Reproduction and Contraception

1. Reproduction and Contraception Prepared by: Nadia JradiMasri, M.D

2. Introduction to Reproductive system Female

3. Female reproductive system

4. Hymen The hymen is a membrane that surrounds or partially covers the external vaginal opening It has no biological significance, its only of social importance Different types are present.

5. Hymen Variations

6. Hymen variations Elastic hymen: Dilates and contracts back after penetration of penis Does not rupture No sign of blood after first sexual intercourse Avascular hymen: Absence of blood vessels penetrating the hymen No sign of blood after first sexual intercourse

7. Hymenoplasty An operation of resuturing the hymen after its rupture ( intercourse or trauma) Mainly done to reclaim virginity

8. Female reproductive system

9. Present since birth Released from the ovary in ovulation Female reproductive cellOvum=Eggalways of X type

10. Ovulation It is production of the “egg” by the ovary Starts after puberty (nl age= 10-15y) It occurs at regular monthly intervals Usually at the middle of a menstrual cycle

11. Ovulation

12. Menstrual Cycle

13. Menstrual Cycle

14. Menstruation Bleeding coming from the vagina produced by the uterus occuring at regular intervals: every 28 +/- 7d It stays for 5 +/- 3 days Blood loss is approximately 50 ml, and the blood lost is regular blood (wrong concept: Dirty blood)

15. Female fertility Starts at puberty (10-15y) and ends at menopause (40-60y) Fertile period: Fertility awareness Used to avoid or to Achieve pregnancy Female fertility decreases With age

16. Introduction to reproductive system Male

17. Male reproductive system

18. Not present since birth Produced by the testis by Spermatogenesis every 70 days Male reproductive cellSperm: X or Y type

19. Male fertility Starts at puberty (12-16 y) No limited fertility intervals ( unlike females) Sperm count decreases with age

20. Fertilization

21. Sperm pathway

22. Fertilization Zygote

23. Zygote Zygote sex: If an X sperm meets an X egg Female XX If a Y sperm meets an X egg Male XY Zygote will travel back to the uterus where it is implanted After implantation in the uterus, it produces BHCG hormone

24. Pregnancy test Becomes positive around the time of the next expected menstrual cycle

25. Infertility

26. Infertility A couple is considered to be infertile if: The couple has not conceived after 12 months of contraceptive-free intercourse if the female is under the age of 34. (WHO def.)2] The couple has not conceived after 6 months of contraceptive-free intercourse if the female is over the age of 35

27. Infertility causes Data from UK, 2009

28. Infertility causes

29. Assisted reproductive techniques A major treatment of many cases of infertility Do not apply to all cases of infertility E.g: In Vitro Fertilization IVF

30. 1 IVF Pregnancy rate 20-35% depending on the center and many maternal factors 3 2 a process by which egg cells are fertilised by sperm outside the body

31. Contraception Birth Control

32. Birth Control methods

33. Birth control methods Most birth control methods are quite effective if used properly However, contraceptives can fail for a number of reasons, including incorrect use and failure of the medication, device, or method itself.

34. Birth control Methods

35. Contraception No method of birth control is perfect. The advantages and disadvantages of each method should be balanced and then choose The best method is the one that will be used consistently and correctly

36. Birth Control Pills

37. Birth Control Pills Also referred to as "the pill," contain a combination of two female hormones: estrogen and progestin (a progesterone like hormone) Present since 1960

38. Hormonal Contraception

39. Birth control Pills

40. Birth control Pills Efficacy: Very effective if taken properly Ideal Failure rate is 0.1 % Actual Failure rate is 8% (Missed Pills) Disadvantages: Some side effects as mood changes, breast Pain, Spotting Proper use is essential

41. Birth Control Pills Contraindicated ( Cannot be used) in: Females age 35y or older who smoke (High risk of cardiovascular diseases) History of Breast Cancer Family history of blood clots Preexisting cardiovascular diseases Other Safe and reliable option for most healthy non smoking females

42. Birth control pills OCPs should not be available as “over-the-counter” medications, they need a doctor’s prescription

43. Birth control pills Most females are able to become pregnant immediately after discontinuation of pills

44. Other hormonal contraception Injectable birth control Skin Patch Vaginal Ring Birth control implant

45. Barrier Methods

46. 1. Male Condoms Advantages: Have fewer side effects than hormonal contraceptives Offer effective protection against certain sexually transmitted diseases (STDs) Are available without a prescription

47. 1. Male Condoms Disadvantages: Proper use is essential ( Men should follow instructions of insertion carefully) Can break Can be a problem for people with latex allergy Actual Failure rate can reach 10-15% ( can be improved if combined with spermicides)

48. 2. Female Diaphragm/ cervical Cap

49. 3. Female Condom

50. 4. Spermicides Chemical substances that destroy sperm. They are available in most pharmacies without a prescription May be used alone (High Failure rate), but are more effective when used in combination with a condom, diaphragm, or cervical cap Not effective in preventing transmission of sexually transmitted infections