Contraceptive Physiology & ART

CONTRACEPTIVE PHYSIOLOGY : 

PPTAD: REP PHYSIO : CONTRART 1 CONTRACEPTIVE PHYSIOLOGY By Dr.M.Anthony David MD Professor of Physiology

HUMAN REPRODUCTION : 

PPTAD: REP PHYSIO : CONTRART 2 HUMAN REPRODUCTION

CONTRACEPTION : 

PPTAD: REP PHYSIO : CONTRART 3 CONTRACEPTION The prevention of conception is called as contraception. Contraception is useful to prevent population explosion. It is also called as Birth Control methods or Family Planning Methods. This can be done at the female, male or coital stages.

ABORTION : 

PPTAD: REP PHYSIO : CONTRART 4 ABORTION Abortion is the abrupt and unsuccessful ending or termination of pregnancy. It can be spontaneous or induced. Induced Abortion is the medical termination of pregnancy. In Abortion, a formed embryo or fetus is killed due to health problems of the mother.

CONTRACEPTIVE METHODS: A CLASSIFICATION : 

PPTAD: REP PHYSIO : CONTRART 5 CONTRACEPTIVE METHODS: A CLASSIFICATION TERMINAL OR PERMANENT METHODS: There is a permanent stopping of conception. Used by couples who have finished their family. TEMPORARY SPACING METHODS: Used for spacing or giving a gap between children Used to postpone children’s arrival while the couple gets adjusted.

TERMINAL METHODS : 

PPTAD: REP PHYSIO : CONTRART 6 TERMINAL METHODS I. VASECTOMY: MALE STERILISATION: A SIMPLE OUT PATIENT PROCEDURE. THE ‘VAS DEFERENS’ IS ISOLATED AND CUT. THE TWO ENDS ARE LIGATED. LATEST METHOD: NSV: NON SCALPEL VASECTOMY. LEAST DONE IN INDIA DUE TO PREJUDICE & SUPERSTITIONS.

VASECTOMY : 

PPTAD: REP PHYSIO : CONTRART 7 VASECTOMY

TERMINAL METHODS : 

PPTAD: REP PHYSIO : CONTRART 8 II. TUBECTOMY: FEMALE STERILIZATION: PART OF THE FALLOPIAN TUBE IS REMOVED. THE TWO ENDS ARE TIGHTLY LIGATED. CAN BE DONE AS: POST PARTUM STERILIZATION INTERVAL STERILIZATION LAPAROSCOPIC STERILIZATION TERMINAL METHODS

TUBECTOMY: TYPES : 

PPTAD: REP PHYSIO : CONTRART 9 TUBECTOMY: TYPES

Slide 10: 

PPTAD: REP PHYSIO : CONTRART 10 INTERVAL STERILIZATION

SPACING : 

PPTAD: REP PHYSIO : CONTRART 11 SPACING BARRIER METHODS: A) PHYSICAL BARRIER: CONDOMS DIAPHRAGM VAGINAL SPONGE FEMALE CONDOM. B) CHEMICAL BARRIER:SPERMICIDAL FOAMS CREAMS SUPPOSITORIES METHODS

CONDOMS SPERMICIDES : 

PPTAD: REP PHYSIO : CONTRART 12 CONDOMS SPERMICIDES

Slide 13: 

PPTAD: REP PHYSIO : CONTRART 13 DIAPHRAGM + SPERMICIDE

IUCDs : 

PPTAD: REP PHYSIO : CONTRART 14 IUCDs INTRA UTERINE CONTRACEPTIVE DEVICES (IUCD): FUNCTION BY PREVENTING IMPLANTATION. I GENERATION: NON MEDICATED: LIPPE’S LOOP II GENERATION: MEDICATED BIOACTIVE COPPER T III GENERATION: HORMONE RELEASING PROGESTASERT

Slide 15: 

PPTAD: REP PHYSIO : CONTRART 15 LIPPE’S LOOP Cu T & PROGESTASERT

HORMONAL CONTRACEPTIVES : 

PPTAD: REP PHYSIO : CONTRART 16 HORMONAL CONTRACEPTIVES ALSO CALLED ORAL PILLS OR ORAL CONTRACEPTIVES. ARE USUALLY HORMONES OR COMBINATIONS TAKEN BY MOUTH. THEY CAUSE THE TEMPORARY CESSATION OF THE OVARIAN CYCLES.

