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BIOLOGY NOTES
CLASS - XII

CHAPTER – 4
REPRODUCTIVE HEALTH

1. Reproductive Health –
● According to WHO, reproductive health means a total well-being in physical,
emotional, behavioural and social aspects of reproduction.
● A reproductively healthy society is the society with people having physically and
functionally normal reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects.
● India is the first country to initiate action plans / programmes at the national level
to attain total reproductive health; these programmes are called Family Planning
and were initiated in 1951.
● Later they have been improved to include more reproduction-related areas and are
currently called as Reproductive and Child Health Care ( RCH ) programmes.
● The major tasks of these programmes are :
(i) Creating awareness among the people about various reproduction-related
aspects, and
(ii) Providing facilities and support for building up a reproductively healthy
society.
● Governmental and non-governmental agencies have taken up various steps to
create awareness among people about reproduction-related aspects; they take help
of audio-visual and print media.
● Introduction of sex-education in schools should be encouraged to give right
information and to avoid myths and misconceptions about sex-related aspects;
proper information about reproductive organs, adolescence and the related
changes, safe and hygienic sexual practices and sexually transmitted diseases
(STDs) would help people to lead a reproductively healthy life.
● Educating people, especially the fertile couples and those in marriageable age
group about the following can help them to make up a socially-conscious healthy
family of desired size :
a) Available birth control options
b) Care of pregnant women
c) Postnatal care of the mother and child
d) Importance of breast feeding
e) Equal opportunities for the female and male child
● People should also be made aware of the problems due to uncontrolled population
growth, social evils like sex abuse and sex-related crimes, to enable them to think
and take up necessary steps to prevent them from these evils and build up a
reproductively healthy society.
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2. Population Explosion –
● An enormous increase in the size of a population in a short span of time, is called
population explosion.
● Increased health facilities and improvement in technology leading to better living
conditions, have an explosive impact on the growth of population.
● The same trend is observed in India also; our population at the time of
independence was about 350 million and it has reached one billion in 2000 A.D.
● The probable reasons are :
(i) Decline in death rate
(ii) Decline in Maternal Mortality Rate ( MMR )
(iii) Decline in Infant Mortality Rate ( IMR )
(iv) Increase in the number of people in the reproductive age

3. Birth Control –
● The most important step to control population growth is to motivate smaller
families by using contraceptive methods ( methods which prevent unwanted
pregnancies ).
● Other steps include :
(i) Raising of marriageable age to 18 for females and 21 for males.
(ii) Incentives given to couples with small families.
● An ideal contraceptive should be :
(i) User friendly
(ii) Easily available
(iii) Effective
(iv) Reversible with no or least side-effects
(v) Non-interfering with the sexual drive / desire and / or the sexual act of the
user.

4. Methods of Birth Control – Birth control methods, which range in effectiveness

and ease of use, act by blocking one of the three major steps in the reproductive
process :
● Blocking sperm transport to the ovum,

● Blocking ovulation, and

● Blocking implantation of the early embryo.

The contraceptive methods are grouped into the following categories :
(i) Natural Methods
(ii) Barrier Methods
(iii) Intra-Uterine Devices ( IUDs )
(iv) Oral Contraceptives
(v) Injectables and Implants
(vi) Surgical Methods
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BLOCKAGE OF SPERM TRANSPORT TO THE OVUM

Contraception by blocking sperm transport to the ovum may be through
natural, mechanical or chemical methods

5. Natural Methods – These methods work on the principle of avoiding chances

of meeting between the gametes.
(i) Periodic Abstinence – In this method, the couples avoid or abstain from coitus
from day 10 – 17th of the menstrual cycle, when ovulation is expected to occur and
chances of fertilization are very high. During this time, the couple refrain from
intercourse.
(ii) Coitus interruptus (withdrawal) – In this method, the penis is withdrawn from
the vagina before ejaculation and insemination is avoided.
(iii) Lactational amenorrhoea – It refers to the absence of menstruation during the
period of intense lactation following parturition. As ovulation does not occur in
this period, chances of conception are almost nil; but this is effective for a
maximum period of six months after parturition.

