STDs), Diaphragm, Cervical caps, Vaults. IUDs (Intrauterine Devices): Non-medicated (Lippes loop), Copper-releasing (CuT, Cu7, Multiload 375 — Cu ions reduce sperm motility and fertilizing capacity), Hormone-releasing (Progestasert, LNG-20 — thicken cervical mucus, inhibit implantation).
Hormonal methods: Oral pills (Saheli — non-steroidal, once a week, centchroman), Injectable contraceptives (Depo-Provera), Implants (Norplant). Surgical methods (Sterilisation): Vasectomy (vas deferens cut in males — permanent), Tubectomy (fallopian tubes cut in females — permanent).
Emergency contraception: Within 72 hours of unprotected coitus (levonorgestrel pills). MTP (Medical Termination of Pregnancy): Legal in India up to 20 weeks (MTP Act, 1971). Used for unwanted pregnancies, foetal abnormalities.
Sexually Transmitted Diseases (STDs/STIs)
Bacterial: Gonorrhoea (Neisseria), Syphilis (Treponema), Chlamydiasis (Chlamydia). Viral: Genital herpes (Herpes simplex), Genital warts (HPV), AIDS (HIV), Hepatitis B (HBV). Protozoan: Trichomoniasis (Trichomonas). Fungal: Candidiasis (Candida). Prevention: avoid multiple partners, use condoms, regular check-ups.
Infertility and Assisted Reproductive Technologies (ART)
IVF (In Vitro Fertilization): Fertilization outside body in lab; embryo transferred to uterus — "test tube baby" (first: Louise Brown, 1978). ZIFT: Zygote transferred to fallopian tube (at zygote stage). IUI (Intra Uterine Insemination): Semen collected and artificially introduced into uterus. GIFT (Gamete Intra Fallopian Transfer): Ovum from donor + sperm transferred to fallopian tube. ICSI (Intra Cytoplasmic Sperm Injection): Single sperm injected directly into ovum. AI (Artificial Insemination): Semen from husband or donor used. Surrogacy: Another woman carries pregnancy.
Summary
Reproductive health encompasses physical, emotional, and social well-being in reproduction. Contraceptive methods range from natural to surgical. STDs are transmitted through sexual contact and can be prevented by safe practices. ART helps infertile couples achieve parenthood through techniques like IVF, ZIFT, GIFT, and ICSI.
Important Terms
- Saheli: Non-steroidal oral contraceptive (centchroman), once-a-week pill developed in India
- IVF: In Vitro Fertilization — test tube baby technique
- Amniocentesis: Prenatal diagnostic technique (banned for sex determination in India)
- Vasectomy: Surgical cutting of vas deferens in males
- Tubectomy: Surgical cutting of fallopian tubes in females
- MTP: Medical Termination of Pregnancy; legal up to 20 weeks in India
- ZIFT: Zygote Intra Fallopian Transfer — embryo at zygote stage transferred to tube
- Lactational amenorrhea: Absence of menstruation during breastfeeding
Quick Revision
- India's family planning programme started 1951 (first in the world)
- CuT: Cu ions reduce sperm motility; hormone IUDs thicken cervical mucus
- Saheli: non-steroidal, once weekly, centchroman (developed by CDRI, Lucknow)
- Vasectomy = males; Tubectomy = females (both permanent)
- STDs: Gonorrhoea, Syphilis (bacterial); AIDS, Herpes (viral)
- IVF = fertilization in lab; ZIFT = zygote to tube; GIFT = gamete to tube
- MTP legal up to 20 weeks in India
- Amniocentesis banned for sex determination (PCPNDT Act)