TABLE OF CONTENTS

S.NO TOPIC PG.NO

1 Introduction - Reproductive health 2

2 Reproductive Health – Problems And 3

Strategies

3 Population Explosion And Birth Control 5

4 Goals Of Reproductive Health 6

5 Issues In Reproductive Health 7

6 Ways To Enhance Reproductive Health 8

7 Understanding Amenocentesis 9

8 Contraception 10

9 Medical Termination Pregnancy 23

10 Sexually Transmitted Disease 24

11 Infertility 26

INTRODUCT
ION – 1
REPRODUCT
IVE HEALTH
The WHO defines reproductive health as a state of complete
physical, mental and social well-being, and not merely the
absence of reproductive disease or infirmity. Reproductive
health involves all of the reproductive processes, functions
and systems at all stages of human life. This definition implies
that people are able to have a satisfying and safe sex life and
that they have the capability to reproduce and the freedom to
decide if, when and how often to do so. Men and women have
the right to be informed and to have access to safe, effective,
affordable and acceptable methods of family planning of their
choice that are not against the law. Furthermore, men and
women should have access to appropriate health care services
that will enable women to go safely through pregnancy and
childbirth, as well as to provide couples with the best chance
of having a healthy infant. Reproductive health is a universal
concern, but is of special importance for women particularly
during the reproductive years. However, men also demand
specific reproductive health needs and have particular
responsibilities in terms of women's reproductive health
because of their decision-making powers in some
reproductive health matters. Reproductive health is a
fundamental component of an individual’s overall health
status and a central determinant of quality of life

REPRODUCTIVE
2
HEALTH-
PROBLEMS
 Information about the problems and strategies of
reproductive health………

As per the WHO -World Health Organization, reproductive

health can be defined as a healthy, the total well-being and proper
functioning of reproductive organs in all phases of reproduction.
This includes a complete state of mental, physical, and social
well-being.

Problems and Strategies

The common problems or concerns associated with the
reproductive health are :

 Deformities.
 Overpopulation.
 Sexually Transmitted Diseases.
 the health of both the mother and her baby.
 Early marriages before attaining the puberty.
 An increased mortality rate of both mother and Infants.

Listed below are a few strategies followed to improve

Reproductive health.

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 The introduction of sex education is one of the steps taken
by the government which aims to create awareness among
the adolescents about safe sexual practices.
 As adolescents become eligible to reproduce, it is essential
to inform them about the consequences of unsafe sexual
practices and early pregnancy. It is achieved by the
implementation of ‘National Adolescent Education
Program’ at various schools from classes 9th to 12th.
 People in the marriageable group are educated all about
infertility, birth control methods, pregnancy, post-childbirth
care of the baby and mother, etc. It is also essential to
provide proper medical facilities to deal with obstacles like
infertility and other reproductive difficulties.
 There are a few evil practices related to reproduction that
still plague our society. Female infanticide is one such
example. In order to prevent this crime, a legal ban has been
put on Amniocentesis Test.

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 POPULATION
EXPLOSION
(a) The rapid increase in human population size over a
relatively short period is called human population-
explosion.
(b) Population growth rate depends on factors like fertility,
natality, mortality, migration, age and sex structure.
(c) Increased health facilities and better living conditions
are the cause behind population explosion.
(d) Out of 6 billion world population 1.3 billion
populations is of Indians.
(e) Rapid decline in death rate, Maternal Mortality
Rate (MMR) and Infant Mortality Rate (IMR) are major
cause of population growth.
(f) Growth rate of Indian population is around 1.7 percent.
(g) Most of the urban people are uneducated.

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(h) The regulation of conception by preventive methods or
devices to limit the number of offsprings is called Birth
Control.
(i) A birth control method which deliberately prevents
fertilization are referred to as contraception.
(j) Contraceptive methods are preventive methods and are
of two types – Temporary and Permanent.

