Reproductive Health | CBSE Biology Class 12 Notes
⮚ Reproductive Health
✔ General Meaning:
o It refers to healthy reproductive organs with normal functions.
✔ As per WHO:
o It refers to a total well-being in all aspects of reproduction, i.e., physical, emotional, behavioural and social.
⮚ Problems and Strategies
✔ Family Planning Programmes (1951)
o Included action plans and programmes at a national level to attain total reproductive health as a social goal.
✔ Reproductive and Child Health Care (RCH) programmes.
o Improved programmes covering wider reproduction-related areas.
✔ Aim/Goals of these programmes:
o Creating awareness among people about various reproduction related aspects
o Providing facilities and support for building up a reproductively healthy society.
⮚ How to create awareness?
o By Governmental and NGO – by audio-visual and print media on reproduction related aspects.
o Sex education in school to provide right information and avoid misconception and myths.
o Proper information about sex organs, adolescence and changes related with it, safe and hygienic sexual practices, STDs, AIDS, etc.
o Educating people in the fertile and marriageable age regarding the following:
▪ birth control options
▪ care of pregnant mothers,
▪ post-natal care of the mother and child,
▪ importance of breast feeding,
▪ equal opportunities for the male and the female child, etc.
o Awareness on the following so as to make people think and take up necessary steps to prevent them and thereby build up a socially responsible and healthy society
▪ Problems due to uncontrolled population growth,
▪ social evils like sex-abuse and sex-related crimes, etc.
⮚ Statutory ban on amniocentesis
o In amniocentesis some of the amniotic fluid of the developing foetus is taken to analyse the fetal cells and dissolved substances.
▪ This biochemical analysis allows the detection of various genetic disorders like down syndrome, haemophilia, sickle cell anemia, etc.
o It was also misused to determine the sex of the child in the foetal stage and if the foetus is that of a female, it would lead to female foeticide.
o This is why the government has placed Statutory ban on amniocentesis.
⮚ Cause for the decline of IMR & MMR
o IMR – Infant Mortality Rate ; MMR – Maternal Mortality Rate
o Better awareness about sex related matters,
o increased number of medically assisted deliveries
o better post-natal care
⮚ Indicators of improved reproductive health of the society
o decreased maternal and infant mortality rates,
o increased number of couples with small families,
o better detection and cure of STDs
o overall increased medical facilities for all sex-related problems, etc.
⮚ Population stabilisation
⮚ Reason for explosive impact on the growth of population
o A rapid decline in death rate,
o A rapid decline in maternal mortality rate (MMR)
o A rapid decline in infant mortality rate (IMR)
o an increase in number of people in reproducible age
⮚ Steps taken by government to check this explosive population growth rate
o Motivation of smaller families by using various contraceptive methods
▪ advertisements in the media as well as posters/bills, etc., showing a happy couple with two children with a slogan Hum Do Hamare Do.
o Statutory raising of marriageable age of the female to 18 years and that of males to 21 years.
o Incentives for couples with small families.
⮚ Birth Control
⮚ Features of an ideal Contraceptive
o Should be user-friendly,
o It should be easily available,
o It must be effective and reversible with no or least side-effects.
▪ Here reversible means the couple should be in a condition to have child in future.
o It should not interfere with the sexual drive, desire and/or the sexual act.
✔ Conception: Process of becoming pregnant.
✔ Contraception: Birth control of prevention of pregnancy.
⮚ Natural methods of contraception
o Principle of working: Prevent the meeting of sperm and ovum.
o Benefit: Side effects are almost nil as there is no medicine or devices involved.
o Drawback: Chances of failure is high.
1. Periodic Abstinence
o The couple should avoid coitus/sexual intercourse during the fertile period of the female.
▪ Fertile period of the female – day 10 to 17 of the menstrual
▪ cycle when ovulation could occur.
2. Withdrawal or Coitus Interruptus
o The male partner withdraws his penis from the vagina just before ejaculation.
o This prevents insemination and thereby prevents fertilisation.
