Class 12 Notes Biology for Chapter 2 Human Reproduction

Reproductive health encompasses more than just healthy reproductive organs with normal functions; it also includes the emotional and social aspects of reproduction . According to the World Health Organisation (WHO), it signifies a total well-being in all aspects of reproduction: physical, emotional, behavioural, and social . Maintaining reproductive health is significant, and India was one of the first countries to initiate national-level action plans, starting with 'family planning' in 1951, which evolved into the current Reproductive and Child Health Care (RCH) programmes . These programmes aim to create awareness and provide facilities for a reproductively healthy society.

Key Concepts in Reproductive Health

Definition and Significance:

• Reproductive health means healthy reproductive organs with normal functions, including emotional and social aspects.
• WHO defines it as total well-being (physical, emotional, behavioural, social) in all aspects of reproduction.
• Maintaining reproductive health is crucial for a healthy society.

Reproductive Health – Problems and Strategies:

• India initiated 'family planning' programmes in 1951 to achieve total reproductive health as a social goal.
• These evolved into Reproductive and Child Health Care (RCH) programmes .
• Major tasks include creating awareness and providing support for a reproductively healthy society.

• Awareness Creation:

• Utilizing audio-visual and print media by governmental and non-governmental agencies.
• The significant role of parents, relatives, teachers, and friends in information dissemination.
• Encouraging sex education in schools to provide accurate information and dispel myths. This should cover reproductive organs, adolescence, safe sexual practices, STDs, and AIDS.
• Educating fertile couples and those of marriageable age about birth control, care during and after pregnancy, breastfeeding, and gender equality.
• Creating awareness about population growth problems, sex abuse, and related crimes.

• Required Infrastructure and Support:

• Strong infrastructural facilities, professional expertise, and material support are essential.
• Providing medical assistance for pregnancy, delivery, STDs, abortions, contraception, menstrual problems, and infertility.
• Implementing better techniques and new strategies for efficient care.
• Statutory ban on amniocentesis for sex determination to curb female foeticides.
• Massive child immunisation programmes. Amniocentesis is used to test for genetic disorders.

• Research and Development:

• Governmental and non-governmental agencies support research in reproduction-related areas.
• Development of new contraceptives like ‘ Saheli ’ by CDRI, Lucknow. Saheli is a non-steroidal, once-a-week oral contraceptive for females with few side effects.

• Indicators of Improved Reproductive Health:

• Better awareness about sex-related matters.
• Increased medically assisted deliveries and better postnatal care, leading to decreased maternal and infant mortality rates.
• Increased number of couples with small families.
• Better detection and cure of STDs.
• Overall increased medical facilities for all sex-related problems.

Population Stabilisation and Birth Control:

• Increased health facilities and better living conditions led to population explosion in the last century.
• India's population grew significantly from independence (350 million) to 2011 (over 1.2 billion).
• Reasons include a rapid decline in death rate, MMR, IMR, and an increase in people in reproductive age.
• RCH programmes had a marginal impact on population growth rate.
• Alarming growth rate can lead to scarcity of basic necessities.
• Government measures to check population growth include motivating smaller families using contraception.
• Slogan: Hum Do Hamare Do (we two, our two) .
• Adoption of ‘ one child norm ’ by some couples.
• Statutory raising of marriageable age (female: 18 years, male: 21 years).
• Incentives for couples with small families.

• Contraceptive Methods:

• An ideal contraceptive should be user-friendly, easily available, effective, reversible with minimal side effects, and should not interfere with sexual drive.
• Natural/Traditional Methods: Avoid meeting of ovum and sperm.
• Periodic abstinence: Avoiding coitus during the fertile period (day 10-17 of the menstrual cycle). High chance of failure.
• Withdrawal (coitus interruptus): Male partner withdraws before ejaculation. High chance of failure.
• Lactational amenorrhea: Absence of menstruation during intense lactation for up to six months post-parturition. Effective for a limited period, high chance of failure. No side effects as no medicines or devices are used.
• Barrier Methods: Prevent physical meeting of ovum and sperm.
• Condoms (male and female): Rubber/latex sheath covering the penis or vagina and cervix. Prevents semen entry, protects against STIs and AIDS. Disposable and self-inserted. 'Nirodh' is a popular male condom brand.
• Diaphragms, cervical caps, and vaults: Rubber barriers inserted to cover the cervix. Prevent sperm entry, reusable, used with spermicidal creams, jellies, foams to increase efficiency.
• Intra Uterine Devices (IUDs): Inserted by doctors/nurses in the uterus.
• Non-medicated IUDs (e.g., Lippes loop) .
• Copper releasing IUDs (CuT, Cu7, Multiload 375): Increase phagocytosis of sperms, Cu ions suppress sperm motility and fertilising capacity.
• Hormone releasing IUDs (Progestasert, LNG-20): Make the uterus unsuitable for implantation and the cervix hostile to sperms.
• Ideal for delaying pregnancy and spacing children, widely accepted in India.
• Oral Contraceptives (Pills): Small doses of progestogens or progestogen-estrogen combinations taken daily for 21 days, followed by a 7-day gap. Inhibit ovulation and implantation, alter cervical mucus. Effective with lesser side effects. Saheli is a non-steroidal, once-a-week pill.
• Injectables and Implants: Progestogens alone or in combination with estrogen administered as injections or implants under the skin. Similar action to pills, longer effective periods.
• Emergency Contraceptives: Administration of progestogens or progestogen-estrogen combinations or IUDs within 72 hours of coitus. Effective in avoiding pregnancy due to rape or unprotected intercourse.
• Surgical Methods (Sterilisation): Terminal method for preventing more pregnancies. Block gamete transport.
• Vasectomy (male): Small part of vas deferens removed or tied.
• Tubectomy (female): Small part of the fallopian tube removed or tied.
• Highly effective but reversibility is poor.
• Selection of contraceptive method should be done in consultation with medical professionals.
• Contraceptives are used against natural reproductive events for preventing, delaying, or spacing pregnancy due to personal reasons.
• Widespread use helps in checking uncontrolled population growth.
• Possible side effects (nausea, abdominal pain, bleeding, breast cancer) should not be ignored.