ORAL CONTRACEPTIVES : 

PPTAD: REP PHYSIO : CONTRART 17 ORAL CONTRACEPTIVES COMBINED PILLS: HAVE BOTH ESTROGEN & PROGESTERONE. POP : PROGESTRONE ONLY PILL. MORNING AFTER PILL. EMERGENCY CONTRACEPTION. DEPOT FORMULATIONS INJECTABLES: DEPOT PROVERA,‘DMPA’, ‘NET EN’

OTHER METHODS : 

PPTAD: REP PHYSIO : CONTRART 18 OTHER METHODS ABSTINENCE: THE BEST PART OF THE A B C TO PREVENT HIV/AIDS. COITUS INTERRUPTUS: HISTORICALLY THE OLDEST IN HUMANS. THE SEMEN WAS SPILLED ON THE GROUND. THE MALE PILL: GOSSYPOL : COTTON SEED OIL KILLS SPERMATIDS. VERY TOXIC AND SO NOT USED.

NATURAL FAMILY PLANNING METHODS : 

PPTAD: REP PHYSIO : CONTRART 19 NATURAL FAMILY PLANNING METHODS SAFE PERIOD METHOD: DURING THE FERTILE PERIOD, COITUS IS AVOIDED. THE REST OF THE CYCLE IS ‘SAFE’ OVULATION TESTS: BASAL BODY TEMPERATURE CHARTS CERVICAL MUCUS : BILLINGS METHOD SYMPTOTHERMIC: ‘SELF RECOGNITION’

SAFE PERIOD METHOD : 

PPTAD: REP PHYSIO : CONTRART 20 SAFE PERIOD METHOD

ASSISTED REPRODUCTIVE TECHNOLOGY : 

PPTAD: REP PHYSIO : CONTRART 21 ASSISTED REPRODUCTIVE TECHNOLOGY ARTIFICIAL REPRODUCTIVE TECHNIQUES. THESE ARE TECHNIQUES WHICH HELP INFERTILE COUPLES TO CONCEIVE & BEAR CHILDREN. THEY ARE OFFERED TO THEM AT FERTILITY CENTERS.

INFERTILITY : 

PPTAD: REP PHYSIO : CONTRART 22 INFERTILITY What is fertility? The capacity to conceive and bear children is called fertility. Infertility: A couple is said to be infertile if pregnancy does not result after 1 year of normal sexual activity without contraceptives. 25% of couples experience infertility at some point in their reproductive lives.

WHO IS RESPONSIBLE FOR INFERTILITY? : 

PPTAD: REP PHYSIO : CONTRART 23 WHO IS RESPONSIBLE FOR INFERTILITY? The male partner in 40% cases. Artificial insemination is resorted to in such cases. A combination of factors can be the reason for infertility.

ARTIFICIAL INSEMINATION : 

PPTAD: REP PHYSIO : CONTRART 24 ARTIFICIAL INSEMINATION SPERMS ARE INJECTED INTO THE CERVIX DIRECTLY. DONE IN CASES OF MALE INFERTILITY OR FEMALE TRACT HOSTILITY.

