Reproductive Health: common doubts

Question 1

What does reproductive health mean?

Accepted Answer

Reproductive health means total well-being in all aspects of reproduction: physical, emotional, behavioural and social. It is more than the absence of disease in the reproductive organs. A society with good reproductive health has people who can reproduce safely, are free from sexually transmitted infections, and can choose whether and when to have children.

Question 2

Why is amniocentesis banned for sex determination?

Accepted Answer

Amniocentesis tests the amniotic fluid for genetic disorders such as Down's syndrome, but the same test can reveal the sex of the foetus. It is legally banned for that purpose because it was misused for female foeticide, which distorts the sex ratio. It is permitted only for detecting genetic abnormalities.

Question 3

What causes the rapid growth of the human population?

Accepted Answer

The population grew rapidly because death rates fell while birth rates stayed high. Better health care, food and living conditions reduced the death rate and infant mortality, and increased the number of people in the reproductive age. Population then rose very fast, creating pressure on resources and the need for family planning.

Question 4

What is the legal minimum marriageable age in India?

Accepted Answer

It is 18 years for females and 21 years for males. Raising the age of marriage is one of the measures used to keep family size small, because later marriage shortens the reproductive span. This is among the steps the government promotes alongside contraceptive awareness and small-family incentives.

Question 5

What is the periodic abstinence method and why is it unreliable?

Accepted Answer

Periodic abstinence means avoiding intercourse from day 10 to day 17 of the cycle, the period when ovulation is expected and the chances of fertilisation are highest. It is unreliable because ovulation can shift with stress or illness and cycle lengths vary. A mistake in counting days easily leads to pregnancy.

Question 6

How does the lactational amenorrhea method work, and for how long?

Accepted Answer

Intense breast-feeding suppresses ovulation and so the cycle does not resume, which prevents conception. The method works only while the mother is feeding fully and only up to a maximum of six months after delivery. Afterwards ovulation may return even before the first period, so pregnancy becomes possible.

Question 7

How do condoms differ from diaphragms?

Accepted Answer

A condom is a thin sheath worn over the penis (or a female version inside the vagina) and is used once. A diaphragm is a rubber barrier placed over the cervix in the female tract and is reusable. Both stop sperm from reaching the ovum, but condoms also protect against STIs and AIDS.

Question 8

How do copper-releasing IUDs prevent pregnancy?

Accepted Answer

Copper ions released from a Cu-T or similar device suppress the motility and fertilising capacity of sperm. IUDs in general also increase the phagocytosis of sperm inside the uterus. Hormone-releasing IUDs add further actions on the uterus and cervix, but in a copper IUD it is the copper ions that do the main work. A doctor or trained nurse inserts the device into the uterus through the vagina.

Question 9

What are the types of IUDs with examples?

Accepted Answer

There are three types. Non-medicated IUDs, such as the Lippes loop, have no active substance. Copper-releasing IUDs include CuT, Cu7 and Multiload 375. Hormone-releasing IUDs include Progestasert and LNG-20, which also make the uterus unsuitable for implantation and the cervix hostile to sperm.

Question 10

How do oral contraceptive pills work?

Accepted Answer

The pills contain progestogen alone or a progestogen-estrogen combination. They inhibit ovulation and implantation and change the quality of cervical mucus so that sperm entry is impeded. A woman starts taking them within the first five days of the cycle, for 21 days, then stops for seven days before starting the next pack.

Question 11

What is Saheli?

Accepted Answer

Saheli is a non-steroidal oral contraceptive pill for women, taken once a week. It was developed at the Central Drug Research Institute in Lucknow. Its once-a-week schedule and non-steroidal nature set it apart from the usual hormonal pills, which are taken daily and contain steroid hormones.

Question 12

What is emergency contraception and how soon must it be used?

Accepted Answer

Emergency contraception is used to avoid pregnancy after unprotected intercourse or contraceptive failure. The hormonal pill or an IUD must be used within 72 hours of coitus to be effective. It is meant for emergencies and not as a regular method.

Question 13

What is the difference between vasectomy and tubectomy?

Accepted Answer

Vasectomy is the male sterilisation in which the vas deferens is cut and tied. Tubectomy is the female one in which the fallopian tube is cut and tied. Both prevent gametes from being transported, but the testes and ovaries keep making gametes and hormones. Reversal is very poor in both.

Question 14

Up to how many weeks is MTP considered safe, and when are two doctors needed?

Accepted Answer

MTP is relatively safe in the first trimester, that is up to 12 weeks of pregnancy. Up to 12 weeks the opinion of one registered medical practitioner is enough, and between 12 and 24 weeks the opinion of two is required. MTP became legal in India to reduce illegal and unsafe abortions.

Question 15

Why was MTP legalised in India?

Accepted Answer

MTP was legalised in India in 1971 to cut down the many illegal and unsafe abortions, often done by unqualified people, which caused deaths and illness among women. It is allowed only on stated grounds and only by registered medical practitioners, and these conditions exist to prevent misuse. The main misuse is finding the sex of the foetus by amniocentesis and then aborting a female foetus, which is illegal.

Question 16

Which STIs are not completely curable?

Accepted Answer

Hepatitis-B, genital herpes and HIV infection are not completely curable. Other STIs such as gonorrhoea and syphilis are curable when detected early and fully treated. Early detection is therefore important, and the infections can be avoided by safe practices, such as using condoms, avoiding multiple partners and not sharing needles.

Question 17

What complications can untreated STIs cause?

Accepted Answer

Untreated STIs can cause pelvic inflammatory disease, still births, ectopic pregnancies, infertility and cancer of the reproductive tract. These effects are particularly serious in women. The infections are very common in the 15 to 24 year age group, so awareness and early treatment matter.

Question 18

What is the difference between ZIFT and IUT?

Accepted Answer

In ZIFT a zygote or an early embryo of up to 8 blastomeres is transferred into the fallopian tube. In IUT an embryo of more than 8 blastomeres is transferred into the uterus. Both follow in vitro fertilisation in the laboratory, and the stage of the embryo decides where it is placed.

Question 19

What are GIFT, ICSI and IUI?

Accepted Answer

GIFT transfers a donor ovum into a woman's fallopian tube, so fertilisation occurs inside her body. ICSI injects a sperm directly into an ovum in the laboratory. IUI places semen into the uterus of a woman, used when the male partner has low sperm count. All are assisted reproductive techniques for infertility.

Question 20

Why is a couple considered infertile only after two years of unprotected cohabitation?

Accepted Answer

Because pregnancy can take time even in fertile couples, infertility is defined as an inability to conceive after two years of unprotected cohabitation. The cause may lie with either partner and is very often the male partner, so both are examined. Treatment then depends on the cause, ranging from counselling to assisted reproduction.

Reproductive Health: common doubts, answered

About the chapter

Why is a couple considered infertile only after two years of unprotected cohabitation?

Reproductive health and the RCH programmes