Managing your fertility

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Managing your fertility

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  • Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer
  • <number>
    There are differences between the concept of birth control and contraception. Birth control is an umbrella term referring to all procedures you might use to prevent a birth of a child.
    Contraception refers to a more specific concept of preventing the fertilization of an ovum.
  • Figure 13-1 Periodic abstinence
  • Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer
  • Figure 13-2 Use of Spermicide
  • Figure: Maximizing the Effectiveness of Condoms
  • Image source: The McGraw-Hill Companies, Inc./Kirstan Price, photographer
  • Figure 13-3 Use of a Diaphragm
  • Figure 16-4A Vasectomy
  • Figure 13-4B Tubal Ligation
  • Figure 13-5 Dilation and Evaluation. The cervix is dilated and the contents of the uterus are aspirated (removed by suction). This procedure is used to perform abortions during the second trimester.
  • Figure 13-6 Fertilization and Implantation
  • Figure 13-7 Labor and Delivery
  • Image source: The McGraw-Hill Companies, Inc./Jill Braaten, photographer
  • Managing your fertility

    1. 1. © 2009 McGraw-Hill Higher Education. All rights reserved. Managing Your Fertility Brought to you by
    2. 2. © 2009 McGraw-Hill Higher Education. All rights reserved. Birth Control vs. Contraception Birth control refers to all procedures and methods that can prevent the birth of a child Contraception refers to procedures used to prevent fertilization Brought to you by
    3. 3. © 2009 McGraw-Hill Higher Education. All rights reserved. Theoretical Effectiveness vs. Use Effectiveness Theoretical effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when the method is used precisely as directed during every act of intercourse Use effectiveness: Measure of a contraceptive method’s ability to prevent a pregnancy when used by the general public Brought to you by
    4. 4. © 2009 McGraw-Hill Higher Education. All rights reserved. Selecting Your Contraceptive Method Safety Effectiveness Reliability Reversibility  Affordability  Ease of use  Interference with sexual expression Considerations when choosing contraception Brought to you by
    5. 5. © 2009 McGraw-Hill Higher Education. All rights reserved. Behavioral Contraceptive Methods Abstinence No sexual activity 100% effective Chance No method used 15% use effectiveness Withdrawal (“coitus interruptus”) Removal of penis from vagina before ejaculation 73% use effectiveness Brought to you by
    6. 6. © 2009 McGraw-Hill Higher Education. All rights reserved. Behavioral Contraceptive Methods (cont.) Periodic abstinence (rhythm method) • Calendar (calculating the unsafe days of a women’s menstrual cycle) • Basal body temperature (rise in body temperature correlates with timing of ovulation) • Billings cervical mucus method (evaluate consistency of vaginal discharge to predict ovulation) • Symptothermal (combines basal temperature and mucus methods) 75% use effectiveness Brought to you by
    7. 7. © 2009 McGraw-Hill Higher Education. All rights reserved. Periodic Abstinence Brought to you by
    8. 8. © 2009 McGraw-Hill Higher Education. All rights reserved. Over-the-Counter Contraceptive Methods Spermicides  Foams  Creams  Jellies  Films  Suppositories Condoms  Male  Female Contraceptive sponge Brought to you by
    9. 9. © 2009 McGraw-Hill Higher Education. All rights reserved. Over-the-Counter Contraceptive Methods Vaginal spermicides OTC agents that are capable of killing sperm 71% use effectiveness Brought to you by
    10. 10. © 2009 McGraw-Hill Higher Education. All rights reserved. Over-the-Counter Contraceptive Methods (cont.) Male condom OTC latex shield designed to cover erect penis and retain semen upon ejaculation 85% use effectiveness Male condom with spermicide Latex condom in combination with spermicide 95% use effectiveness Female condom Polyurethane sheath inserted into the vagina 79% use effectiveness Contraceptive sponge Small, pillow-shaped contraceptive that contains spermicide; placed in the vagina to cover the cervical opening 84% use effectiveness Brought to you by
    11. 11. © 2009 McGraw-Hill Higher Education. All rights reserved. Use of a Male Condom  Keep a supply on hand  Handle condoms with care  Put condom on before genital contact  Lubricate the condom  Take care the condom is not dislodged from penis  Inspect condom for tears before discarding Brought to you by
    12. 12. © 2009 McGraw-Hill Higher Education. All rights reserved. Prescription Contraceptive Methods  Diaphragm  Lea’s Shield  FemCap  Intrauterine device (IUD)  Oral contraceptives  Combined pills  Minipills  Injectable contraceptive  Contraceptive implant  Contraceptive ring  Contraceptive patch Brought to you by
