Dr. Sheela will be be arrested under PCPNDT Act - preconception and prenatal diagnostic technique Act-1994.

1. Avoiding coitus with unknown/multiple partners.
2. Use of condoms during coitus.

1. Invitro fertilisation
2. Zygote intra-fallopian transfer (ZIFT)
3. Gamete intra-fallopian transfer (GIFT)
4. Surrogacy

Oral contraceptive pills are enriched with synthetic progesterone and oestrogen hormones. These pills prevent the ovulation by inhibiting the secretion of LH and FSH hormones.

The techniques used to detect the foetal disorders during the early stages of pregnancy are:
(i) Ultrasound scanning
(ii) Amniocentesis
(iii) Chorionic villus sampling (CVS)
(iv) Foetoscope

Cryopreservation (or freezing) of embryos is often used when there are more embryos than needed for a single IVF transfer. Embryo cryopreservation can provide an additional opportunity for pregnancy, through a Frozen embryo transfer (FET), without undergoing another ovarian stimulation and retrieval.

(i) Low body fat or anorexia in women. i.e. a psychiatric eating disorder characterised by the fear of gaining weight.
(ii) Under developed ovaries or testes.
(iii) Female may develop antibodies against her partner's sperm.

(i) Copper releasing IUD - Multiload 375 CuT 380.
(ii) Hormone - releasing IUD - LNG-20.
(iii) Non-medicated IUD - Lippes loop.

1. Periodic abstinence
2. Coitus interruptus
3. Lactational amenorrhea

1. Amniocentesis is the pre-natal diagnostic technique in which a sample of amniotic fluid from the womb of a pregnant woman is taken during early stages of embryonic development and the cells are cultured and analysed synthetically.
2. Any chromosomal disorder or a metabolic error can be detected and if necessary MTP can be advised.
3. But this technique is misused for knowing the sex of the foetus followed by female foeticide.
4. Female foeticide refers to aborting the female in the mother's womb.
5. In order to prevent female foeticide and infanticide, Government of India has taken various steps like PCPNDT Act .(preconception and prenatal diagnostic technique act-1994) enacted to ban the identification of sex and to prevent the use of prenatal diagnostic techniques for selective abortion.

1. Directly gametes cannot be transferred into the uterus, because the uterine environment is not suited for the survival of the gametes.
2. If the gametes directly transferred into the uterus, gametes will undergo degeneration (or) could be phagocytosed and viable zygotes will not be formed.
3. In this method, the own collected from a donor female is transferred to the fallopian tube of another woman.
4. The ovum has to be fertilized by the sperm of the woman's husband; the fallopian tube is the site for fertilization in a human female.
5. The gamete (ovum) if introduced into the uterus cannot move to the fallopian tube, the site of fertilization.

The method I suggest is Artificial lnsemination Technique (AI)
1. In AI, the semen is collected either from the husband or a healthy donor and then artificially introduced into the vagina or into the uterus (IUI- Intra Uterine Insemination) of the female.
2. It is commonly used in cases where male partner are unable to inseminate the female due to very low sperm counts in the ejaculate.

All women are born with ovaries, but some do not have functional uterus. This condition is called Mayer- Rokitansky syndrome.

(i) Foetoscope is used to monitor the foetal heart rate and other functions during late pregnancy and labour. The average foetal heart rate is between 120 and 160 beats per minute.
(ii) An abnormal foetal heart rate or pattern may mean that the foetus is not getting enough oxygen and it indicates other problems.

Ultrasonography is usually performed in the first trimester for dating, determination of the number of foetuses, and for assessment of early pregnancy complications.

AIDS and Genital Herpes

(i) MTP stands for medical termination of pregnancy
(ii) Medical method of abortion is a voluntary or intentional termination of pregnancy in a non-surgical or non-invasive way.

IUD - Intra-Uterine Device. They increase of phagocytosis of sperm within the uterus and prevent meeting of gametes there by acting as birth control measure.

The voluntary use of contraceptive procedures to prevent fertilization or prevent implantation of a fertilized egg in the uterus is termed as birth control.

IVF is used to treat women with blocked, damaged or absent fallopian tubes.

Natural method is used to prevent meeting of sperm with ovum. i.e., Rhythm method (safe period), coitus interruptus, continuous abstinence and lactational amenorrhoea.
a. Periodic abstinence/rhythm method: Ovulation occurs at about the 14th day of the menstrual cycle. Ovum survives for about two days and sperm remains alive for about 72 hours in the female reproductive tract. Coitus is to be avoided during this time.
b. Continuous abstinence is the simplest and most reliable way to avoid pregnancy is not to have coitus for a defined period that facilitates conception.
c. Coitus interruptus is the oldest family planning method. The male partner withdraws his penis before ejaculation, thereby preventing deposition of semen into the vagina.
d. Lactational amenorrhoea : Menstrual cycles resume as early as 6 to 8 weeks from parturition. However, the reappearance of normal ovarian cycles may be delayed for six months during breast-feeding. This delay in ovarian cycles is called lactational amenorrhoea. It serves as a natural, but an unreliable form of birth control. Suckling by the baby during breast-feeding stimulates the pituitary to secrete increased prolactin hormone in order to increase milk production. This high prolactin concentration in the mother's blood may prevent menstrual cycle by suppressing the release of GnRH (Gonadotropin Releasing Hormone) from hypothalamus .and gonadotropin secretion from the pituitary.

