.reproductive health medical termination of pregnancy (mtp),

1. REPRODUCTIVE HEALTH
MEDICALTERMINATION OF PREGNANCY (MTP),
SEXUALLYTRANSMITTED DISEASES (STDs) AND
INFERTILITY
PREPARED BY:
INDERJIT SINGH
PGT BIOLOGY
KV SECTOR 31 D CHANDIGARH

2. MEDICAL TERMINATION OFPREGNANCY(MTP)
• Intentional or voluntary termination of pregnancy is called medical
termination of pregnancy (MTP)orinduced abortion.
• 45 to 50 million MTPs/ year-world
• Decreases population- not meant for thatpurpose
• Accept/ legalise is debated due toemotional, ethical, religious &
social issues
• Government of India legalized- 1971, with strict restrictions to check
indiscriminate & illegal femalefoeticide
• MTP-rid of unwanted pregnancy due to unprotected intercourse,
failure of contraceptive, rapes, pregnancy which may fatal to mother
or foetus
• Thismethod is safewithin 1st trimester (12 weeks), 2ndtrimester
abortions areriskier
• Illegal- unqualified quacks, unsafe & fatal- avoided bycounselling
• Misuse of amniocentesis, followed by MTP-avoided

3. SEXUALLY TRANSMITTED DISEASES (STDs)
• Diseasesor infections which are transmitted through sexual
intercourse are called Sexually transmitted diseases(STDs)/Venereal
diseases(VD)/ Reproductive tract infections(RTI)
• Gonorrhea, Syphilis, Genital herpes, Chlamydiasis, genitalwarts,
Trichomoniasis, hepatitis-B andHIV.
• Mode of transmission- Hepatitis- B & HIV
1. Sexualcontact with infectedperson
2. Sharing of injectionneedles
3. Sharing the unsterilized surgical instruments
4. Transfusion of blood from infected person to healthy person
5. Infected mother to foetus
• Except hepatitis-B, genital herpes and HIVinfections, othersare
curable.

4. S.no STD
CAUSAL
AGENT
SYMPTOMS
EFFECT ON PERSON
AFFECTED
1 CHLAMYDIOSIS
Chlamydia
trachomatis
Painful urination & intercourse
Mucus discharge from
penis/vagina
Pelvic inflammatory disease,
Infertility, Ectopic pregnancy
2 GONORRHOEA Neisseria gonorrhoea
Painful urination
in men
Pelvic inflammatory disease,
Infertility, Rash, Death
3 TRICHOMONIASIS Trichomonas vaginalis
Inflammation, Itching& vaginal
white discharge (Leucorrhoea)
Vulvar erythema, Burning
dysuria
4 GENITAL HERPES Herpes simplex virus Genital sores, Fever Cervical cancer.
5 SYPHILIS Treponema pallidum
Initially sores in genitalia &
mouth, Rashes
Death
6 GENITALWART
Human papilloma
virus
Warts on genitalia Cervical cancer
7 HEPATITIS-B Hepatitis –B virus
Fatigue, Fever, Jaundice, Rash,
Abdominal pain
Liver cirrhosis, Liver cancer
8 AIDS HIV
Fever, Prone to infection,
Inflammation
Dementia, Death
COMMON SEXUALLY TRANSMITTED DISEASES (STDs)

5. KNOWTHE SYMPTOMS OF STDs
• Men
• • Swelling or tenderness in genital area.
• Blisters ,sores or bumps around the mouth or genitals.
• Fever, chills and aches.
• Unusual itching.
• Burning sensation when you pass urine or move your bowels.
•White, watery or yellow discharge from the penis.
• Women
• • Have fewer symptoms than men, often none at all. STDs can lead to cancer. Women should
watch for-
• Bleeding that is not part of their period.
• Pelvic or vaginal pain.
• Discharge from the vagina.
• Painful urination.
• Unusual rash, sore or growth in the genital area.