6. Barrier ( Mechanical ) Methods –

● The ovum and sperms are prevented from coming closer with the help of
barriers.
● Such barriers are available for males and females.

● Condoms are the barriers made of thin rubber or latex sheath, to cover the penis
in male or vagina and cervix in females. Condoms prevent deposition of sperm in
the female reproductive tract. Condoms also provide protection against sexually
transmitted diseases like AIDS. It is the most commonly employed method of
birth control all over the world.

Male Condom

● Diaphragms, cervical caps and vaults are the barriers ( made of rubber ), used by
females; they are reusable. Diaphragm is a flexible rubber dome that is inserted
through the vagina and positioned over the cervix to block sperm entry into the
cervical canal.
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● Spermicidal creams (chemical methods ) are used along with these barriers to
increase their contraceptive efficiency. Chemical methods of contraception
include spermicidal methods. Application of various foams, creams, jellies make
the vagina and cervix unfavourable for sperm survival.

7. Surgical Methods –
● These are advised as a terminal method to prevent only pregnancy.

● Surgical methods block the transport of gametes and thereby conception.

● Vasectomy is the sterilization procedure in males, where a small portion of the

vas deferens is removed or tied up, thus blocking the exit of sperms from the
testis. The sperms that accumulate behind the tied-off portion of the vas deferens
are removed by phagocytosis.
Although this procedure blocks the exit of sperm cells, it does not interfere with
testosterone activity because the Leydig cells keep secreting testosterone into the
blood, as before the operation. Thus, there is no decrease in testosterone-
dependent masculinity following vasectomy. Moreover, no change in the amount
of semen ejaculated is noticed because sperm account for only a small part of
semen volume.
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● Tubectomy or Tubal Ligation is the sterilization procedure in females, where a

small part of fallopian tube is removed or tied up through a small incision in the
abdomen or through vagina. The ovum is thus prevented from passing into the
fallopian tubes, and the sperms cannot reach the ovum. Thus ligation normally
does not affect sexual performance.

Sterialisation procedures are difficult to reverse, thereby making them

unpopular with individuals who still plan to have children but want to select
the time.
BLOCKING OVULATION
Oral Contraceptives, or birth control pills prevent ovulation by suppressing
gonadotropin secretion

8. Oral Contraceptives –
● Oral contraceptives are hormonal preparations in the form of ‘pills’.

● They are either progestogens or progestogen-estrogen combinations.

● The high level of progesterone inhibits the secretion of follicle stimulating

hormone ( FSH ). As a result, follicle maturation and ovulation do not take place,
so conception is impossible.
● In addition to blocking ovulation, oral contraceptives also prevent pregnancy by
increasing the viscosity of cervical mucus, which makes sperm penetration more
difficult, and by decreasing muscular contractions in the female reproductive tract
which reduces sperm transport to the oviduct.
● The high progesterone level also inhibits menstruation, so the pill is usually taken
for 21 days starting within the first five days of menstrual cycle and then not taken
for 7 days.
● However, the endometrium responds to the exogenous steroids by thickening and
developing secretory capacity, just as it would to the natural hormones. When
these synthetic steroids are withdrawn after three weeks, the endometrial lining
sloughs and menstruation occurs, as it normally would upon the degeneration of
corpus luteum.
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● Saheli is an example of oral contraceptive, which contains a non-steroidal

principle. It is once a week pill. It was developed by scientists at Central Drug
Research Institute ( CDRI ) in Lucknow.

BLOCKING IMPLANTATION OF THE EARLY EMBRYO

Blockage of implantation is most commonly accomplished by the insertion of
a small Intrauterine Contraceptive Device

9. Intra-Uterine Devices ( IUDs ) –

● These are the devices introduced into the uterus.

