HLTH377 Exam 2 Study Guide Contraception Hierarchy of Effectiveness Implanon Nexplanon Intrauterine Device IUD 1 2 3 Depo Provera 4 Oral Contraception Patch Nuvaring 5 Condom Foam 6 Diaphragm Gel or cream College students reasons for not using contraception 1 Knew it was risky but took a chance 2 Didn t plan for sex to happen 3 Not really very sexually active 4 I we were too drunk to think about it Highest rate of pregnancy by year in school is seniors Effectiveness Rates Theoretical if used perfect every time vs Actual Effectiveness drunk mistakes etc Method failure method didn t work vs User failure didn t use the method correctively Reversibility Once you stop using the method you can get pregnant immediately if the method is not reversible a woman will not be able to get pregnant after using the method Oral Contraception First Marketed in the 1960 s How does the pill work Estrogen and progesterone combination pill Estrogen helps to prevent ovulation Progesterone helps to prevent ovulation and thicken cervical mucous Types of Oral Contraception Sequential Not combined estrogen and progesterone Combination Estrogen and progesterone Triphasic Developed combination pill because the patent ran out on the combination pill Seasonale 84 active pills only 4 periods a year Combination pill Lybrel No period at all Mini Pill Progestin only not as effective as a combination pill Examples of Contraindications History of cancer History of heart problems History of strokes Migraines If you have any history of these you should not go on this birth control Emergency Contraception Plan B Progestin only most effective if taken within 72 hours OTC 17 years and older previously Now no prescription is necessary and is available to all ages Ella Active ingredient is ulipristal effective if taken within 120 hours available with prescription only 4 sexually active women used in 2002 11 in 2010 Sterilization is the most effective form of contraception Contraceptive Patch combined hormones Change patch every 7 days After 3 patches 7 days without a patch Resume new patch on day 29 or day 1 new cycle Contraindications and side effects similar to the pill Possibility that there is a higher possibility of stroke Not 100 sure yet Nuvaring combined hormones Situated around the cervix Left in place for 21 days Removed on day 22 new ring on day 29 or day 1 of new cycle Contraindications and side effects similar to the pill Implanon Nexplanon Plastic capsule containing progestin only Implanted under the skin Effective against pregnancy for up to 3 years Contraindications and side effects similar to the pill Possibility of amenorrhea after 1 year Intrauterine Devices IUD Unclear how IUD s work Device placed in uterus by practitioner Can be left in for several years Most common type used is Mirena contains progestin Depoprovera Injectable Progestin only Effective up to 12 weeks Might delay fertility Amenorrhea in some Condoms Latex lambskin polyurethane Should really be used with spermicide Failure rate usually due to user failure Move to create different sizes Risug Injection into vas deferens Method from India that is not approved in the US Female Condoms Polyurethane Marketed in US as Reality Failure rate not very accurately documented Tend to be noisy Diaphragm Latex with spring rim Fitted for size by practitioner Must be used with spermicide gel or cream Must be left in place for 6 hours after intercourse Not effective against STI s A lot of potential for user failure Contraceptive Sponge Polyurethane sponge impregnated with spermicide One size fits all kind of AKA one size never fits all Must be left in place for 6 hours after intercourse Taken off the market Natural Family Planning Rhythm Basal body temperature Cervical mucous Computation Takes a great deal of motivation Only having sex when the woman is not ovulating Pregnancy and Childbirth Infertility About 10 15 of couples are unable to have children Approximately 40 of problems relate to make factors 10 20 of couples will have no diagnosable cause of infertility Female Causes of Infertility Lack of ovulation usually corrected by fertility drugs clomiphene HMG usually quite successful 75 if only cause of infertility Cervical mucous impedes passafe into uterus several months of condom use might reduce sperm antibodies in mucous PID blocked fallopian tubes Endometriosis Male Causes of Infertility Low sperm count Unusually high proportion of defective sperm Poor motility sperm should be able to swim for at least 2 hours after intercourse and 60 or more must be normal in shape Sperm Count At least 60 000 000 ml normal fertility 40 59 000 000 fair fertility 20 39 000 000 fertility possible 10 19 000 000 conception barely possible Less than 10 000 000 Major Cause of Infertility Category 1 Sperm 2 Eggs and Ovulation 3 Transport cervical mucous Tube peritoneum 4 Uterus Cases Attributed To 30 40 10 15 10 15 30 40 1 Fertility Treatment Fewer than 1 of couples who have infertility problems attempt further interventions A major reason for this is high cost of treatment Intrauterine Insemination Ovaries stimulated to produce eggs Sperm injected into uterus Relatively cheap about 2 000 Difficult to control how many eggs are fertilized In Vitro Fertilization World s first test tube baby Louise Brown born in England on July 25 1978 Fertilization occurs in lab dish Fertilized eggs 1 4 placed in uterus 2 days after fertilization 10 12 000 each cycle Woman s age is the best predictor of success under 35 years Chance of success does not necessarily increase with number of attempts Multiple births most common about 20 chance of twins and 4 chance of triplets Women 40 most likely to have multiple births Society for Assisted Reproductive Technology 2009 recommend Women younger than 35 1 embryo Women 35 37 years 1 2 embryos Women 38 40 no more than 3 embryos Women 40 years up to 5 embryos Gamete Intrafallopian Transfer GIFT Ova and sperm are placed directly into fallopian tubes Fertilization occurs in tube Reported success rate fairly similar to in vitro Multiple births common about 20 chance of twins and 4 chance of triplets Intracytoplasmic sperm injection Used when male has extremely low sperm count Sperm injected directly into egg which is then placed in uterus About 35 success rate but possibility of birth defects Preimplantation Genetic Diagnosis Screening own embryos to find a genetic match to existing child who may have a health problem Surrogate Parenting Several