The causes for infertility are
(i) Tumours formed in the pituitary or reproductive organs.
(ii) Inherited mutations of genes responsible for the biosynthesis of sex hormones.
(iii) Malformation of the cervix or fallopian tubes and inadequate nutrition before adulthood.
(iv) Long-term stress damages many aspects of health especially the menstrual cycle.
(v) Ingestion of toxins (heavy metal cadmium)
(vi) Heavy use of alcohol, tobacco and marijuana.
(vii) Injuries to the gonads and ageing also cause infertility.
Other causes:
(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 (varicocoele) in women.
(iv) Tight clothing in men may raise the temperature in the scrotum and affect sperm production.
(v) Under developed ovaries and testes.
(vi) Female may develop antibodies against is partner's sperm.
(vii) Males may develop an autoimmune response to their own sperm.

(i) Cervical cancer is caused by a sexually transmitted virus called Human Papilloma virus (HPV).
(ii) HPV may cause abnormal growth of cervical cells (or) cervical dysplasia.
(iii) The most common symptoms and signs of cervical cancer are pelvic pain, increased vaginal discharge and abnormal vaginal bleeding.
(iv) The risk factors for cervical cancer include
1. Having multiple sexual partners
2. Prolonged use of contraceptive pills
(v) Cervical cancer can be diagnosed by a Papanicolaou smear (PAP smear) combined with an HPV test. X-Ray, CT scan, MRI and a PET scan may also be used to determine the stage of cancer.
(vi) The treatment options for cervical cancer include radiation therapy, surgery and chemotherapy.
(vii) Modern screening techniques can detect precancerous changes in cervix.
(viii) Therefore screening is recommended for women above 50 years once in year.
(x) Cervical cancer can be prevented with vaccination.
(xi) Primary preventions begins with HPV vaccination of girls aged 9 - 13 years, before they become sexually active
(xii) Modification in lifestyle can also help in preventing cervical cancer.
(xiii) Healthy diet, avoiding tobacco usage, preventing early marriages, practicing monogramy and regular exercise minimize the risk of cervical cancer.

(a) Male infertility can be due to
(i) Inability of the male to inseminate the female partner.
(ii) Very low sperm counts in the semen
(b) (i) Artificial insemination.
In this method, the semen collection from the husband or a healthy donor, is artificially introduced into the vagina or into the uterus (Intra-Uterine insemination).
(ii) Test tube baby programme
(i) In this method the ovum of the woman and the sperm of her husband or a donor are made to fuse under laboratory conditions, it is called in vitro fertilization [IVF].
(ii) The zygote or early embryo is implanted in the fallopian tube or uterus respectively for further development.
(iii) Intra Cytoplasmic Sperm Injection [ICS] :
In this method the sperm is injected directly into the ovum to form the zygote and then embryo transfer is carried out.
(c) Her professional ethics, and honestly not to hide things and patience to convince the couple.

(a) Amniocentesis
(b) (i) A small sample of the amniotic fluid found around the foetus, is taken out without causing any harm to the foetus.
(ii) The free cells in the fluid are cultured and then analysed for chromosomal or metabolic abnormalities.
(c) The doctor must convince Mrs. Nita, that it is illegal to find the sex of the foetus and carrying out female foeticide. It shows her honesty in her profession.
(d) (i) The government should make the punishment very severe for finding out the sex of the foetus and carrying out female foeticide.
(ii) It has already enforced a ban on this technique.
(iii) Government must also advertise in mass communication media that both female and male children are equal in more effective ways.
(iv) Government can announce some incentives/help of families having two or more female children.

(a) It is called vasectomy in males and tubectomy in females.
(b) In vasectomy a small apart of the vas deferens is removed or tied up through a small incision in the scrotum.
(i) Tubectomy a part of fallopian tube is cut and tied up through a small incision in the abdomen through vagina.
(c) By giving examples of some people who have already undergone this, and doing their normal routine, people can be convinced that it will not affect their normal activities. Since it is not involving any major muscle there is no hindrance in movements.
(d) (i) Advertisements in television, radio newspaper, posters, etc.
(ii) Health workers talking individually or collectively to a group of villagers

(a) Such population explosion will lead to an absolute scarcity of basic requirements like food, shelter, clothing etc. despite the progress made in those areas. The employment opportunities will be affected.
(b) The available options are:
(i) Statutory raising of marriageable age for females to 18 years and that of males to 21 years.
(ii) Incentives can be given to couples with small families. 
(c) (i) By advertisements in mass media like television, newspapers, etc.
(ii) By NGOs and health workers visiting the villages and talking to people. 
(iii) By street plays organised by NGOs or any other social activities.

(i) Family planning programmes [now called reproductive and child health care (RCH) programmes] create awareness among people about reproduction-related aspects.
(ii) Audio-visual and print media give information about the nutrition for pregnant women lactating mothers and importance of breast feeding to the infants.
(iii) Governmental and non-governmental agencies have taken various steps to create awareness about the measures to be taken, during pregnancy, immunisation programme, etc.
(iv) Sex-education in schools plays a major role in giving right information about reproduction-related problems.
(v) Health workers in villages also create awareness about the parental care for pregnant women and the importance of post natal care and medically aided deliveries.

