Summary

Reproductive health means a state of complete physical, mental and social well-being in all matters relating to the reproductive system, not merely the absence of disease. The WHO defines it this way, and India’s family planning programmes (started in 1951) aim to achieve it.

Amniocentesis is a prenatal diagnostic technique to detect genetic disorders (e.g., Down’s syndrome) in the foetus. Its misuse for sex determination led to a decline in the female sex ratio, so it is legally banned in India under the Pre-conception and Pre-natal Diagnostic Techniques (PCPNDT) Act, 1994.

Natural contraceptive methods include the rhythm method (avoiding intercourse during the fertile period, days 10-17 of a 28-day cycle) and coitus interruptus (withdrawal before ejaculation). These are unreliable.

Barrier methods physically block sperm from reaching the egg: condoms (for males; also protect against STDs), diaphragms, cervical caps, and vaults (for females; used with spermicidal creams/jellies).

Intrauterine devices (IUDs) are inserted by a doctor into the uterus. Non-medicated IUDs (e.g., Lippes loop) increase phagocytosis of sperm. Copper-releasing IUDs (e.g., CuT, Cu7) release copper ions that suppress sperm motility and fertilising capacity. Hormone-releasing IUDs (e.g., Progestasert, LNG-20) make the uterus unsuitable for implantation and thicken cervical mucus.

Oral contraceptives (birth control pills) contain a combination of oestrogen and progesterone (or progestogen alone). They inhibit ovulation by suppressing FSH and LH release, alter cervical mucus, and prevent implantation. Saheli is a non-steroidal, once-a-week oral pill developed in India.

Injectables (e.g., Depo-Provera) and implants (e.g., Norplant) release progestogens and are effective for months to years.

Emergency contraceptives (morning-after pills) are high-dose progestogens (levonorgestrel) or IUD insertion within 72 hours of unprotected intercourse to prevent implantation.

Surgical methods are permanent: vasectomy in males (cutting and tying the vas deferens) and tubectomy in females (cutting and tying the fallopian tubes).

Medical Termination of Pregnancy (MTP) is the intentional termination of a pregnancy before the foetus becomes viable (up to 24 weeks in India). First legalised in 1971, MTP is governed today by the MTP (Amendment) Act, 2017, which permits it on two grounds: risk to the mother’s life or grave injury to her physical/mental health, or substantial risk of serious foetal abnormality. One doctor's opinion suffices up to 12 weeks; two doctors' opinions are needed from 12 to 24 weeks. MTP is safer in the first trimester (up to 12 weeks) than in the second.

Sexually Transmitted Diseases (STDs) include bacterial (gonorrhoea, syphilis, chlamydia, chancroid), viral (HIV, genital herpes, genital warts, hepatitis B), and parasitic (trichomoniasis) infections. Many are curable (bacterial, parasitic), but viral ones (HIV, herpes) are not. Early detection and treatment are critical; prevention includes using condoms and avoiding multiple partners.

Infertility is the inability to conceive after two years of unprotected intercourse. Assisted Reproductive Technologies (ART) include:

• IVF (in vitro fertilisation) – egg and sperm are fertilised in a lab dish; the embryo is transferred to the uterus (ET).
• ZIFT (zygote intrafallopian transfer) – a zygote is transferred into the fallopian tube. …