● IUDs are of the following types :

(ii) Non-medicated IUDs, e.g., Lippes loop
(iii) Copper-releasing IUDs, e.g., CuT, Cu-7, Multiload 375
(iv) Hormone-releasing IUDs, e.g., Progestasert, LNG-20
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● They prevent contraception in the following ways :

(i) The presence of this foreign object in the uterus induces a local
inflammatory response that prevents implantation of a fertilized ovum, by
making the uterus unsuitable for implantation.
(ii) By increasing phagocytosis of sperms within the uterus. ( IUDs are foreign
so phagocytes in uterus becomes active and they engulf most of the sperms )
(iii) By suppressing sperm motility and thereby the fertilising capacity ( by
copper ions released by some IUDs ). Copper ions are spermicidal in action.
(iv) By making the cervix unhostile to sperms.
(v) Hormonal IUDs have an additional advantage that they create an hormonal
imbalance in the uterus so conception or implantation becomes difficult.

Mirena IUD
10. Injections and Implants –
● Progestogens or progestogen-estrogen combination is also used as injections or
implants under the skin.
● Though their mode of action is similar to oral contraceptives, their effective
periods are longer.
● Administration of progestogens or progestogen-estrogen combinations within 72
hours of coitus have been found to be very effective as emergency contraceptives
as they could be used to avoid possible pregnancy due to rape or casual
unprotected intercourse.
● Unlike oral contraceptives, however, which must be taken on a regular basis, the
implants are effective for five years.
● Similar in action but on a shorter time scale are injectable synthetic female sex
hormones that exert contraceptive effects for a month or three months, depending
on the product.
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11. Advantages of contraceptives :

a) Prevent pregnancy
b) Delay or space pregnancy
c) Checking uncontrolled growth of population

12. Disadvantages of contraceptives :

The possible ill-effects or side effects of contraceptives are nausea, abdominal
pain, breakthrough bleeding, irregular menstrual bleeding and breast cancer.

13. Summary of Common Methods of Contraception :

S. No. Method Mode of Action

1 Periodic Abstinence Abstain from sex near to time of ovulation
2 Coitus interruptus Penis withdrawn before ejaculation
Thin sheath over erect penis which collects semen and
3 Condom
prevents sperm from reaching cervix
Soft rubber cup which covers the entrance to uterus
Diaphragm
4 and prevents sperms from reaching an egg.
& Cervical Cap
Holds spermicide
Spermicidal gel, Chemical spermicides inserted in vagina before
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foams, creams, jellies intercourse which kills sperm
Male sterilization Vas deferens cut so that semen contains no
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( Vasectomy ) spermatozoa
Female Sterilisation Fallopian Tubes cut and tied so that eggs do not pass
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( Tubectomy ) into the fallopian tubes
Oral Contraceptive Hormonal combinations which prevent ovulation and
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Pills implantation
Small plastic or metal device placed in the uterus
9 IUCDs
which prevents implantation
Progeterone derivative injections taken once every 3
10 Hormonal Injections months, that release a hormone slowly and prevent
ovulation
Capsules surgically implanted under skin that slowly
11 Hormonal Implants
release hormone that blocks ovulation.

14. Medical Termination of Pregnancy ( MTP ) –

● Intentional or voluntary termination of pregnancy before full term, is called
medical termination of pregnancy or induced abortion.
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● MTP has been legalized by the government of India in 1971, with strict conditions
to avoid its misuse, especially indiscriminate and illegal female foeticides.
● MTP is essential where pregnancy could be harmful to the mother or the foetus or
both.
● MTPs are safe during the first trimester ( i.e., upto 12 weeks of pregnancy )
whereas MTPs, during second trimester are riskier.

15. Sexually Transmitted Diseases –

● Diseases or infections that are transmitted through sexual intercourse, are
called sexually transmitted diseases or venereal diseases ( VDs ) or
reproductive tract intections ( RTIs ).
● The following table provides a list of the sexually transmitted diseases and their
causative agents.

