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Birth Control & Infertility. Chapter 9. Introduction. We’ve just discussed the entire process of sex and childbirth, discovering that both are magical, rewarding, and demanding (both physically and financially). What if you don’t want to have children, but just want to enjoy each other?
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Birth Control & Infertility Chapter 9
Introduction • We’ve just discussed the entire process of sex and childbirth, discovering that both are magical, rewarding, and demanding (both physically and financially). • What if you don’t want to have children, but just want to enjoy each other? • Does becoming a couple mean you must risk becoming a group?? • Many couples find themselves facing the reality of these questions and others we’ll discuss later this semester without fully considering the results of sexual activity. (Rem: ONE sperm is all it takes!) • Are you ready?
Introduction (cont.) • What if you’re in the opposite corner. “Kids: Want ‘em, can’t have ‘em?” • Now what?? • In as much as society cautions us about over population, we’re also sympathetic, toward couples who want to start a family, but are unable. • Many options exist in both cases. We’ll discuss many of these in the next two lectures.
Birth Control • Birth control, or conception, is loosely defined as any method which prevents the sperm and the egg (oocyte) from making contact, or in some cases, preventing the embryo from implanting on the endometrium. • Okay…this seems obvious…prevent the egg and the sperm from getting together and no babies! However, what does this say about personal satisfaction?? Frankly, not much. • To complicate matters, some methods of birth control seem to be designed to prevent disease more than prevent conception (Condoms: Effective, sure, but not easiest road to an orgasm.) • As we will now see, some methods of birth control have been given much more thought than others. • It may come down to what your individual goal is…no kids, no disease, or both.
Abstinence…100 % efficacy, or overstating the obvious? • “Okay…we could just not have sex.” • Yes!!! Finally, a way that always works!! • As much as I’d love to be able to preach this point, we are a sexual society. We were made for sex. It’s how we keep the species alive, and the desire (dare I say, drive) is incredibly strong. • I’m not saying we should all just run out and have sex. As we already observed, sexual interactions between individuals has both personal and cultural significance.
Cultures and Sex • REM: Many cultures have restricted (or strongly cautioned against) men and women from engaging in sexual activity until they are both emotionally and financially ready to support children. • China even has a one-child-per-couple rule. • Many other cultures are staring over population in the face (India, Mexico, US?. • Let’s also not forget that sexually transmitted diseases are rampant! • But let’s face reality for a moment. Sex is good. Sex is how we have kids (usually). Again, how do we stop people from having sex, or babies? • As most of you have already figured out…we don’t. But we can provide information to let couples make good decisions, based on accurate information.
How effective is “effective?” • Efficacy of birth control methods has always been a major concern. • If you’re going to use it at all, it had better work, right? • Most non-surgical methods are between 75-90% effective in preventing pregnancy. • Surgical sterilization is one method which provides nearly 100% prevention from birth control, yet allows couples to “feel every sensation.” • We’ll overview several methods of each in the next several slides.
Many non-surgical methods of birth control seem more medieval than modern. Spermacide and diaphragm Contraceptive Implant Birth Control Pill Depo-Provera injection Female Condom Intrauterine Device (IUD)
Vasectomy • Severing the vas deferens results in a vasectomy. • In many cases men choose this option for ultimate birth control. • Like other surgical procedures, vasectomies do nothing to prevent STD’s.
Vasectomy: in’s and out’s • Vasectomies don’t alter sexual desire, or performance in most healthy men. • Vasectomies don’t alter secondary sex characteristics. • Sometimes vasectomies result in antibodies being produced to the male’s sperm. • A vasectomy, severing of the vas deferens, is reversible.
Tubal Ligation • Tubal ligation is performed in order to prevent the egg from ever reaching the sperm. • Much more invasive than a vasectomy and therefore, more discomfort and potential post-surgery complications are expected. • “Tubals” are usually performed under a local anesthetic. • Hysteroscopic sterilization is an additional procedure in which uterine tubes are cauterized with a “hot” wire (electric).
Tubal Ligation • Also a “permanent” condition. • Tubal ligation doesn’t result in diminished sexual desire, or performance for the female. • Vasectomies are much easier…(and cheaper).
Birth Control Pill • Popular, but not 100% effective. • Used during 21 days of cycle. • Progesterone and estrogen in pill shut down pituitary action and prevents (hinders FSH and LH development) follicle development, thus reducing the likelihood of ovulation. • May also alter implantation by slowing egg travel through the fallopian tube.
Pill Side Effects • Shorter menstural cycle! • Relief from acne. • Formation of blood clots in some women (Thromboembolism).
Others… • “Morning-after” pill (Preven): synthetic progesterone which alters endometrium and thus hinders or prevents implantation of the eggs. • Interuterine Device (IUD): molded plastic or copper wire inserted into the uterus (Mirena). Mimics implantation, so future implantation is unlikely. • IUD’s can be expelled, or uterine perforation may occur. • Pelvic inflammatory disease (PID), a bacterial infection of the uterine tubes may also result.
Norplant • Contraceptive implants such as Norplant are long lasting hormonal implants which contain a synthetic progesterone (progestin). • Lasts up to five years. • Prevents the hypothalamus from secreting GnRH. Eggs aren’t released. • 99.7% efficacy! • Once tubes are removed, women can become pregnant again.
Physical Barrier Contraceptives • Diaphram for women. • Must be fitted by physician • Can be an interuption to sexual activity. • Should also be used with spermicide (nonoxynol-9).
Condoms for Men • Condoms for men are about 85% effective, even when properly used. • Prevent ejaculate from entering vagina. • No side effects (unless you have a latex allergy).
Female Condoms • Female condoms are also availble. • Idea here is a sperm barrier. • Like male condoms, is effective in protecting against STD’s.
Natural Planning Method* *Longest monthly cycle – 11 days, shortest cycle -18 days,