    13. 13. © 2009 McGraw-Hill Higher Education. All rights reserved. Prescription Birth Control Methods Diaphragm • Soft rubber cup that covers the cervix • Fitted by health care professional • Used with spermicide 84% use effectiveness Lea’s Shield or FemCap • Lea’s shield: Reusable oval silicone device that covers the cervix • FemCap: Reusable hat-shaped silicone cap that covers the cervix • Use similar to diaphragm 86% use effectiveness Intrauterine device (IUD) • T-shaped device inserted into the uterus • Medicated or unmedicated • Somehow interferes with implantation of the ovum • World’s most popular reversible contraceptive method 99%+ use effectiveness Brought to you by
    14. 14. © 2009 McGraw-Hill Higher Education. All rights reserved. Use of a Diaphragm Brought to you by
    15. 15. © 2009 McGraw-Hill Higher Education. All rights reserved. Prescription Birth Control Methods (cont.) Oral contraceptive pills • Daily pills • Estrogen works by reducing ovum development • Progesterone reduces ovulation and thickens cervical mucus • 92% use effectiveness Side effects •Tenderness in breasts •Nausea •Headaches •Spotting •Weight gain •Sex drive fluctuation •Frequent vaginal infections •Mild depression Potential risks Blood clots, stroke, hypertension, heart attack Brought to you by
    16. 16. © 2009 McGraw-Hill Higher Education. All rights reserved. Brought to you by
    17. 17. © 2009 McGraw-Hill Higher Education. All rights reserved. Prescription Birth Control Methods (cont.) Minipills • Daily pill • Low-dose progesterone • 92% use effectiveness Injectable contraceptive • Each shot effective for a 3-month period • Prevents ovulation and thickens the cervical mucus • 97% use effectiveness Contraceptive ring (NuvaRing) • Polymer device containing estrogen and progestin • Placed deep in the vagina for a 3-week period • 92%+ use effectiveness Contraceptive patch • Skin patch containing estrogen and progestin • Worn for 3 weeks, then 1 week off, then new patch • 92%+ use effectiveness Brought to you by
    18. 18. © 2009 McGraw-Hill Higher Education. All rights reserved. Prescription Birth Control Methods (cont.) Contraceptive implant • Protection is good for 3 years • Can be used while breastfeeding • Physician must insert and remove • May cause temporary irregular bleeding • Possibility of cardiovascular problems • Use effectiveness not yet known Brought to you by
    19. 19. © 2009 McGraw-Hill Higher Education. All rights reserved. Emergency Contraception  Contraceptive measured used to prevent pregnancy within a few days of unprotected intercourse  Hormonal or IUD insertion  “Morning after” pill; not RU-486 (“abortion pill”)  Plan B available behind the pharmacy counter  Those under age 18 must have a prescription  Will not cause abortion or affect established pregnancy Brought to you by
    20. 20. © 2009 McGraw-Hill Higher Education. All rights reserved. Sterilization Sterilization = Generally permanent birth control techniques that surgically disrupt the normal passage of ova or sperm Vasectomy: Removal of a section of the vas deferens Tubal ligation: Fallopian tubes are cut and the ends tied back Brought to you by
    21. 21. © 2009 McGraw-Hill Higher Education. All rights reserved. Male Sterilization: Vasectomy Brought to you by
    22. 22. © 2009 McGraw-Hill Higher Education. All rights reserved. Female Sterilization: Tubal Ligation Brought to you by
    23. 23. © 2009 McGraw-Hill Higher Education. All rights reserved. Abortion: Termination of a Pregnancy First Trimester Procedures  Manual vacuum aspiration  Procedure performed by dilating the cervix and removing uterine contents  Dilation and suction curettage (D&C)  Procedure in which the cervical canal is dilated to allow the uterine wall to be scraped  Medication abortion  RU-486 (mifepristone) blocks the action of progesterone and causes the lining of the uterus to break down Brought to you by
    24. 24. © 2009 McGraw-Hill Higher Education. All rights reserved. Abortion: Termination of a Pregnancy (cont.) Second Trimester Procedures  Dilation and Evacuation (D&E)  Performed between 13 and 16 weeks of pregnancy  Cervix is dilated and contents are removed by suction  Rarely used procedures  Hypertonic saline procedure  Prostaglandin procedure Brought to you by
    25. 25. © 2009 McGraw-Hill Higher Education. All rights reserved. Dilation and Evacuation Brought to you by
    26. 26. © 2009 McGraw-Hill Higher Education. All rights reserved. Abortion: Termination of a Pregnancy (cont.) Partial-birth abortion  Federal ban Third-trimester abortion procedures  Hysterotomy  Hysterectomy Brought to you by
    27. 27. © 2009 McGraw-Hill Higher Education. All rights reserved. Pregnancy Obstacles to Fertilization Acid level in the vagina Cervical mucus thickness Location of cervical entrance for sperm Location of the correct fallopian tube for sperm Distance sperm travels Motility of sperm Brought to you by