ASSISTED REPRODUCTIVE TECHNOLOGY: A CLASSIFICATION : 

PPTAD: REP PHYSIO : CONTRART 25 ASSISTED REPRODUCTIVE TECHNOLOGY: A CLASSIFICATION I. PROCESSES INVOLVING DIRECT RETRIEVAL OF OOCYTES FROM THE OVARIES. II. TECHNIQUES OF SPERM RETRIEVAL AND INJECTION

I. TECHNIQUES OF OOCYTE RETRIEVAL : 

PPTAD: REP PHYSIO : CONTRART 26 I. TECHNIQUES OF OOCYTE RETRIEVAL IVF –ET: IN VITRO FERTILIZATION & EMBRYONAL TRANSFER: TEST TUBE BABY GIFT: GAMETE INTRA FALLOPIAN TRANSFER ZIFT: ZYGOTE INTRA FALLOPIAN TRANSFER TET: TUBAL EMBRYONAL TRANSFER POST: PERITONEAL OOCYTE & SPERM TRANSFER

1.IVF-ET: THE TEST TUBE BABY! : 

PPTAD: REP PHYSIO : CONTRART 27 1.IVF-ET: THE TEST TUBE BABY! IN VITRO FERTILIZATION & EMBRYONAL TRANSFER. TEST TUBE BABY IS A MISNOMER FERTILIZATION DONE IN A PETRIDISH. AFTER THE EMBRYO DEVELOPS, IT IS TRANSFERRED INTO THE BODY OF THE UTERUS.

I. TECHNIQUES OF OOCYTE RETRIEVAL : 

PPTAD: REP PHYSIO : CONTRART 28 I. TECHNIQUES OF OOCYTE RETRIEVAL IVF –ET: IN VITRO FERTILIZATION & EMBRYONAL TRANSFER: TEST TUB BABY GIFT: GAMETE INTRA FALLOPIAN TRANSFER ZIFT: ZYGOTE INTRA FALLOPIAN TRANSFER TET: TUBAL EMBRYONAL TRANSFER POST: PERITONEAL OOCYTE & SPERM TRANSFER

2. GAMETE INTRA FALLOPIAN TRANSFER (GIFT) : 

PPTAD: REP PHYSIO : CONTRART 29 2. GAMETE INTRA FALLOPIAN TRANSFER (GIFT) BOTH THE GAMETES, THE MATURE SPERMATOZOON AND THE OVUM ARE PUT INTO THE FALLOPIAN TUBE. THERE THEY FERTILIZE AND CAUSE CONCEPTION. DONE IN CASES OF: LOW MOTILITY FOR SPERMS INCREASED CERVICAL MUCUS HOSTILITY

GAMETE INTRA FALLOPIAN TRANSFER (GIFT) : 

PPTAD: REP PHYSIO : CONTRART 30 GAMETE INTRA FALLOPIAN TRANSFER (GIFT)

I. TECHNIQUES OF OOCYTE RETRIEVAL : 

PPTAD: REP PHYSIO : CONTRART 31 I. TECHNIQUES OF OOCYTE RETRIEVAL IVF –ET: IN VITRO FERTILIZATION & EMBRYONAL TRANSFER: TEST TUB BABY GIFT: GAMETE INTRA FALLOPIAN TRANSFER ZIFT: ZYGOTE INTRA FALLOPIAN TRANSFER TET: TUBAL EMBRYONAL TRANSFER POST: PERITONEAL OOCYTE & SPERM TRANSFER

3. ZYGOTE INTRA FALLOPIAN TRANSFER (ZIFT) : 

PPTAD: REP PHYSIO : CONTRART 32 3. ZYGOTE INTRA FALLOPIAN TRANSFER (ZIFT) THE FERTILIZATION IS DONE OUTSIDE, INVITRO. THE SINGLE CELLED ZYGOTE IS PUT INTO THE FALLOPIAN TUBE. IT THEN DEVELOPS INTO AN EMBRYO AND MOVES INTO THE BODY OF THE UTERUS.

