HLTH 377 Test 2 Notes October 8 2013 Contraception Implanon Nexaplanon Intrauterine Device IUD Contraception Depo Provera Oral contraception Patch Nuvaring Condom Foam Diaphragm Gel or Cream College Students Reasons for Non Use Knew it was risky but took a chance Didn t expect sex to happen Not really very sexually active Highest rate of pregnancy by year in school Seniors I we were too drunk to think about it Selecting a Method Effectiveness rates Theoretical versus Actual Effectiveness o Theoretical if the method was used completely correctly o Actual effectiveness how effective the method is in actual practice accounts for human error Method versus User Failure o Method did the method fail o User did the user not use the method correctly and that s why it failed Let s get rich Developing the perfect method Oral contraception First marketed in the 1960s First time that you could almost guarantee that if you had sex while using the contraception that you would not get pregnant How does the pill work o Contains estrogen that helps to prevent ovulation o Contains progesterone that helps to prevent ovulation and also thickens cervical mucous Same amount of estrogen throughout or jacks up in the middle then goes back down Seasonale o Before when women were on the combination pill they would skip weeks when they were supposed to menstruate placebo pill and just take the active pills o Progesterone only o Not a combination o Recommended for certain individuals who have problems tolerating estrogen in Types of Oral Contraception Sequential o Weren t combined pills o Some had estrogen and no progesterone o Others had progesterone and no estrogen Combination Triphasic o Has both estrogen and progesterone o Fancy combination pill o Triphasil Increase in increments o Trinorinyl o People would only menstruate 4 times a year o 84 active days of pill Lybrel o You NEVER menstruate o Take all active pills that hinder menstruation Mini pill other pills o Not as effective as combination pill Examples of Contraindications History of cancer History of heart problems History of strokes Migraines Weight gain Yeast infections Acne Relieve pms Reduce risk of ovarian and cervical cancer Reduce cramps Breasts grow but become more tender Lighter periods Emergency Contraception Plan B progestin only most effective if taken within 72 hours OTC 17 years and older Ella active ingredient is ulipristal effective if taken within 120 hours prescription only Contraceptive patch combined hormones Change patch every 7 days After 3 patches 7 days without Resume new patch on day 29 or day 1 in new cycle Contraindications and side effects similar to the pill 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 in new cycle Contraindications and side effects similar to the pill Implanon Nexplanon Plastic capsule containing progestin only Effective against pregnancy for up to 3 years Contraindications and side effects similar to the pill Implanted under the skin Intrauterine Devices IUD Unclear how IUDs work Device placed in uterus by practitioner Can be left in for several years Most common type used Mirena DepoProvera Injectable Progestin only Effective up to 12 weeks Might delay fertility Amenorrhea in some Condoms Move to create different sizes Latex lambskin polyurethane Should really be used with spermicide Failure rate usually user failure Female Condoms Polyurethane Marketed in U S as Reality Tend to be noisy Failure rate not very accurately documented Latex with spring rim Fitted for size by practitioner Diaphragm Must be used with spermicide gel or cream Must be left in place for 6 hours after intercourse Contraceptive sponge Polyurethane sponge impregnated with spermicide One size fits all kind of Must be left in place for 6 hours after intercourse Better than nothing just Natural Family Planning Basal body temperature Cervical mucus Billings Computation Takes a great deal of motivation October 15 2013 Pregnancy and Child Birth Infertility About 10 15 of couples are unable to have children Approximately 40 of problems relate to male 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 passage into uterus several months of condom use might reduce sperm antibodies in mucous P I D 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 Cases Attributed to 1 Sperm 2 Eggs Ovulation 3 Transport Cervical mucous Tube Peritoneum 4 Uterus 30 40 10 15 10 15 30 40 1 Fertility Treatment Major reason is high cost of treatment Fewer than 1 of couples who have infertility problems attempt further interventions Intrauterine insemination Ovaries stimulated to produce eggs Sperm injected into uterus Relatively cheap 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 In Vitro Fertilization Approximate Success Rates o 30 35 women under 35 years o 25 women 35 37 years o 15 20 women 38040 years o 6 10 women over 40 years Chance of success does not necessarily increase with number of attempts Multiple births common about 20 chance of twins and 4 chance of triplets In 1998 56 of live births resulting from fertility treatments involved multiple infants versus 3 of natural conceptions 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 Reported success rate fairly similar to in vitro Multiple births common about 20 chance of twins and 4 chance of triplets Fertilization occurs in tube Intracytoplasmic sperm injection Used when male has