GOALS OF REPROUCTIVE
HEALTH
The primary objectives of promoting reproductive health are:

.
1. To ensure accessibility of quality maternal and
reproductive health services, especially in rural areas.
2. To enhance prevention and control of diseases affecting
maternal health.
3. To strengthen the capacity of local governments, health
centres, and communities, as well as individuals involved
in reproductive health.

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 ISSUES IN
REPRODUCT
IVE HEALTH
The common challenges associated with reproductive
health include:

o Birth defects
o Overpopulation
o Sexually Transmitted Diseases
o Health risks for mother and child
o Early marriages and childbearing
o High mortality rates for mothers and infants

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 WAY TO
ENHANCE
REPRODUCTIV
Several strategies can be implemented to improve
E HEALTH
reproductive health:

o Introduction of sex education to inform adolescents

about safe sexual practices.
o Implementation of programs like 'National
Adolescent Education Program' to inform teenagers
about the implications of unsafe sexual practices
and early pregnancies.
o Education for adults on topics like infertility, birth
control methods, pregnancy, and postnatal care.
Providing medical facilities to address issues like
infertility is also crucial.
o Legal bans on practices like the Amniocentesis Test
to prevent crimes like female infanticide.

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 UNDERSTAND
ING
AMNIOCENTE
The Amniocentesis
SIS Test is a procedure used to
determine the sex of an unborn child by analyzing the
chromosomal content of the amniotic fluid surrounding
the fetus. It can also detect chromosomal abnormalities
early on.

All these steps taken to achieve a reproductively healthy

society would be fruitless without our cooperation.
Therefore, with the combined efforts of society,
government bodies, and other organizations, we can
strive towards a reproductively healthy society.

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Contraception:
Characteristics of an ideal contraceptive are:
(a) User friendly
(b) Easily available
(c) Nor or least side effects
(d) No way interferes with sexual drive

Types of Birth Control

 Continuous abstinence

 Natural family planning/rhythm method

 Barrier methods

 Contraceptive sponge

 Diaphragm, cervical cap, and cervical

shield
 Female condom

 Male condom

 Hormonal methods

 Oral contraceptives — combined pill ("The

pill")
 Oral contraceptives — progestin-only pill

("Mini-pill")
 The Patch

 Shot / Injection

 Vaginal Ring

 Implantable devices

 Implantable Rods

 Intrauterine Devices

 Permanent birth control methods

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  Sterilization Implant
 Surgical Sterilization

 Emergency contraception

The above mentioned ways are discussed in details

as follows:
Continuous abstinence: This implies not engaging
in sexual relations at any time (vaginal, oral, or anal).
It is the main, beyond any doubt approach to
counteract pregnancy and secure against Sexually
Transmitted Infections (STIs), including AIDS.
Natural family planning/rhythm method: This
strategy is the point at which you don't have
intercourse or utilize a barrier technique on the days
you are most fruitful (destined to end up getting
pregnant). A woman who has a normal menstrual
cycle has around at least 9 days every month when
she can get pregnant. These prolific days are around
5 days before and 3 days after ovulation, and in
addition the day of ovulation.
Barrier methods: Utilize a block, or boundary, to
keep sperm from penetrating the egg.

Contraceptive Sponge

Sponge
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This barrier strategy is a delicate, disc- shaped
gadget with a loop for taking it out. It is made out of
polyurethane (pah-lee-YUR-uh-thayn) froth and
contains the spermicide (SPUR-muh-syd) nonoxynol-
9. Spermicide kills the sperm.
One and only sort of preventative sponge is sold in
the United States. It is known as Today Sponge.
Women sensitive to the spermicide nonoxynol-9
ought not to utilize the sponge.
Diaphragm, Cervical Cap, and Cervical Shield

Fig: How to use a diaphragm

These barrier techniques hinder the sperm from
entering the cervix (the opening to your womb) and
achieving the egg.