S. No. Disease Causative Agent ( BEYOND THE TEXT )

(i) Syphilis Treponema pallidum
(ii) Gonorrhoea Neisseria gonorrhoeae
(iii) Chlamydiasis Chlamydia trachomatis
(iv) Trichomoniasis Trichomonas vaginalis
(v) AIDS Human Immuno-deficiency Virus ( HIV )
(vi) Hepatitis – B Hepatitis virus
(vii) Genital Herpes Herpex simplex virus, Human papilloma virus

● Of these, the three viral infections, AIDS, genital herpes and hepatitis B cannot be
cured while others are curable STDs. (The first three are caused by bacteria and
the fourth by a protozoan ).
● The early symptoms include the following in the genital region :
(i) Itching
(ii) Fluid discharge
(iii) Slight pain, and
(iv) Swellings
● The infected persons do not seek medical help for the following reasons :
(i) Absence or less significant symptoms in the early stages of infection.
(ii) Social stigma attached to the STDs.
● This could lead to complication later, which includes pelvic inflammatory
diseases (PID), abortions, still births, ectopic pregnancies, infertility or even
cancer of the reproductive tract.
● These diseases are reported to be high among individuals of age group 15 – 24
years.
● These infections could be avoided / prevented by the following practices or
principles :
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(i) Avoiding sex with unknown partner or multiple partners.

(ii) Using condoms during coitus every time.
(iii) Seeking medical help in case of doubt and getting it completely cured.

16. Infertility –
● Infertility refers to the inability of a couple to produce children inspite of
unprotected sexual cohabitation, for at least a year without any success.
● Doctors accept that a couple may need infertility treatment if they have been
trying to conceive for at least a year without any success.
● The reasons for infertility could be physical, congenital diseases, use of certain
drugs, immunological reactions or even psychological.

● Female infertility may be caused by :

a) Blocked fallopian tubes
b) Altered hormone levels leading to a failure to ovulate or implant . Failure to
ovulate is known as anovulatory infertility, is usually due to a failure to secrete
the right balance of hormones.
c) Cervical mucus that halts, repels or kills sperms.
● Male infertility may be caused by :
a) A low sperm count. Samples which are found to have fewer than 20 million
sperm per cm3 are said to be abnormally low.
b) Production of large numbers of abnormal sperm ( more than 4 % ).
c) Production of antibodies that make the sperm stick together.
● Specialised health care units called Infertility Clinics could diagnose the problem
and give corrective treatments for many of these problems.
● Where corrective treatments are not available, there are special techniques called
Assisted Reproductive Technologies ( ART ) to help the couple produce
children; they are as follows :

(i) Test Tube Baby Programmes –

⮚ The babies born by in vitro (= ‘in glass’ or ‘in test-tube’) fertilization
are called Test Tube Babies.
⮚ In this method, ova from the wife or a donor female and the sperms from
the husband or a donor are allowed to fuse under stimulated conditions
(as that of the body) in the laboratory; it is called in vitro fertilization
(IVF).
⮚ The zygote or early embryo is transferred into the uterus or fallopian
tube for further development; this process is called Embryo Transfer
(ET) and can be done in the following ways :
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✔ The zygote or embryo upto eight blastomeres is transferred into the

fallopian tube; it is called Zygote Intra Fallopian Transfer
(ZIFT).
✔ Embryos with more than eight blastomeres are transferred into the
uterus; it is called Intra Uterine Transfer ( IUT ).

(ii) Gamete Intra Fallopian Transfer ( GIFT ) – This method involves the
transfer of an ovum collected form a donor female into another female, who
cannot produce ova, but can provide suitable conditions for fertilization and
further development of the foetus upto parturition.

(iii) Intra Cytoplasmic Sperm Injection ( ICSI ) – In this method, the sperm is
directly injected into the ovum to form an embryo in the laboratory and then
embryo transfer is carried out.

(iv) Artificial Insemination –

⮚ In this method, the semen collected from the husband or a healthy donor,
is artificially introduced into the vagina or into the uterus ( Intra
Uterine Insemination, IUI ).
⮚ This method is used in cases where infertility is due to the inability of
the male partner to inseminate the female or due to very low sperm
counts in the ejaculates.

17. Amniocentesis –
● It is a prenatal diagnostic technique in which a sample of amniotic fluid from the
womb of a pregnant woman, is taken during the early stages of foetal development
and the cells are cultured and analysed.
● By this method the chromosomal abnormalities, the sex of the foetus and
development disorders could be detected; it is misused for destroying the normal
female fetuses.
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