CONTRACEPTION

Contraception aims to control birth, by using contraceptives

 Prevention of conception or fertilization of ovum during
sexual inter course is called contraception.
 An ideal contraceptive should be user- friendly, easily
available, effective and reversible with no or least
side effects

THE DIFFERENT TYPES OF CONTRACEPTIVES

ARE:
1. Natural / Traditional method
2. Barrier method
3. Intra uterine device [IUD’s]
4. Oral contraceptives
5. Injection and implants
6. Surgical method
. Natural methods:
 It work on the principle of avoiding chances of ovum
and sperms meeting.
a) Periodic abstinence:
b) Withdrawal or coitus interruptus:
c) Lactational amenorrhea:
Physical contraceptive or Barrier methods:
 This method prevents contact of sperm and ovum by
barrier.
 Available both for male and female.
a) Condoms:
 Barriers made of thin rubber/ latex sheath, self
inserted & disposable
 Covers penis in male & vagina and cervix in female.
It is used so that semen do not enter the female
reproductive tract.
 It also prevents AIDS and STDs
b) Diaphragm, cervical caps and vaults:
 Barrier, made of rubber latex.
 Inserted into the female reproductive tract to cover
the cervix
 Block entry of sperm through cervix, reusable
 Spermicidal cream, jellies, foams along with these
barriers
Intra Uterine Devices (IUDs )
 These devices are only used by female
 Inserted by doctor or nurses in the uterus through
vagina.
 They are available as:
a) Non-medicated IUDs e.g. Lippes loop: Phagocytosis
of sperm
b) Copper releasing IUDs (CuT, Cu7, Multiload 375):
 Cu ion released suppresses sperm motility and
fertilizing capacity of sperm.
 IUDs increases phagocytosis of sperm within the
uterus
Injections or implants:
 Progesterone alone or in combination with estrogen
used as injections or implants under the skin of female.
 Action similar to pills, effective for long periods

Progesterone or combination of progesterone and

estrogen or IUDs- within 72 hours of coitus are effective
as emergency contraceptives to avoid possible pregnancy
due to rape or unprotected intercourse
Emergency contraceptives:
 These methods are used within 72 hours of coitus,
casual in unprotected intercourse.
 Administration of progesterone or progesterone-
estrogen combination

Surgical methods:
 It is also called as sterilization method advised to
male/ female partner to prevent any future pregnancy.
 Blocks gamete transport, thus prevent conception
 Sterilization in male is called-vasectomy & female-
‘tubectomy’
 Vasectomy- a small part of the vas deferens is
removed or tied up through incision made on scrotum
Assisted Reproductive Technologies
Assisted reproductive technology (ART) a general
term referring to methods used to achieve pregnancy by
artificial or partially artificial means. It is reproductive
technology used primarily in infertility treatments.
Some forms of ART are also used in fertile couples for
genetic reasons. ART is also used in couples who are
discordant for certain communicable diseases, e.g.
AIDS, to reduce the risk of infection when a pregnancy
is desired. Examples of ART include in vitro
fertilisation, intra-cytoplasmic sperm injection (ICSI),
cryopreservation, and intrauterine insemination (IUI).
There is yet no strict definition of the term. Usage of
the ART mainly belongs in the field of reproductive
endocrinology and infertility.
Definition:

The Centres for Disease Control and Prevention

(CDC)—which is required as a result of the 1992
Fertility Clinic Success Rate and Certification Act to
publish the annual ART success rates at U.S. fertility
clinics—defines ART to include "all fertility treatments
in which both eggs and sperm are handled. In general,
ART procedures involve surgically removing eggs from
a woman's ovaries, combining them with sperm in the
laboratory, and returning them to the woman's body or
donating them to another woman." According to CDC,
"they do not include treatments in which only sperm are
handled (i.e., intrauterine—or artificial—insemination)
or procedures in which a woman takes medicine only to
stimulate egg production without the intention of having
eggs retrieved."

Brief Discussion

ART has been used in the United States since 1981 to

help women become pregnant, most commonly through
the transfer of fertilized human eggs into a woman’s
uterus (in vitro fertilization). However, deciding
whether to undergo this expensive and time-consuming
treatment can be difficult.

According to CDC’s 2010 ART Success Rates,

147,260* ART cycles were performed at 443 reporting
clinics in the United States during 2010, resulting in
47,090 live births (deliveries of one or more living
infants) and 61,564 infants. Although the use of ART is
still relatively rare as compared to the potential
demand, its use has doubled over the past decade.
Today, over 1% of all infants born in the U.S. every
year are conceived using ART.
*Excludes cycles in which a new treatment procedure
was being evaluated.
The National Institute of Child Health and Human
Development held a workshop on September 12-13,
2005, to summarize the risks for adverse pregnancy
outcomes after assisted reproductive technology (ART),
develop an approach to counseling couples regarding
these risks, and establish a research agenda. Although
the majority of ART children are normal, there are
concerns about the increased risk for adverse pregnancy
outcomes. More than 30% of ART pregnancies are twins
or higher-order multiple gestations (triplets or greater)
and more than one half of all ART neonates are the
products of multifetal gestations, with an attendant
increase in prematurity complications. Assisted
reproductive technology singleton pregnancies also
demonstrate increased rates of perinatal complications-
small for gestational age infants, preterm delivery, and
perinatal mortality-as well as maternal complications,
such as preeclampsia, gestational diabetes, placenta
previa, placental abruption, and cesarean delivery.
Although it is not possible to separate ART-related risks
from those secondary to the underlying reproductive
pathology, the overall increased frequency of obstetric
complications, including preterm birth and small for
gestational age neonates, should be discussed with the
couple. Significant gaps in knowledge were identified,
and the basic science and clinical and epidemiologic
research required to address these gaps is outlined.
Examples

 Artificial Insemination

 Cloning

 Embryonic splitting or cleavage

 Cryopreservation of sperms, oocytes or embryos

 Embryo transfer

 Fertility medication

 Hormone treatment
 In-vitro fertilization

 Intra-cytoplasmic sperm injection

 Pre-implantation genetic diagnosis