Reproductive Health

According to the World Health Organisation (WHO), reproductive health means a total well-being in all aspects of reproduction, i.e., physical, emotional, behavioral and social. Some of the significances of reproductive health in society are

• Awareness among the youth is important for prevention of sexually transmitted diseases such as AIDS so that they can live a reproductively healthy life. Right information should be provided to them, preventing them from believing in myths and misconceptions about sex-related issues.

• Educating people especially fertile and people of marriageable age about birth control options and family planning is important for uncontrolled population growth.

• Awareness about birth control methods, gender equality , sexually transmitted diseases and other reproductive health issues is necessary to create a socially concious healthy society.

Aspects of reproductive health which requires special attention are:

• Providing strong infrastructural facilities, professional expertise, material support, medical assistance and care to people in reproduction-related problems like pregnancy, delivery, STDs, abortions, contraception, menstrual problems, infertility, etc.

• Implementation of better techniques and developing new strategies from time to time are required to provide more efficient care and assistance to people.

• Research should be encouraged on reproduction-related areas and get supported by governmental and non-governmental agencies to find out new methods and/or to improve upon the existing ones.

Introduction of sex education is important in schools and it is necessary to provide students correct information regarding reproductive organs, adolescence and related changes, safe and hygenic sexual practices, sexually transmitted diseases etc.. to prevent young people from believing in myths and misconceptions about sex-related issues and for building a future society that is reproductively healthy.

• Parents, other close relatives, teachers and friends, also play a major role in giving information to the young students.

Yes, there are several areas when reproductive health has improved in India in last 50 years. Some of the areas of improvement are:

Increased used of contraceptive have lowered the growth rate of population, decreased the rate of sexually transmitted diseases and unwanted pregnancies.

b) Improved health facilities have lead to rapid decrease in maternal mortality rate and infant mortality rate.

c) Awareness about family planning has lead to smaller families.

d) Assisted reproductive technologies have enabled infertile could to have children.

There are several reasons that have caused population explosion:

• Development in various field have improved the quality of life significantly in the last century. Especially, increased health facilities such as vaccination and better living conditions has lead to population explosion.

• Decreased in maternal mortality rate and infant mortality rate and increase in the number of people in reproducible age have lead to increased population.

• The death rate has decreased and birth rate has increased in past 50 years due to better health facilities, food supply and other advancements

Yes, use of contraceptives is totally justified for the following reasons.

• It helps to prevent unwanted pregnancies.

• Earth resources are limited, and the population has increased a lot in the decade due to better living conditions. It is necessary for countries such India with large population to take measures to have smaller families. Overpopulation leads to various social and economic problems. Hence, contraception is necessary for population control as it helps bringing decreasing birth rate.

Removal of gonads can not be reversed. The sex hormones are produced by gonads which are necessary for accessory sex organs and certain functions. Sexual life of the person is affected after removal of gonads. A contraceptive should be user friendly, reversible and available. Hence, removal of gonads cannot be considered as a contraceptive option.

Amniocentesis is a foetal sex determination test based on the chromosomal pattern in the amniotic fluid surrounding the developing embryo. It was developed to know genetic disorder in the foetus. In India, many people prefer male child due to patriarchal society and hence there were lot of female foeticide leading to low sex ratio. Hence, it was necessary to ban sex determination.

In cases of infertile couples where correction of problems are possible, assisted reproductive technologies can be used to help them have children.

In vitro fertilisation (IVF)

It is a fertilization method outside the body in almost similar conditions as that in the body which is followed by embryo transfer (ET) is one such method. This method, popularly known as test tube baby program, ova from the wife/donor (female) and sperms from the husband/donor (male) are collected and are induced to form zygote under simulated conditions in the laboratory. The zygote or early embryos (upto 8 blastomeres) could then be transferred into the fallopian tube (ZIFT–zygote intra fallopian transfer) and embryos with more than 8 blastomeres, into the uterus (IUT – intra uterine transfer), to complete its further development. Embryos formed by in-vivo fertilisation (fusion of gametes within the female) also could be used for such transfer to assist those females who cannot conceive.

GIFT – gamete intra fallopian transfer

It is transfer of ova on one female to another female who cannot produce one, but can provide suitable environment for fertilisation and further development is another method attempted.

Intra cytoplasmic sperm injection (ICSI)

It is another specialised procedure to form an embryo in the laboratory in which a sperm is directly injected into the ovum.

• Infertility cases either due to inability of the male partner to inseminate the female or due to very low sperm counts in the ejaculates, could be corrected by artificialinsemination (AI) technique. In this technique, the semen collected either from the husband or a healthy donor is artificially introduced either into the vagina or into the uterus (IUI – intra-uterine insemination) of the female.

Sexually transmitted diseases are transmitted through sexual contact. To prevent STDs several precautions can be taken such as

• Using contraceptives such as condoms during intercourse prevents transmission of diseases.

• Avoiding sex multiple sexual partners.

• Avoiding sex with unknown people.

• Young and adolescents are more at risk of contracting STDS and so awareness should be spread among them.

(a) True.

Miscarriages occur when pregnancy is not viable. i.e. the foetus cannot survive. It can be occur due to several reason.

(b) False.

Infertility is not always due to abnormality in female partner. Abnormalities in male can also cause infertility such as low sperm count in male can lead to infertility. Infertility can be due to either male or female or both.

(c) False.

Complete lactation as a contraception is only limited to six months after parturition.

(d) True.

Creating awareness about sex related aspects helps in improving reproductible health of the people.

(a) Surgical methods help prevention of flow of gametes during intercourse.

(b) Not all sexually transmitted diseases are curable

(c) Oral pills are very popular contraceptives among the urban women.

(d) In E.T. technique, 8 celled embryos are transferred into the fallopian tube while more than 8 celled embryos are transferred into the uterus.