Causes for male infertility:
(i) Undescended tests and swollen veins in scrotum
(ii) Underdeveloped testes
(iii) Tight clothing increases the temperature in scrotum and affect sperm production.
(iv) Autoimmune response against own sperm.
(v) Usage of alcohol, tobacco, marijuana drugs etc.
Causes for female infertility:
(i) Malformation of cervix or fallopian tubes.
(ii) Inadequate nutrition at puberty.
(iii) Low body fat (anorexia = psychological eating disorder due to fear of gaining weight) .
(iv) Pelvic Inflammatory Disease (PID), uterine disorders, endometriosis.
(v) underdeveloped ovaries.
(vi) Developing antibodies against sperm.
Common Causes for both the sexes:
(i) Tumours in pituitary or sex organs
(ii) Inherited mutation of hormone synthesizing genes
(iii) Long term stress
(iv) Ingestion of toxins (Cadmium) & drugs
(v) Injuries to gonads
(vi) Ageing

Intrauterine Devices (IUDs) are inserted by medical experts in the uterus through the vagina. These devices are available as copper releasing IUDs, hormone-releasing IUDs and nonmedicated IUDs. IUDs increase phagocytosis of sperm within the uterus. IUDs are the ideal contraceptives for females who want to delay pregnancy. It is one of the popular methods of contraception in India and has a success rate of 95 to 99%.
Copper releasing IUDs differ from each other by the amount of copper. Copper IUDs such as Cu T-380 A, Nova T, Cu 7, Cu T 380 Ag, Multiload 375, etc. release free copper and copper salts into the uterus and suppress sperm motility. They can remain in the uterus for five to ten years.
Hormone-releasing IUDs such as Progestasert and LNG - 20 are often called as intrauterine systems (IUS). They increase the viscosity of the cervical mucus and thereby prevent sperms from entering the cervix.
Non-medicated IUDs are made of plastic or stainless steel. Lippes loop is a double S-shaped plastic device.

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.

A collection of procedures, which includes the handling of gametes and/or embryos outside the body to achieve a pregnancy as known as Assisted Reproductive Technology. It increases the chance of pregnancy in infertile couples. ART includes intra-uterin insemination (IUI), in vitro fertilization, (IVF) Embryo transfer, (ET), Zygote intra-fallopian transfer (ZIPT), Gamete intrafallopian transfer (GIFT), Intra-cytoplasmic, sperm Injection (ICSI), .Preimplantation genetic diagnosis, oocyte and sperm donation and surrogacy.
(i) Intra-cytoplasmic sperm injection (ICSI): 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 , occurs in 75 - 85% of eggs injected with the sperms. The zrgote is allowed to divide to form an 8 celled blastomere and then transferred to the uterus to develop a productive pregnancy.
(ii) Surrogacy: Surrogacy is a method of assisted reproduction or agreement whereby a woman agrees to carry a Pregnancy for another person, who will become the newborn child's parent after birth. Through in vitro fertilization (IVF), embryesz are created in a lab and are transferred into the surrogate mother's uterus.

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.

cervial cancer: Cervical cancer is caused by a sexually transmitted virus called Human Papilloma virus (HPV). HPV may cause abnormal growth of cervical cells or cervical dysplasia.
The most common symptoms and signs of cervical cancer are pelvic pain, increased vaginal discharge and abnormal vaginal bleeding. The risk factors for cervical cancer include
(i) Having multiple sexual partners
(ii) Prolonged use of contraceptive pills
Cervical cancer can be diagnosed by a Papanicolaou smear (PAP smear) combined With an HPV test. X-Ray, CT scan, MRI and a PET scan may also be used to determine the stage of cancer. The treatment options for cervical. cancer include radiation therapy, surgery and chemotherapy.
Modern screening techniques can detect precancerous changes in the cervix. Therefore screening is recommended for women above 30 years once in a year. Cervical cancer can be prevented with vaccination. Primary prevention begins with HPV vaccination of girls aged 9 - 13 years, before they become sexually active. Modification in lifestyle can also help in preventing cervical cancer. Healthy diet, avoiding tobacco usage, preventing early marriages, practicing monogamy and regular exercise minimize the risk of cervical cancer.

Breast self examination and early diagnosis of cancer.
(i) Breast is divided into 4 quadrants and the center (Nipple) which is the 5th quadrant.
(ii) Each quadrant of the breast is felt for lumps using the palm of the opposite hand.
(iii) The examination is done in both lying down and standing positions, monthly once after the 1st week of menstrual cycle. This way if there are lumps or any deviation of the nipple to one side or any blood discharge from the nipple we can identify cancer at an early stage. Mammograms are done for women above the age of 40 years and for young girls and women below 40 years. Ultrasound of the breast aids in early diagnosis.

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.