Inability to conceive or produce children even after unprotected sexual cohabitation is called infertility. That is, the inability of a man to produce sufficient numbers or quality of sperm to impregnate a woman or inability of a woman to become pregnant or maintain a pregnancy. The causes for infertility are tumours formed in the pituitary or reproductive organs, inherited mutations of genes responsible for the biosynthesis of sex hormones, malformation of the cervix or fallopian tubes and inadequate nutrition before adulthood. Long-term stress damages many aspects of health especially the menstrual cycle. Ingestion of toxins (heavy metal cadmium), heavy use of alcohol, tobacco and marijuana, injuries to the gonads and aging also cause infertility.
Other causes of infertility:
(i) Pelvic inflammatory disease (PID), uterine fibroids and endometriosis are the most common causes of infertility in women.
(ii) Low body fat or anorexia in women. i.e. a psychiatric eating disorder characterised by the fear of gaining weight.
(iii) Undescended testes and swollen veins (varicocele) in scrotum. Tight clothing in men may raise the temperature in the scrotum and affect sperm production.
(iv) Under developed ovaries or testes.
(v) Female may develop antibodies against her partner's sperm.
(vi) Males may develop an autoimmune response to their own sperm.

A collection of procedures which includes the handling of gametes and/or embryos outside the body to achieve a pregnancy is known as Assisted Reproductive Technology. ART includes
(i) Intra - uterine insemination : This is a procedure to treat infertile men with low sperm count. The semen is collected either from the husband or from a healthy donor and is introduced into the uterus through the vagina by a catheter after stimulating the ovaries to produce more ova. The sperms swim towards the fallopian tubes to fertilize the egg, resulting normal pregnancy.
(ii) Zygote intra - fallopian transfer(ZIFT)
The zygote is allowed to divide to form 8 celled blastomere and transferred to the fallopian tube by laparoscopy. The zygote continues its natural divisions and migrates towards the uterus where it gets implanted.
(iii) Intra uterine transfer (iUT)
Embryo with more than 8 blastomeres is inserted into uterus to complete its further development.
(iv) Gamete Intra-falloplan transfer(GIFT)
Transfer of an ovum collected from a donor into the fallopian tube. In this, the eggs are collected from the ovaries and placed with the sperms in one of the fallopian tubes. The zygote travels toward the uterus and gets implanted in the inner lining of the uterus.
(v) Intra-cytoplasmic sperm injection (ICS):
In this method, only one sperm is injected into the focal point of the egg to fertilize. The sperm is carefully injected into the
cytoplasm of the egg. Fertilization occursin 75% -  85% of eggs injected with the sperms. The zygote is allowed to divide to form an 8 celled blastomere and then transferred to the uterus to develop a protective pregnancy.

1. Reproductive health refers not only to healthy reproductive functions, but to the total well being of physical mental emotional, behavioural and social aspects of reproduction.
2. People having physically and functionally normal reproductive organs and exhibit normal behavioural and emotional interactions among themselves in all reproduction-related aspects are considered reproductively healthy.
3. 214 million women of reproductive age in developing countries who wants to avoid pregnancy are not using a modern contraceptive method.
4. Some family planning methods, such as condoms help prevent the transmission of HIV and other sexual transmitted infections.
5. Family planning contraception reduces the need for abortion, especially unsafe abortion.
6. Family planning reinforces people's rights to determine the number and spacing of their children.
7. By preventing unintended pregnancy, family planning/contraception prevents deaths of mothers and children.
8. Family planning is the key to slowing unsustainable population growth and the resulting negative impacts on the economy, environment and National and Regional development efforts.

Sexually transmitted diseases (STD) or veneral diseases(VD) or Reproductive tract infections (RTI) are called as Sexually transmitted infections (STI).
Transmissions:
1. Normally STI are transmitted from person to person during intimate sexual contact with an infected partner.
2. Infections like Hepatitis-B and HIV are transmitted sexually as well as by sharing of infusion needles, surgical instruments, etc with infected people, blood transfusion (or) from infected mother to baby.
3. People in the age of 15 to 24years are prone to these infections.
4. The bacterial STI are gonorrhoea syphilis, chancroid, chlamydiasis and lymphogranuloma venereum.
5. The viral STI are genital herpes, genital warts Hepatitis-B and AIDS.
6. Trichomoniasis is a protozoan STI, and candidiasis is a fungal STI.

The major sexually transmitted diseases are
(i) Gonorrhoea
1. Causative agent: Neisseria gonorrhoeae
2. Symptoms: Affects the urethra, rectum and throat and in females the cervix also get affected
3. Pain and pus discharge in the genital tract and burning sensation during urination.
4. Incubation period: 2 to 5 days
(ii) Syphilis
Causative agent : Treponema pallidum
Symptoms:
1. Primary stage: Formation of painless ulcer on the external genitalia.
2. Secondary stage : Skin lesions, rashes, swollen joints and fever and hair loss.
3. Tertiary stage : Appearance of chronic ulcers on nose. Lower legs and palate, loss of movement mental disorder visual impairment, heart problems, gummas (soft non-cancerous growths) etc.
(iii) Hepatitis B
1. Causative agent: Hepatitis B virus (HBV) with DNA.
2. Symptoms: Fatigue, jaundice, fever, rash and stomach pain.
3. Liver cirrhosis and liver failure occur in the later stage.
4. Incubation period: 30-80 days
(iv) AIDS:
1. Causative agent: Human immuno deficiency Virus (HIV) .
2. Symptoms: Enlarged lymph nodes, prolonged fever, prolonged diarrhoea, weight reduction, night sweating.
3. Incubation periods: 2 to 6 weeks even more than 10 years