I. TECHNIQUES OF OOCYTE RETRIEVAL : 

PPTAD: REP PHYSIO : CONTRART 33 I. TECHNIQUES OF OOCYTE RETRIEVAL IVF –ET: IN VITRO FERTILIZATION & EMBRYONAL TRANSFER: TEST TUB BABY GIFT: GAMETE INTRA FALLOPIAN TRANSFER ZIFT: ZYGOTE INTRA FALLOPIAN TRANSFER TET: TUBAL EMBRYONAL TRANSFER POST: PERITONEAL OOCYTE & SPERM TRANSFER

4. TUBAL EMBRYO TRANSFER (TET) : 

PPTAD: REP PHYSIO : CONTRART 34 4. TUBAL EMBRYO TRANSFER (TET) TUBAL EMBRYO TRANSFER. THE ZYGOTE IS ALLOWED TO GROW AND BECOME AN EMBRYO IN VITRO. THEN AT THAT STAGE IT IS PUT INTO THE FALLOPIAN TUBE.

I. TECHNIQUES OF OOCYTE RETRIEVAL : 

PPTAD: REP PHYSIO : CONTRART 35 I. TECHNIQUES OF OOCYTE RETRIEVAL IVF –ET: IN VITRO FERTILIZATION & EMBRYONAL TRANSFER: TEST TUB BABY GIFT: GAMETE INTRA FALLOPIAN TRANSFER ZIFT: ZYGOTE INTRA FALLOPIAN TRANSFER TET: TUBAL EMBRYONAL TRANSFER POST: PERITONEAL OOCYTE & SPERM TRANSFER

5. PERITONEAL OOCYTE & SPERM TRANSFER (POST) : 

PPTAD: REP PHYSIO : CONTRART 36 5. PERITONEAL OOCYTE & SPERM TRANSFER (POST) BOTH THE GAMETES ARE PUT INTO THE PERITONEAL CAVITY. THEY ARE EXPECTED TO FERTILIZE IN THE PERITONEUM. LATER THE ZYGOTE OR EMBRYO IS TO MOVE INTO THE TUBE AND THE UTERUS.

II. TECHNIQUES OF SPERM RETRIEVAL & INJECTION : 

PPTAD: REP PHYSIO : CONTRART 37 II. TECHNIQUES OF SPERM RETRIEVAL & INJECTION DONE IN CASES SUCH AS: AZOOSPERMIA LOW SPERM COUNTS HYPO & EPISPADIAS. TECHNIQUES HELP THE SPERM TO REACH THE OVUM BETTER

II. TECHNIQUES OF SPERM RETRIEVAL & INJECTION : 

PPTAD: REP PHYSIO : CONTRART 38 II. TECHNIQUES OF SPERM RETRIEVAL & INJECTION ICSI: INTRA CYTOPLASMIC SPERM INJECTION. TESE: TESTICULAR SPERM EXTRACTION. MESA: MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION.

1. INTRA CYTOPLASMIC SPERM INJECTION : 

PPTAD: REP PHYSIO : CONTRART 39 1. INTRA CYTOPLASMIC SPERM INJECTION

1. INTRA CYTOPLASMIC SPERM INJECTION : 

PPTAD: REP PHYSIO : CONTRART 40 1. INTRA CYTOPLASMIC SPERM INJECTION

2. TESTICULAR SPERM EXTRACTION (TESE) : 

PPTAD: REP PHYSIO : CONTRART 41 2. TESTICULAR SPERM EXTRACTION (TESE) The sperms are extracted or teased from the testes. Done in cases where there is a block in the ductular system. The extracted sperms are used for fertilization.

3. MESA : 

PPTAD: REP PHYSIO : CONTRART 42 3. MESA MICROSURGICAL EPIDIDYMAL SPERM ASPIRATION. DELICATE MICROSCOPIC SURGERY IS DONE. SPERMS ARE ASPIRATED FROM THE EPIDIDYMIS. THEY ARE THEN USED FOR FERTILIZATION.

REVIEW WEIVER : 

PPTAD: REP PHYSIO : CONTRART 43 Contraception is the prevention of conception. There two main types: Permanent or Terminal methods: Vasectomy or Male sterilization. Tubectomy or Female sterilization. Temporary or Spacing methods: Barriers IUCDs Other methods. REVIEW WEIVER

Slide 44: 

PPTAD: REP PHYSIO : CONTRART 44 Thank you