3. Lactational amenorrhea
o Ovulation and menstruation do not occur during the period of intense lactation following parturition.
▪ as long as the mother breast-feeds the child fully, chances of conception (pregnancy) is almost nil.
o It is effective only up to a maximum period of six months following parturition.
⮚ Artificial methods of contraception
1. Mechanical barrier
o Physical meeting of the sperm and ovum is prevented.
o Can be used by both male and female.
o E.g.-1 Condom
▪ Barrier made up of thin rubber/latex sheath that are used just before coitus
▪ The ejaculated semen does not enter the female reproductive tract
▪ In male – used for covering the penis
▪ In female – used for covering the vagina and cervix.
▪ A popular brand – Nirodh
▪ It also prevents the transmission of STIs like AIDS
o E.g.-2 : Diaphragms, cervical caps and vaults
▪ Barrier made up of rubber
▪ Placed inside the female reproductive tract to cover the cervix during coitus.
▪ Prevent the entry of sperm into the cervix thereby prevent conception.
▪ These are reusable.
o Increasing the contraceptive efficiency:
▪ Use of Spermicidal creams, jellies and foams along with these barriers.
2. Intra Uterine Devices (IUDs)
o A T-shaped device that is placed inside the uterus of the female.
o The IUDs are inserted by doctors or expert nurses.
Types of IUDs
▪ Non-medicated IUDs
● Lippes loop
▪ Copper releasing IUDs
● CuT, Cu7, Multiload 375
▪ Hormone releasing IUDs
● Progestasert, LNG-20
Mechanism of functioning of IUDs
▪ It increases phagocytosis of sperms within the uterus
▪ Cu ions released suppress sperm motility and the fertilising capacity of sperms.
▪ Hormone releasing IUDs make the uterus unsuitable for implantation and the cervix hostile to the sperms.
3. Pills / Oral contraceptives
o Available in the form of tablets.
o Composition of pills:
▪ Small dose of progesterone only
▪ Small dose of progestogen–estrogen combinations
o Mechanism of action of pills:
▪ Inhibit ovulation and implantation
▪ Alter the quality of cervical mucus to prevent/retard entry of sperms
o Dosage of pills:
▪ Daily for 21 days of the menstrual cycle.
● It should start within the first five days of menstrual cycle.
▪ Then a gap of 7 days (during menstruation).
▪ This cycle to be repeated till the time the female wants to prevent conception.
Saheli :
o Oral contraceptive pill developed by CDRI Lucknow
▪ CDRI- Central Drug Research Institute
o Non-steroidal in nature
▪ Low side effect with high contraceptive value
o Needs to be taken only once a week.
Injections or implants under the skin :
o Composition: Progestogens alone or in combination with estrogen
o Mode of action: Similar to pills
o Benefit: effective periods are much longer than pills
Emergency contraceptives
o Female can take progesterone or estrogen-progesterone combination preparations.
o It must be taken within 72 hours of coitus.
o Useful to prevent pregnancy in cases of rape or casual unprotected intercourse.
4. Surgical method/Sterilisation
o Terminal method of contraception
o Non-reversible
▪ There will be no more pregnancy
o Mechanism: Surgical procedure blocks the gamete transport and thereby prevents conception.
Vasectomy
o Sterilisation method in male.
o A small portion of the vas deferens is removed or cut and tied.
o The surgery is performed by making an incision in the scrotum.
Tubectomy
o Sterilisation method in female.
o A small portion of the fallopian tube is removed or cut and tied.
⮚ Ill effects of artificial contraceptives
o Nausea
o Abdominal pain
o Breakthrough bleeding
o Irregular menstrual bleeding
o Breast cancer
⮚ Medical Termination of Pregnancy (MTP)
✔ Also known as induced abortion:
o Intentional or voluntary termination of pregnancy before full term (complete development of foetus).
