Reproductive health is defined as a state of complete physical, emotional, behavioural, and social well-being in all matters related to the reproductive system and its functions, and not merely the absence of disease or infirmity.
Definitions [5]
Define amniocentesis.
It is a technique in which amniotic fluid is withdrawn from the uterus of a pregnant lady and the amniotic cells are cultured and studied for cytological observations to determine any chromosomal abnormalities.
Definition: Reproductive Health
Definition: Birth Control
Birth Control refers to the regulation of conception by preventive methods or devices to limit the number of offspring.
Definition: Induced Abortion or Medical Termination of Pregnancy (MTP)
Intentional or voluntary termination of pregnancy before full term is called medical termination of pregnancy (MTP) or induced abortion.
Definition: Azoospermia
Azoospermia is defined as the absence of spermatozoa in the ejaculate semen on atleast two occasions and is observed approximately in 1% of the population.
Key Points
Key Points: Reproductive Health
- Reproductive health, as defined by WHO, refers to complete physical, emotional, behavioural, and social well-being in all aspects related to reproduction.
- India’s Reproductive and Child Health (RCH) programmes aim to promote reproductive health through family planning, maternal and child care, awareness creation, and access to medical facilities.
- Education and awareness, including sex education for adolescents, help prevent myths, sexually transmitted diseases (STDs), unsafe practices, and promote hygienic and responsible sexual behaviour.
- Preventive measures such as menstrual hygiene, genital cleanliness, planned parenthood, immunisation, and statutory bans on sex determination are essential for a healthy society.
- Sexually transmitted diseases like syphilis and gonorrhoea adversely affect reproductive health, highlighting the need for early diagnosis, treatment, and improved medical infrastructure.
Key Points: Initiatives for Reproductive Health Promotion
- India started family planning programmes in 1951 to improve reproductive health.
- Reproductive and Child Health (RCH) programmes focus on awareness, care and overall reproductive health.
- Education and awareness (including sex education) help remove myths and promote healthy practices.
- Healthcare support and facilities are important for a safe pregnancy, child care and family planning.
- Preventive measures like immunisation and laws (e.g., a ban on sex determination) improve society.
- Research and new methods (like contraceptives such as Saheli) help in better reproductive health.
- These efforts have led to reduced maternal & infant mortality and smaller family size.
Key Points: Population Stabilisation and Control Measures
- Rapid population growth is due to improved health facilities, reduced death rate, MMR, IMR, and increased life expectancy.
- Population explosion leads to a scarcity of basic needs such as food, shelter, and clothing, and affects national development.
- Birth control is essential to maintain a balance between the birth and death rates and to ensure the sustainable use of resources.
- Government measures include family planning programmes (RCH), promotion of the small-family norm, raising the marriageable age, and incentives for small families.
- Contraceptive methods and awareness through mass media help prevent unwanted pregnancies and control population growth.
Key Points: Birth Control
| Method | Basis of Action | Advantage | Examples |
|---|---|---|---|
| Barrier | Physical barrier; prevents sperm reaching egg | Protects against STDs; low failure rate | Condoms, Diaphragm, Cervical cap |
| Hormonal | Inhibits FSH → prevents egg development and ovulation | Highly effective; protects against ovarian and endometrial cancer | Mala-D, Saheli |
| IUDs | Increases phagocytosis of sperm; suppresses sperm motility | Highly effective; ideal for females | Cu-T, LNG-20, Lippes loop |
| Natural | Avoid intercourse during fertile periods | No side effects; no expenditure | Abstinence, Withdrawal, Lactational amenorrhea |
| Surgical | Prevents sperm release or egg transport (permanent) | Very reliable | Vasectomy (male), Tubectomy (female) |
Key Points: Natural Contraceptive Methods
| Method | Basis | Key Feature | Limitation |
|---|---|---|---|
| Calendar (Rhythm) method | Calculation of fertile days | Avoids intercourse during fertile period | Ovulation time may vary |
| Temperature method | Change in basal body temperature | Slight rise in temperature after ovulation | Stress/illness affects accuracy |
| Cervical mucus method | Change in cervical mucus | Thin, watery mucus indicates ovulation | Requires daily observation |
| Periodic abstinence | Avoiding coitus on days 10–17 | Prevents sperm–ovum meeting | Needs regular cycle |
| Lactational amenorrhoea | Suppressed ovulation during lactation | Effective during exclusive breastfeeding | Effective only up to 6 months |
Key Points: Artificial Contraceptive Methods
| Method | Type | Mode of Action | Examples |
|---|---|---|---|
| Barrier methods | Physical | Prevent entry of sperms into female tract | Male condom (Nirodh), Female condom (Femidom), Diaphragm, Cervical cap |
| Spermicides | Chemical | Kill sperms chemically in vagina | Creams, jellies, foams, suppositories |
| Intra-uterine devices (IUDs / IUCDs) | Mechanical / Chemical | Prevent implantation; reduce sperm motility | Lippes loop, CuT, Cu7, Multiload 375, LNG-20 |
| Hormonal methods | Hormonal | Inhibit ovulation; alter uterine lining | Combined pills, Mini pill, Saheli |
| Sterilization | Surgical | Permanently block gamete transport | Vasectomy (male), Tubectomy (female) |
| Medical termination of pregnancy (MTP) | Medical | Termination of early pregnancy | Vacuum aspiration (as per MTP Act) |
| Emergency contraception | Hormonal | Prevent pregnancy after unprotected sex | Levonorgestrel pills (within 72 hours) |
Key Points: Induced Abortion or Medical Termination of Pregnancy (MTP)
- Medical Termination of Pregnancy (MTP) is the voluntary termination of pregnancy before full term, also called induced abortion.