6. • Symptoms are minor- early stages:
1. Itching, fluid discharge, slight pain, swelling in the genital region.
2. STDsremain asymptomatic in female and remain undetectedfor
long.
3. In the later stage it may leads to Pelvic inflammatory diseases (PID),
abortion, still birth, ectopic pregnancy, infertility or even cancer in
reproductive tract.
• Preventions:
1. Avoiding sexwith unknown partners or multiplepartners.
2. Always using condoms during coitus.
3. In caseof doubt, consult adoctor forearly detection.
4. Getting complete treatment for diagnoseddisease.

7. • Pelvic Inflammatory Disease Overview
• Pelvic inflammatory disease (PID) is infection of a woman's reproductive organs. Infection
spreads upward from the cervix to the uterus, Fallopian tubes, ovaries, and surrounding
structures
Pelvic Inflammatory Disease (PID) Symptoms: -
• If a woman has PID, she may have any of these symptoms:
• Abdominal pain (especially lower abdominal pain) or tenderness
• Back pain
• Abnormal uterine bleeding
• Unusual or heavy vaginal discharge
• Painful urination
• Painful sexual intercourse
• Symptoms not related to the female reproductive organs include fever, nausea, and
vomiting. PID symptoms may be worse at the end of a menstrual period and during the
first several days following a period.

8. INFERTILITY
• Thecouple unable to produce children in spite of unprotected
sexis due to Infertility. Problems of infertility may be in male or
female.
• Thereason of infertility may be:- physical, congenial,diseases,
drugs, immunological or evenpsychological.
• Female are blamed often in India
• Specialized Health care units like Infertility clinics-diagnose,
corrective treatments to havechild
• When treatments are not enough, couple are assisted with
techniques called assisted reproductive technologies
(ART)

9. • Methods of infertility control:
1. IVF- ET (In Vitro Fertilization- Embryo Transfer)
• Testtube baby, fertilization takes place outside & embryois
transferred
• Female is induced to produce multiple egg/ova
• Eggis then collected from wife/ donor & sperm collected from
husband/ donor
• Incubated in culture medium- fertilization & form zygote
• It is then transferred to the uterus of wife, implants & pregnancy
continues
• Two types
a. ZIFT (Zygote Intra fallopian Transfer)- Zygote/ Embryo
with 8 blastomeres transferred to fallopian tube
b. IUT (Intra- Uterine Transfer)- Embryo transferred at 32
celled stage to uterus

10. IN MALES IN FEMALES
Oligospermia: Low sperm count Anovulation:Absence of ovulation.
Azoospermia: Absence of sperm. Oligoovulation: Deficient ovulation.
Asthenospermia: Low sperm motility.
Hyperprolactinemia: excess of prolactin
can lead to anovulation.
Teratozoospermia: Defective sperm
morphology.
Idiopathic Infertility: Failure or abnormal
fertilization.
Cryptorchidism: Failure ofTestes to
descend in the scrotal sac.
Tubal Infertility: Damaged/ligated
fallopian
tube
INFERTILITY IN HUMAN: -
Causes & Consequences

11. • Significance:
a. Boon to infertile mother
b. Men with Oligospermia (low sperm
count)
c. Embryos canbe frozen & used forfuture

12. 2. GIFT (Gamete Intra Fallopian transfer)
• Ovum collected from donor & transferred to female who cannot
produce one but provide suitable environment forfertilization
• Washedsperms & ova are transferred to the ampulla of fallopian
tube with the help of laparoscope- fertilization & cleavage
• Useful when fimbriae fail to capture ovum & females having sperm
antibodies in their cervicalsecretion

13. 3. Intra Cytoplasmic Sperm Injection (ICSI)
• Sperm is directly injected into the ovum in culture medium
• Zygote or Embryo- transferred to fallopian tube or uterus

14. 4. Artificial insemination (AI)
• It is useful in cases either the male partner unable to inseminate
the female or very lowsperm counts (oligospermia)
• Semenof male partner/ donor is collected, concentrated&
introduced into vagina or uterus of female- intra -uterine
insemination (IUI)
Drawbacks:
1. Thesetechniques are not possible with female withdamaged
uterine wall.
2. Require high precision, specialized professional & expensive
instrumentation & so available in few centers & available to few
people only.
3. Raisedseveral ethical, emotional, religious & moral issues inthe
society.