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 The diaphragm is a shallow latex container.
 The cervical cap is a thimble-molded latex glass. It
regularly is called by its brand name, FemCap.
 The cervical shield is a silicone glass that has a
one-way valve that creates suction and helps it fit
against the cervix. It regularly is called by its brand
name, Lea's Shield.

Female Condom
Female Condoms are the barriers worn by the
woman inside their vagina. It keeps sperm from
getting into their body and fusing with egg. It is made
of thin, adaptable, synthetic elastic and is bundled
with a lubricant.

Female Condom
Male Condom
Male Condoms are a thin sheath put over a penis in
an erect position to keep sperm from entering a
woman's body. Condoms can be made of

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polyurethane, latex, or "regular/lambskin". The
regular types do not ensure against STIs or STDs.
Condoms are the best option when utilized with a
vaginal spermicide, which leads to the sperm killing.
Also, you have to utilize a new condom with every sex
demonstration.

Hormonal Methods: Pregnancy is prevented by

meddling with ovulation, treatment, or potentially
implantation of the fertilized egg.

Oral contraceptives — combined pill ("The pill")

The pill contains the hormones estrogen and
progesterone. It is taken day by day to keep the
ovaries from discharging an egg. The pill additionally
causes changes in the coating of the uterus and the
cervical bodily fluid to keep the sperm from fusing
with the egg.
A few women incline toward the "extended cycle"
pills. These have 12 weeks of pills that contain
hormones (dynamic) and 1 week of pills that don't
contain hormones (dormant). While taking amplified
cycle pills, women just have their period three to four
times each year.
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 Contraceptive Pills
The Patch
Likewise called by its brand name, Ortho Evra, this
skin patch is worn on the lower abdomen, bottom,
external arm, or abdominal area. It discharges the
hormones progestin and estrogen into the circulatory
system to prevent the ovaries from discharging eggs
in to the fallopian tubes. It additionally thickens the
cervical bodily fluid, which keeps the sperm from
joining with the egg. You put on another patch once
every week for 3 weeks. You don't utilize a patch the
fourth week to have a period.
Women ought to hold up three weeks after delivery
before utilizing conception prevention that contains
both estrogen and progestin. These strategies
increment the danger of perilous blood clots that
could frame in the wake of conceiving an offspring.
Women who had a cesarean segment or have other
hazard variables for blood clots, for example, history
of blood clots, obesity, smoking, or preeclampsia,
ought to hold up for six weeks.

Contraceptive patch
Shot / Injection
The contraception shot frequently is called by its
brand name Depo-Provera. With this strategy you get
infusions, or shots, of the hormone progestin in the
rear end or arm at regular intervals. Another sort is
infused under the skin. The anti-conception
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medication shot prevents the ovaries from
discharging an egg in numerous women. It
additionally causes changes in the cervix that keep
the sperm from joining with the egg.
The shot ought not be utilized over 2 years as a part
of a line since it can bring about an impermanent loss
of bone thickness. The misfortune expands the more
extended this strategy is utilized. The bone starts to
develop after this technique is ceased. Yet, it might
expand the danger of fracture or osteoporosis if
utilized for quite a while.

Vaginal Ring

Vaginal Ring
This is a thin, adaptable ring that discharges the
hormones progestin and estrogen. It works by
preventing the ovaries from discharging eggs. It
likewise thickens the cervical bodily fluid, which keeps
the sperm from joining the egg.
It is ordinarily called NuvaRing, its brand name. You
press the ring between your thumb and pointer and
embed it into your vagina. You wear the ring for 3

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weeks, take it out for the week that you have your
period, and afterward put in another ring.
Women ought to hold up three weeks after delivery
before utilizing conception prevention that contains
both estrogen and progestin. These strategies
increment the danger of perilous blood clots that
could frame in the wake of conceiving an offspring.
Women who had a cesarean segment or have other
hazard variables for blood clots, for example, history
of blood clusters, obesity, smoking, or preeclampsia,
ought to hold up for six weeks.