    28. 28. © 2009 McGraw-Hill Higher Education. All rights reserved. Aids to Fertilization  200-500 million sperm cells are deposited into the vagina during ejaculation  Sperm are deposited near the cervical opening  Male accessory glands help make the semen nonacidic  Uterine contractions aid sperm movement in the proper direction  Sperm cells move fairly quickly  Sperm can live for days  Cervical mucus is thin and watery at the time of ovulation Brought to you by
    29. 29. © 2009 McGraw-Hill Higher Education. All rights reserved. Fertilization and Implantation Brought to you by
    30. 30. © 2009 McGraw-Hill Higher Education. All rights reserved. Signs of Pregnancy (Presumptive) Missed menstrual period after sexual intercourse the previous month Morning sickness Increase in size and tenderness of breasts Darkening of the areolar tissue around the nipples Brought to you by
    31. 31. © 2009 McGraw-Hill Higher Education. All rights reserved. Signs of Pregnancy (Probable) Increased frequency of urination Increased in the size of the abdomen Cervix becomes softer by the sixth week Positive pregnancy test Brought to you by
    32. 32. © 2009 McGraw-Hill Higher Education. All rights reserved. Signs of Pregnancy (Positive) Determination of a fetal heart beat Feeling of the fetus moving (“quickening”) Observations of the fetus by ultrasound or optical viewers Brought to you by
    33. 33. © 2009 McGraw-Hill Higher Education. All rights reserved. Agents that Can Damage a Fetus  Rubella/herpes viruses  Tobacco smoke  Alcohol  Certain OTC drugs  Radiation  Accutane (acne drug) Brought to you by
    34. 34. © 2009 McGraw-Hill Higher Education. All rights reserved. Intrauterine Development  Three trimesters (13 weeks each)  First trimester  Zygote  Blastocyst  Embryo  Fetus (after 8 weeks)  Second trimester: Organs develop, fetal heartbeat and bone structure evident, prominent weight gain in the mother  Third trimester: Fetus increases weight from 2-3 pounds; absorption of major nutrients allowing increased growth and weight Brought to you by
    35. 35. © 2009 McGraw-Hill Higher Education. All rights reserved. Three Stages of Labor Effacement/dilation of the cervix:  Uterine contractions thin the cervix and enlarge the cervical opening  Cervix opens to 10 cm during this stage Delivery of the fetus:  Uterine contractions are aided by mother’s voluntary contractions of abdominal muscles  Fetus moves through the birth canal Delivery of the placenta:  Placenta detaches from uterine wall Brought to you by
    36. 36. © 2009 McGraw-Hill Higher Education. All rights reserved. Stages of Labor and Childbirth Brought to you by
    37. 37. © 2009 McGraw-Hill Higher Education. All rights reserved. Cesarean Deliveries (C-section)  Fetus is removed from the uterus through the abdominal wall  Possibly due to one or more of the following factors:  Fetus is improperly positioned  Mother’s pelvis is too small  Fetus is especially large  Fetus shows signs of distress  Umbilical cord is compressed  Placenta is being delivered before the fetus  Mother’s health is at risk Brought to you by
    38. 38. © 2009 McGraw-Hill Higher Education. All rights reserved. Causes of Infertility  Low sperm count  Poor sperm motility  Sperm abnormalities  Lack of ovulation  Obstruction of fallopian tubes Brought to you by
    39. 39. © 2009 McGraw-Hill Higher Education. All rights reserved. Enhancing Fertility  Cold packs on the scrotum (men)  Boxer shorts vs. briefs (men)  Increase intercourse frequency Brought to you by
    40. 40. © 2009 McGraw-Hill Higher Education. All rights reserved. Treatments for Infertility  Artificial insemination  Surgical procedures  Fertility drugs  Assisted reproductive technology  In vitro fertilization  Gamete intrafallopian transfer  Zygote intrafallopian transfer  Intracytoplasmic sperm injection Brought to you by
    41. 41. © 2009 McGraw-Hill Higher Education. All rights reserved. Options for Infertile Couples  Surrogate parenting  Adoption  Foster parenting Brought to you by
    42. 42. © 2009 McGraw-Hill Higher Education. All rights reserved. Cloning Techniques Procedures involve the following:  Surgical removal of an egg from female donor  Nucleus of the egg is removed  Cell is taken from a cloning subject (male/female)  Through an electrical jolt, the cell is fused with the enucleated egg, creating a clonal zygote  Embryo is implanted in the womb of a surrogate mother  After nine months, a genetically matched reproduction is born Brought to you by
    43. 43. © 2009 McGraw-Hill Higher Education. All rights reserved. Cloning Reproductive cloning  Not yet accomplished  Banned in selected countries and states Therapeutic cloning  Can be used to create stem cells Brought to you by
    44. 44. © 2009 McGraw-Hill Higher Education. All rights reserved. Managing Your Fertility Brought to you by
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