- MTP is done in cases of unwanted pregnancy or when fetal abnormalities are detected, often using amniocentesis.
- Amniocentesis is a diagnostic test that collects amniotic fluid to study fetal chromosomes and detect genetic defects.
- MTP is legally allowed in India under the MTP Act (1971, amended 2017), with conditions and is generally safe in the first 12 weeks.
- It requires the woman’s consent and a doctor’s approval and is allowed only when pregnancy risks the mother’s life or involves serious fetal abnormalities.
Key Points: Sexually Transmitted Diseases (STD) or Sexually Transmitted Infections (STI)
Key Points: Infertility
- Infertility is the inability to conceive after 12 months or more of regular unprotected intercourse and may be due to male, female, or both partners.
- Male infertility includes low sperm count, no sperm production, poor sperm motility, or abnormal sperm structure.
- Female infertility may result from hormonal imbalance, poor egg production, or defects in reproductive organs like the ovaries, fallopian tubes, uterus, or cervix.
- Mechanical or physiological problems, such as blocked reproductive tracts or thick cervical mucus, can prevent fertilisation.
- Infertility is diagnosed and treated by identifying the cause and using methods like hormonal therapy, surgery, or lifestyle changes.
- Assisted Reproductive Technologies (ART) help infertile couples and include IVF, ICSI, GIFT, ZIFT, AI, and IUI, which assist in fertilisation and conception.
Key Points: Assisted Reproductive Technologies (ART)
- ART refers to special techniques used to help infertile couples have children; it includes IVF, ZIFT, IUT, GIFT, ICSI, and AI.
- IVF (In Vitro Fertilisation) - Fertilisation occurs outside the body in a lab ("test tube baby"); the zygote/embryo is then transferred into the female.
- ZIFT - Zygote or embryo with up to 8 blastomeres is transferred into the fallopian tube; IUT - embryo with more than 8 blastomeres is placed directly into the uterus.
- GIFT (Gamete Intra Fallopian Transfer) - Ovum from a donor is transferred into the fallopian tube of a female who cannot produce eggs but can support fertilisation.
- ICSI (Intra Cytoplasmic Sperm Injection) - A single sperm is directly injected into the ovum using a microneedle; used in cases of low sperm count.
- AI (Artificial Insemination) - Semen from husband/donor is introduced into the vagina or uterus (IUI); used when the male cannot inseminate naturally or has a low sperm count.
- Disadvantages of ART - Requires specialised professionals and expensive equipment; affordable to only a limited number of people; emotional, religious and social factors are also deterrents.
Key Points: Assisted Reproductive Technology (ART)
| ART Method | Gametes Used | Site of Fertilisation | Stage Transferred | Site of Transfer | Main Indication |
|---|---|---|---|---|---|
| IUI | Sperm only | Inside body (fallopian tube) | No embryo transfer | Uterus | Low sperm count |
| IVF | Ovum + sperm | Outside body (laboratory) | Early embryo | Uterus | Blocked fallopian tubes |
| ET | Ovum + sperm | Outside body | >8 blastomeres | Uterus | After IVF |
| ZIFT | Ovum + sperm | Outside body | ≤8 blastomeres (zygote) | Fallopian tube | Tubal infertility |
| GIFT | Ovum + sperm | Inside body | Gametes | Fallopian tube | Ovulation-related issues |
| ICSI | Single sperm + ovum | Outside body | Early embryo | Uterus | Severe male infertility |
| Cryopreservation (FET) | Embryo | Outside body | Frozen embryo | Uterus | Future pregnancy |
| Surrogacy | Ovum + sperm | Outside body (IVF) | Embryo | Surrogate uterus | Uterine problems |
| TESE | Sperm | — | Used in ART | — | Azoospermia |
Concepts [10]
- Concept of Reproductive Health
- Initiatives for Reproductive Health Promotion
- Population Explosion and Control Measures
- Birth Control
- Natural Contraceptive Methods
- Artificial Contraceptive Methods
- Induced Abortion or Medical Termination of Pregnancy (MTP)
- Sexually Transmitted Diseases (STD) or Sexually Transmitted Infections (STI)
- Infertility
- Assisted Reproductive Technology (ART)
