Medical termination of pregnancy is carried out to get rid of unwanted pregnancies. It is also essential when the foetus is suffering from an incurable disease or when continuation of the pregnancy could be harmful or even fatal to the mother and/or foetus.

An ideal contraceptive should

(i) be easily available

(ii) effective and reversible with least or no side effects

(iii) no interference with the sexual drive/desire or the sexual act of the user

(iv) be user-friendly

Among the common STDs, hepatitis-B and AIDS are not infections of the reproductive organs though their mode of transmission could be through sexual conact also.

All other diseases like gonorrhoea, syphilis, genital herpes, hepatitis-B are transmitted through sexual contact and are also infections of the reproductive tract so, there are STDs and RTI, Whereas, AIDS and hepatitis are STDs but not RTI.

ART techniques are described as follows

(i) Test-tube Baby Programmes In this method, ova from the wife/donor (female) and the sperms from the husband/donor (male) are collected and are induced to form zygote under simulated conditions in the laboratory. This process is called In Vitro Fertilisation (IVF).

The zygote or early embryo with upto 8 blastomeres is transferred into the Fallopian tube (process is called Zygote Intra Fallopian Transfer or ZIFT) and embryo with more than 8 blastomeres is transferred into the uterus (process is called Intra Uterine Transfer or IUT).

In females who cannot conceive, embryos formed by fusion of gametes within the female (called in vivo fertilisation) are transferred.

(ii) Gamete Intra Fallopian Transfer (GIFT) It is the transfer of an ovum collected from a donor into the Fallopian tube of another female who cannot produce one, but can provide suitable environment for fertilisation and further development of the embryo.

(iii) Artificial Insemination (AI) In this method, the semen collected either from the husband or a healthy donor is artificially introduced into the vagina or into the uterus (Intra Uterine Insemination or IUI).

This technique is used in cases where the male is unable to inseminate sperms in the female reproductive tract or due to very low sperm counts in the ejaculation.

Intra Uterine Devices are presently available as

(a) Non-medicated IUDs (e.g., Lippes loop).

(b) Copper releasing IUDs (e.g., Cu-T, Cu-7, Multiload 375).

(c) Hormone releasing IUDs (e.g., Progestasert, LNG-20).

Mode of Action of Hormonal Contraceptives

The hormones releasing IUDs, make the uterus unsuitable for implantation and the cervix hostile to the sperms. Progesterone can also be used as injections and implants (slow release of hormones) to inhibit ovulation.

Advantages of Hormonal Contraceptives

Administration of progestogens or progestogen-oestrogen combinations or IUDs within 72 hrs of intercourse have been found to be effective as emergency contraceptives as they could be used to avoid possible pregnancy due to rape or causal unprotected intercourse.

Disadvantages of Hormonal Contraceptives

(i) IUDs are suggested as ideal contraceptives for the females but they can have serious side effects.

(ii) Can cause allergic reaction.

(iii) If displaced, can cause tissue damage and profuse bleeding.

(iv) IUDs can damage the normal hormonal balance and later even if desired, pregnancy may not be achieved.

(v) Artificial intake can disrupt normal hormonal interactions in the body system.