Biology: Class 12 — Chapter 3: Reproductive Health

• Family Planning: Initiated in India in 1951 to attain total reproductive health as a social goal.
• RCH Programmes: Reproductive and Child Health Care programmes currently operate to create awareness and provide facilities for building a reproductively healthy society.

• Sex Education: Encouraged in schools to provide right information, discourage myths, and clear misconceptions about sex-related aspects.
• Information Dissemination: Educating people about reproductive organs, adolescence, safe and hygienic sexual practices, STDs, and AIDS.
• Parental & Post-natal Care: Educating fertile couples on birth control options, care of pregnant mothers, post-natal care, and the importance of breast feeding.
• Amniocentesis Ban: Statutory ban on amniocentesis for sex-determination to legally check female foeticide. In this procedure, amniotic fluid is analyzed to test for genetic disorders like Down syndrome, haemophilia, and sickle-cell anemia.
• Saheli: A non-steroidal oral contraceptive for females developed by scientists at the Central Drug Research Institute (CDRI) in Lucknow, India.

An ideal contraceptive must be user-friendly, easily available, effective, reversible with no or least side-effects, and must not interfere with sexual drive or desire.

• Natural/Traditional Methods:
  • Periodic abstinence: Abstaining from coitus from day 10 to 17 of the menstrual cycle (fertile period).
  • Withdrawal (coitus interruptus): Male partner withdraws penis from the vagina before ejaculation.
  • Lactational amenorrhea: Absence of menstruation during intense lactation post-parturition (effective up to 6 months).
• Barrier Methods:
  • Condoms: Thin rubber/latex sheaths (e.g., 'Nirodh' for males) that prevent sperm from entering the female tract and protect against STIs/AIDS.
  • Diaphragms, cervical caps, and vaults: Reusable rubber barriers inserted into the female tract to cover the cervix.
• Intra Uterine Devices (IUDs): Inserted by doctors into the uterus through the vagina.
  • Non-medicated IUDs: e.g., Lippes loop.
  • Copper-releasing IUDs: e.g., CuT, Cu7, Multiload 375 (suppress sperm motility and fertilising capacity).
  • Hormone-releasing IUDs: e.g., Progestasert, LNG-20 (make uterus unsuitable for implantation).
• Oral Contraceptives: Small doses of progestogens or progestogen-estrogen combinations taken daily for 21 days.
  • Saheli: A 'once a week' non-steroidal pill with high contraceptive value and minimal side effects.
• Injectables and Implants: Progestogens alone or with estrogen used as injections or subcutaneous implants under the skin.
• Surgical Methods (Sterilisation): Terminal, highly effective but poorly reversible methods.
  • Vasectomy: Removal or tying up of a small part of the vas deferens in males.
  • Tubectomy: Removal or tying up of a small part of the fallopian tube in females.

• Legalisation: Legalised by the Government of India in 1971 with strict conditions to prevent female foeticide.
• MTP Amendment Act, 2017: Allows termination within the first 12 weeks on the opinion of one registered medical practitioner. Between 12 and 24 weeks, opinions of two practitioners are required based on specific grounds:
  1. Risk to the life or physical/mental health of the pregnant woman.
  2. Substantial risk that the child would suffer from serious physical or mental abnormalities.
• Safety: MTPs are relatively safe during the first trimester (up to 12 weeks). Second-trimester abortions are significantly riskier.

• Examples: Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B, and HIV/AIDS.
• Curability: Except for hepatitis-B, genital herpes, and HIV, all other STIs are completely curable if detected early.
• Early Symptoms: Itching, fluid discharge, slight pain, and swelling in the genital region. Often asymptomatic in females.
• Complications: If untreated, can lead to pelvic inflammatory diseases (PID), abortions, stillbirths, ectopic pregnancies, infertility, or cancer of the reproductive tract.

1. Avoid sex with unknown or multiple partners.
2. Always use condoms during coitus.
3. Consult a qualified doctor immediately in case of doubt for early detection and treatment.

• In Vitro Fertilisation (IVF): Fertilisation outside the body, followed by embryo transfer (ET) (commonly known as the "test tube baby" programme).
  • ZIFT (Zygote Intra Fallopian Transfer): Transfer of zygote or early embryo (up to 8 blastomeres) into the fallopian tube.
  • IUT (Intra Uterine Transfer): Transfer of embryos with more than 8 blastomeres into the uterus.
• In Vivo Fertilisation: Fusion of gametes within the female, where embryos can be collected for transfer to females who cannot conceive.
• GIFT (Gamete Intra Fallopian Transfer): Transfer of an ovum collected from a donor into the fallopian tube of another female who cannot produce one but can provide a suitable environment.
• ICSI (Intra Cytoplasmic Sperm Injection): A specialized procedure where a sperm is directly injected into the ovum in the laboratory.
• Artificial Insemination (AI): Semen collected from the husband or a healthy donor is artificially introduced into the vagina or uterus (IUI - Intra-Uterine Insemination) of the female. Useful for cases of low sperm count or inability to inseminate.