Implantable Devices: Devices embedded into the

body and left set up for a couple of years.

Implantable Rod
This is a matchstick-measure, adaptable rod that is
put under the upper arm skin. It is regularly called by
its brand name, Implanon. The rod discharges a
progestin, which causes changes in the coating of the
uterus and the cervical bodily fluid to keep the sperm
away from penetrating an egg. Less frequently, it

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prevents the ovaries from discharging eggs. It is
powerful for up to three years.

Implanon Diagram
Intrauterine Devices or IUDs

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 An IUD is a little device molded like a "T" that goes in
your uterus. There are two sorts:
 Copper IUD — The copper IUD passes by the

brand name ParaGard. It discharges a little

measure of copper into the uterus, which keeps the
sperm from coming to and fusing with the egg. On
the off chance that fertilization occurs, the IUD
keeps the egg from embedding in the coating of the
uterus. A specialist needs to put in your copper IUD.
It can remain in your uterus for five to ten years.

Copper IUD
 Hormonal IUD — the hormonal IUD passes by the
brand name Mirena. It is often called an intrauterine
system, or IUS. It discharges progestin into the
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 uterus, which keeps the ovaries from discharging an
egg and causes the cervical bodily fluid to thicken
so sperm cannot reach out for the egg. It
additionally influences the capacity of a fertilized
egg to effectively embed in the uterus. A specialist
needs to put in a hormonal IUD. It can remain in
your uterus for up to five years.

Mirena IUD
Permanent Birth Control Methods: For individuals
who are certain they never need to have a youngster
or they don't need more kids.

Sterilization Implant (Essure)

Essure is the main non-surgical strategy for
disinfecting ladies. A thin tube is utilized to string a
minor spring-like gadget through the vagina and
uterus into each fallopian tube. The gadget works by
bringing about scar tissue to conform or wrap around
to the coil. This hinders the fallopian tubes and
prevents the egg and sperm from joining.
It can take around three months for the scar tissue to
develop, so it's imperative to utilize another type of

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contraception amid this time. At that point you will
need to come back to your specialist for a test to
check whether scar tissue has completely hindered
your tubes.

Essure
Surgical Sterilization
In women, surgical disinfection shuts the fallopian
tubes by being cut, tied, or fixed. This prevents the
eggs from being fertilized by preventing them going
down to the uterus. The surgery should be possible in
various ways. Once in a while, a woman having
cesarean birth has the technique done in the
meantime, in order to abstain from having extra
surgery later.

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 Tubectomy
For men, having a vasectomy (vuh-SEK-tuh-mee)
keeps sperm from heading off to his penis, so his
discharge never has any sperm in it. Sperm remains
in the framework after surgery for around 3 months.
Amid that time, utilize a reinforcement type of anti-
conception medication to counteract pregnancy. A
basic test should be possible to check if all the sperm
is gone; it is known as a semen investigation.

Vasectomy
Emergency contraception: Utilized if a woman's
essential strategy for anti-conception medication
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fizzles. It ought not to be utilized as a customary
technique for contraception.
Emergency contraception can be taken as a solitary
pill treatment or in two dosages. A solitary
measurement treatment acts and in addition two
dosages and does not have more reactions. It works
by preventing the ovaries from discharging an egg or
keeping the sperm from joining with the egg.
A solitary pill measurement or two-pill dosage of
emergency contraception is accessible over-the-
counter (OTC) for women ages seventeen and older.