Medical Termination of Pregnancy (MTP):

• Intentional or voluntary termination of pregnancy before full term, also called induced abortion.
• Globally, about 45-50 million MTPs are performed annually.
• Legalisation is debated due to emotional, ethical, religious, and social issues.
• Government of India legalised MTP in 1971 with strict conditions to prevent misuse, especially female foeticides.
• Reasons for MTP: unwanted pregnancies due to casual unprotected intercourse, contraceptive failure, or rape. Also essential when pregnancy continuation is harmful or fatal to mother or foetus.
• MTP is relatively safe during the first trimester (up to 12 weeks) . Second trimester abortions are riskier.
• Illegal MTPs by unqualified individuals are unsafe and fatal.
• Misuse of amniocentesis for sex determination followed by MTP of female foetus is illegal and dangerous.
• The Medical Termination of Pregnancy (Amendment) Act, 2017 aims to reduce illegal abortions and maternal mortality.
• Grounds for termination:
• Risk to the life or physical/mental health of the pregnant woman.
• Substantial risk of physical or mental abnormalities in the child if born.
• Need to avoid unprotected coitus, understand risks of illegal abortions, and improve healthcare facilities.

Sexually Transmitted Infections (STIs):

• Infections/diseases transmitted through sexual intercourse, also called venereal diseases (VD) or reproductive tract infections (RTI).
• Common STIs include gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B, and HIV leading to AIDS.
• Hepatitis-B and HIV can also be transmitted by sharing needles, surgical instruments, blood transfusion, or from infected mother to foetus.
• Except for hepatitis-B, genital herpes, and HIV, other STIs are completely curable if detected early and treated properly.
• Early symptoms can be minor (itching, fluid discharge, slight pain, swellings in the genital region).
• Infected females may be asymptomatic.
• Social stigma can deter timely detection and treatment, leading to complications like pelvic inflammatory diseases (PID), abortions, stillbirths, ectopic pregnancies, infertility, or reproductive tract cancer.
• Prevention and early detection are prime considerations in reproductive health programmes.
• High incidence in the 15-24 year age group.

• Prevention:

• Avoid sex with unknown/multiple partners.
• Always use condoms during coitus.
• In case of doubt, consult a qualified doctor for early detection and complete treatment.

Infertility:

• Inability to produce children despite unprotected sexual cohabitation.
• Reasons can be physical, congenital, diseases, drugs, immunological, or psychological.
• Often, the female is wrongly blamed; the problem can lie with the male partner.
• Specialised health care units (infertility clinics) can help in diagnosis and treatment.
• Assisted Reproductive Technologies (ART): Used when corrections are not possible.
• In vitro fertilisation (IVF) followed by embryo transfer (ET): Fertilisation outside the body (test tube baby programme). Ova and sperms are collected, zygote formed in the lab, and early embryos (up to 8 blastomeres) transferred to the fallopian tube ( ZIFT - zygote intra fallopian transfer ) or embryos with more than 8 blastomeres into the uterus ( IUT - intra uterine transfer ). Embryos from in-vivo fertilisation can also be transferred.
• Gamete intra fallopian transfer (GIFT): Transfer of donor ovum into the fallopian tube of a female who cannot produce one but can support fertilisation and development.
• Intra cytoplasmic sperm injection (ICSI): Sperm directly injected into the ovum in the lab.
• Artificial insemination (AI): Semen from husband or donor artificially introduced into the vagina or uterus ( IUI - intra-uterine insemination ) for male infertility issues like inability to inseminate or low sperm count.
• ART techniques require high precision, specialised professionals, and expensive equipment, making them available in few centres and affordable to a limited number of people.
• Emotional, religious, and social factors can be deterrents.
• Legal adoption is also a method for couples seeking parenthood, especially considering the number of orphaned and destitute children in India.

Frequently Asked Questions:

1. What are the key objectives of India's Reproductive and Child Health Care (RCH) programmes?
• To create awareness among people about various reproduction-related aspects.
• To provide facilities and support for building up a reproductively healthy society.
• To improve reproductive health indicators like maternal and infant mortality rates and STD detection.
2. Explain the different types of barrier methods of contraception.
• Condoms are thin rubber sheaths used by males or females to physically prevent sperm from entering the female reproductive tract.
• Diaphragms, cervical caps, and vaults are rubber barriers inserted by females to cover the cervix and block sperm entry; they are often used with spermicides.
• Barrier methods prevent conception by creating a physical barrier between the sperm and the ovum.
3. What are the potential consequences of untreated Sexually Transmitted Infections (STIs)?
• Untreated STIs can lead to pelvic inflammatory diseases (PID) .
• They can cause complications such as abortions, stillbirths, ectopic pregnancies, and infertility .
• In severe cases, some STIs can even lead to cancer of the reproductive tract .