Module 4 Lesson 5 - 2

Contraception and Fertility Control

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Read pages 530 - 532

Humans are quite concerned about the right timing of fertility. The possibility of having an offspring when an individual is not ready has driven much research into reducing reproductive potential. In fact, some of the oldest research is in controlling reproductive potential.

Some of the methods that reduce reproductive potential are abstinence, tubal ligation, vasectomy, physical and chemical barriers, and natural family planning. Abstinence is refraining from having any type of sexual intercourse. Although this is the most effective method of contraception, several other methods prevent conception for those people who are sexually active.

Tubal ligation and vasectomy are permanent contraception methods and highly effective for individuals who do not wish to have children in the future. Tubal ligation involves cutting the Fallopian tubes and closing them to prevent the egg from fusing with sperm. Vasectomy involves cutting the vas deferens so that the semen cannot contain any sperm.

Other hormonal and barrier methods are not permanent. Hormone medications can be taken orally, by injection, through a patch, or by implants. The hormones mimic progesterone and estrogen to prevent follicles from maturing. Examples of physical and chemical barriers are condoms, diaphragms, and spermicides.

Natural family planning is the least effective contraceptive method. This method monitors the ovarian cycle of the woman, and the couple avoid sexual intercourse during the fertile days of each month.

Assisted Reproductive Technology

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Read pages 529 - 530

As sterility or infertility can happen for a wide range of reasons, much research and advancement has gone into developing fertility enhancing technologies. Technologies such as artificial insemination, in vitro fertilization, surrogate mothers, ovulation test kits, and superovulation  assist in trying to produce a new offspring.

In vitro fertilization (IVF) is a procedure that can help couples who are having difficulty becoming pregnant due to blocked Fallopian tubes, low sperm count, low sperm motility, or sperm that cannot penetrate the outer layer of an egg, among other conditions. During an IVF procedure, follicle stimulating hormone (FSH) is administered so that, instead of one oocyte maturing per month, 10 to 20 oocytes can be produced. Luteinizing hormone (LH) is given to trigger ovulation. The ova is retrieved using a syringe. The eggs and sperm are combined in glassware, and incubated until the zygote reaches the blastocyst stage. At this point, the embryo is implanted on the uterus. A maximum number of embryos can be implanted during each cycle due to highly successful procedures. This reduces the likelihood of multiple pregnancies.

Artificial insemination is used to place concentrated semen in the uterus. Superovulation stimulates the ovaries to produce multiple eggs through hormone treatment. If a woman is unable to carry the baby, the couple can choose a surrogate mother. In surrogacy, one or both gametes from the couple can be contributed to form a zygote.

Before conception, technologies such as at-home fertility test kits may help a couple determine their reproductive potential and determine the optimal time to try conceiving. Another technology used is a take-home pregnancy test available in most local pharmacies.  This test detects the human chorionic gonadotropin (hCG) levels in a woman's urine. More formal urine and blood tests done through a medical laboratory should follow to confirm fertilization.

Watch and Listen

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Video 1: Reproductive Technologies and STDs

As with any technology, advances are made quickly. This is also true in the case of reproductive technologies. Some of the information on reproductive technologies in the multimedia pieces you are about to view may not be as current as that used now. However, most of the information is still correct and relevant and, therefore, will help you to understand in greater detail some of the technologies used.

Video 2: Hormone Controls and Conception

This video outlines a variety of contraceptive methods.   

Monitoring the Fetal Development

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Read pages 529 - 530

After conception, other technologies are needed to monitor the events of embryonic and fetal development. After fertilization has been established, several technologies can be used to monitor the development of the embryo and fetus.

Prenatal Diagnosis

The following tests are used to monitor the development. Ultrasonography (including regular ultrasound, 3D and 4D ultrasound) has been used wisely for more than 50 years to monitor embryonic and fetal development. Fetal surgery is a last resort option technology used to treat certain life-threatening congenital abnormalities. Other technologies that can be used to understand genetic conditions of the fetus are cordocentesis (fetal blood sampling), amniocentesis, and chorionic villi sampling.

1. Ultrasound uses high frequency sound waves to make images of the fetus. It can help doctors visualize the fetal anatomy to determine if any are abnormal. However, it cannot detect well some subtle anatomical abnormalities such as Down syndrome.
   
   
2. Cordocentesis takes a sample of fetal blood from the umbilical cord. It is a not widely used procedure because lower risk procedures such as amniocentesis and chorionic villi sampling can be used instead.
   
   
3. Amniocentesis takes a sample of the amniotic fluid from the amniotic cavity. The amniotic fluid contains fetal cells that can be analysed for chromosomal abnormalities and fetal lung maturity.
   
   
4.  Chorionic villi sampling (CVS) takes a sample of cells from the placental chorionic villi. The cells can be used to determine the karyotype of the fetus. The advantage of CVS is that it can be performed earlier than amniocentesis can.
   
   
5. Reproductive technologies can be used in parturition, also. One is C-section childbirth, which is performed when complications make vaginal childbirth a great risk. Some of the complications that could result in C-section childbirth are the placenta covering the opening of the cervix, multiple births, or the baby in distress due to lack of oxygen.
   
   

At the time of delivery, various technologies are used to assist with the birthing process. These include induction medication (oxytocin drip), fetal heart monitor, epidural, episiotomy, forceps, and suction.

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