Family planning

Family planning:
The use of education and birth control to limit the number of offspring and the population of a country.
Involves the use education about reproduction and birth control in order to allow women to make decision about their fertility and family size.

INFERTILITY IS DEFINED AS FAILURE TO CONCEIVE WITHIN ONE OR MORE YEARS OF REGULAR UN PROTECTED COITUS.

FACTORS RESPONSIBLE FOR FERTILITY
Healthy spermatozoa should deposited high in the vagina.
Spermatozoa should undergo changes and acquire motility.
The motile spermatozoa should ascend through the cervix into the uterine cavity and fallopian tube.
There should be ovulation.
The fallopian tubes should be patent and the oocyte should be picked up by the fimbriated end of the tube

The spermatozoa should fertilize the oocyte at the ampulla of the tube.
The embryo should reach the uterine cavity after 3-4 days of fertilization.
The endometrium should be prepared for implantation and corpus luteum should function adequately.

CAUSES OF INFERTILITY
FACTORS IN MEN
Abnormalities of the sperm.
Abnormal erections
Abnormal ejaculation
Abnormalities of seminal fluid.

FACTORS IN WOMEN
Disorders of ovulation
Abnormalities of fallopian tube.
Abnormalities of the cervix or uterus

REPEATED PREGNANCY LOSS
Abnormalities of fetal chromosomes
Abnormalities of the cervix or uterus.
Endocrine abnormalities.
Immunologic factors
Environmental factors.
Infection

SPECIFIC INVESTIGATIONS
MALE
1. Semen analysis
2. Serum FSH, LH, testosterone, prolactin and TSH
3. Fructose content in seminal fluid
4. Testicular biopsy
5. Karyotype analysis
6. Immunological tests
7. Trans rectal ultra sound (TRUS)
8. Vasogram
9.Presence of pus cells

FEMALE
Basal body temperature
Cervical mucus study
Hormone estimation
Serum progesterone
Serum LH
Serum estradiol
4. Endometrial biopsy
5. Ovum transport: investigation of tube patency
Laparoscopy
Hysterosalpingography

THERAPIES TO FACILITATE PREGNANCY
Stimulation of ovulation
Clomiphene citrate (clomid)
Human chorionic gonadotrophin (HCG)
Human menopausal gonadotrophin (HMG)
Bromocriptine (parlodel)
2. Surgical procedures
3. Egg donation
4. Surrogate parenting

5. Assisted reproductive technology
Artificial insemination by husband (AIH)
Artificial insemination by donor (AID/DI)
Invitro fertilization/ embryo transfer (IVF/ET)
Gamete intrafallopian transfer (GIFT)
Zygote intrafallopian transfer (ZIFT)
Intracytoplasmic sperm injection (ICSI)