⮚ Why MTP is required?
o To get rid of unwanted pregnancies either due to
▪ casual unprotected intercourse
▪ failure of the contraceptive used during coitus
▪ rapes
▪ In case the continuation of the pregnancy could be harmful or even fatal either to the mother or to the foetus or both.
⮚ When MTPs are performed
o Safe in the first trimester (up to 12 weeks of pregnancy)
o Riskier in the second trimester.
⮚ Misuse of MTPs
o Amniocentesis is misused to determine the sex of the unborn child.
o In case the foetus is found to be female – MTP is performed – female foeticide.
⮚ Sexually Transmitted Infections (STIs)
✔ Also known as venereal diseases (VD) or reproductive tract infections (RTI) or sexually transmitted diseases (STDs).
✔ STIs caused by Bacteria:
o Gonorrhoea
o Syphilis
o Chlamydiasis
✔ STIs caused by Protozoa:
o Trichomoniasis
✔ STIs caused by Virus:
o Genital herpes
o Genital warts
o Hepatitis-b
o Aids
✔ 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.
✔ Most of these STIs are completely curable expect for hepatitis-B, genital herpes and HIV infections.
✔ Early symptoms of STIs includes the following in the genital region :
o itching, fluid discharge, slight pain, swellings, etc.,
✔ In case proper treatment is done at early stages of infection it could lead to complications such as:
o Pelvic inflammatory diseases (PID)
o Abortions
o Still births
o Infertility
o Even cancer of the reproductive tract
o Ectopic pregnancies (pregnancy in which the embryo attaches outside the uterus / extrauterine pregnancy)
✔ Simple principles to prevent STIs:
I.Avoid sex with unknown partners/multiple partners.
II.Always try to use condoms during coitus.
III.In case of doubt, one should go to a qualified doctor for early detection and get complete treatment if diagnosed with infection.
⮚ Infertility
✔ Reasons of Infertility
o physical, congenital, diseases, drugs, immunological or even psychological.
✔ Infertility Clinics:
o Specialised health care units that could help in diagnosis and corrective treatment of infertility.
⮚ Assisted Reproductive Technologies (ART)
o Special techniques to help infertile couples to have children.
Method #1: (Test tube baby programme)
o IVF is followed by ET
▪ IVF- In vitro fertilization: fertilisation outside the body
▪ ET – Embryo Transfer
o Mechanism:
▪ Ovum is collected from wife/donor female
▪ Sperm is collected from husband/donor male
▪ The collected ova and sperm are then fertilised in the laboratory.
▪ The zygote is then placed back in the female by either of the two following techniques:
● ZIFT (zygote intra fallopian transfer)
o zygote or early embryos (with up to 8 blastomeres) transferred to the fallopian tube.
● IUT (Intra Uterine Transfer)
o Embryo with more than 8 blastomeres are transferred to the uterus.
o Embryos formed by in-vivo fertilisation also could be used for such transfer to assist those females who cannot conceive.
▪ In-Vivo fertilization – fusion of gametes within the female
Method #2 : GIFT (gamete intra fallopian transfer)
o Condition : If female cannot produce ovum, but can provide suitable environment for fertilisation
o Mechanism:
▪ Ovum is collected from a donor.
▪ Then it is transferred into the female who cannot produce the ovum.
▪ The further development continues as in normal individuals.
Method #3: ICSI (Intra cytoplasmic sperm injection)
o Sperm is directly injected into the ovum to create the embryo in the laboratory condition.
Method #4 : AI (Artificial Insemination)
o Condition: If the reason of infertility is due to either one of the following reasons:
▪ Inability of male partner to inseminate
▪ Very low sperm count
o Mechanism:
▪ Semen is collected from the husband / healthy donor.
▪ It is artificially introduced either in the vagina or into the uterus (IUI – intra-uterine insemination) of the female.
⮚ Possible drawbacks of ART
o These facilities are presently available only in very few centres in the country.
o High cost associated.
o Many may not accept these methods due to emotional, religious and social factors.
Legal adoption is one of the best alternate methods for infertile couples looking for parenthood