MEDICAL TERMINATION OF PREGNANCY (MTP)

Intentional or voluntary termination of pregnancy is called

medical termination of pregnancy (MTP) or induced
abortion. 45 to 50 million MTPs/ year- world. Decreases
population- not meant for that purpose. Accept/ legalise is
debated due to emotional, ethical, religious & social issues.
Government of India legalized- 1971, with strict
restrictions to check indiscriminate & illegal female
foeticide. MTP- rid of unwanted pregnancy due to
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unprotected intercourse, failure of contraceptive, rapes,
pregnancy which may fatal to mother or foetus. This
method is safe within 1st trimester (12 weeks), 2nd
trimester abortions are riskier. Illegal- unqualified quacks,
unsafe & fatal- avoided by counselling. Misuse of
amniocentesis, followed by MTP- avoided

SEXUALLY TRANSMITTED DISEASES (STDs).

Diseases or infections which are transmitted through

sexual intercourse are called Sexually transmitted diseases
(STDs)/ Venereal diseases (VD)/ Reproductive tract
infections (RTI). Gonorrhea, Syphilis, Genital herpes,
Chlamydiasis, genital warts, Trichomoniasis, hepatitis-B
and HIV.

Mode of transmission- Hepatitis- B & HIV

1. Sexual contact with infected person

2. Sharing of injection needles

3. Sharing the unsterilized surgical instruments

4. Transfusion of blood from infected person to healthy

person

5. Infected mother to foetus

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Except hepatitis-B, genital herpes and HIV infections,
others are curable.

Symptoms are minor- early stages:

1. Itching, fluid discharge, slight pain, swelling in the

genital region.

2. STDs remain asymptomatic in female and remain

undetected for long.

3. In the later stage it may leads to Pelvic inflammatory

diseases (PID), abortion, still birth, ectopic pregnancy,
infertility or even cancer in reproductive tract.

Preventions:

1. Avoiding sex with unknown partners or multiple

partners.

2. Always using condoms during coitus.

3. In case of doubt, consult a doctor for early detection.

4. Getting complete treatment for diagnosed disease.

INFERTILITY

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The couple unable to produce children in spite of
unprotected sex is due to Infertility. Problems of infertility
may be in male or female.

The reason of infertility may be:- physical, congenial,

diseases, drugs, immunological or even psychological.

• Female are blamed often in India

• Specialized Health care units like Infertility clinics-

diagnose, corrective treatments to have child

• When treatments are not enough, couple are assisted

with techniques called assisted reproductive technologies
(ART)

• Methods of infertility control:

1) IVF- ET (In Vitro Fertilization- Embryo Transfer)

Test tube baby, fertilization takes place outside & embryo

is transferred. Female is induced to produce multiple egg/
ova. Egg is then collected from wife/ donor & sperm
collected from husband/ donor. Incubated in culture
medium- fertilization & form zygote. It is then transferred
to the uterus of wife, implants & pregnancy continues.

TWO TYPES :
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 a) ZIFT (Zygote Intra fallopian Transfer)- Zygote/
Embryo with 8 blastomeres transferred to fallopian tube

b) IUT (Intra- Uterine Transfer)- Embryo

transferred at 32 celled stage to uterus

2) GIFT (Gamete Intra Fallopian transfer) : Ovum

collected from donor & transferred to female who
cannot produce one but provide suitable environment
for fertilization. Washed sperms & ova are
transferred to the ampulla of fallopian tube with the
help of laparoscope- fertilization & cleavage. Useful

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 when fimbriae fail to capture ovum & females having
sperm antibodies in their cervical secretion.
3) Intra Cytoplasmic Sperm Injection (ICSI):
Sperm is directly injected into the ovum in culture
medium . Zygote or Embryo- transferred to fallopian
tube or uterus.
4) Artificial insemination (AI): It is useful in
cases either the male partner unable to inseminate
the female or very low sperm counts (oligospermia).
Semen of male partner/ donor is collected,
concentrated & introduced into vagina or uterus of
female- intra -uterine insemination (IUI)

Drawbacks:

1. These techniques are not possible with female with

damaged uterine wall.
2. Require high precision, specialized professional &
expensive instrumentation & so available in few
centers & available to few people only.
3. Raised several ethical, emotional, religious & moral
issues in the society

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