1. Unit 14: Fertility Management

2. Factors to consider when choosing a fertility management plan What is the nature of the individual/couple’s sexual activities and relationships? Personal religious and moral beliefs Effectiveness Theoretical effectiveness is what clinical tests have shown Actual effectiveness is how effective it actually is in the overall population

4. Factors to consider when choosing a fertility management plan Safety Cost Accessibility Convenience Comfort, aesthetic considerations

5. Factors to consider when choosing a fertility management plan Interference with spontaneity of sex STD protection effectiveness Active versus passive methods: – a passive method is something you do once and then you don’t have to think about it ex. Tubal ligation. – An active method is something you have to continuously do ex. Condom

6. VARIOUS METHODS OF CONTRACEPTION

7. Abstinence Continuous abstinence – 100% effective at pregnancy, STD prevention Periodic abstinence – Must know cycle well (see next slide)

8. Predicting fertility The ovum lives 1 or 2 days after it is released Sperm can live inside woman for 5-7 days Therefore, women can only get pregnant 9 days a cycle – 7 days before ovulation, – the day of ovulation – maybe the day after

9. Predicting Fertility Determining Ovulation So how do you know when a woman is ovulating? 1. temperature method: the temperature of the body increases by 0.4°C to 0.8°C during ovulation 2. mucous method: the mucous in the vagina becomes clear and slippery (instead of cloudy and sticky) during ovulation 3. calendar method: if you count the day that bleeding starts as day 1, day 14 is typically the day of ovulation

10. Withdrawal “pulling out” When the man pulls his penis out of the vagina before he ejaculates and ejaculates outside of the vagina “Requires skill and trust” Actual effectiveness 73%

11. Barrier method Condoms, diaphragm, cervical cap provide a barrier Condoms: easy to obtain, few side effects, can offer some protection against STDs Diaphragm and cervical caps: soft barriers that cover the uterus both must be used in addition to spermicide

12. Female condom Diaphragm Cervical cap

13. Oral contraceptives (“the pill”) Contains hormones which regulate the menstrual cycle may reduce PMS symptoms Side effects include: bleeding within periods, weight gain/loss, breast tenderness, mood changes Possibility of blood clots The pill should not be taken if you smoke more than 20 cigarettes per day

14. Contraception Injected contraceptives Vaginal ring Implanted contraceptives The “patch”

15. Intrauterine Device Most widely used method of birth control worldwide Placed inside a woman’s uterus IUD’s prevent fertilization of the egg Has a plastic string for removal and to ensure it is in properly

16. IUD

17. Emergency Contraception aka “morning after” Aimed at preventing pregnancy after unprotected vaginal intercourse Can be in the form of a pill (75-90% effective) or an IUD (90%+ effective) Should not be used as a main form of birth control! – Prevention is always better – Expensive – Many lingering side effects

18. PERMANENT METHODS OF BIRTH CONTROL

19. Tubal sterilization “getting your tubes tied” An operation that closes the fallopian tubes, (recall: where fertilization occurs) Everything else pretty much stays the same

20. Vasectomy Permanent birth control for men Blocks the vas deferens (recall: the tube that transfers sperm out of the testes) Does not affect sexuality – Will still ejaculate (minus sperm) – Will still become erect – Will still secrete testosterone

21. ABORTION

22. Abortions in Canada Nearly 100,000 abortions were performed in 2005; rate seems to be decreasing Most common among women in their 20s (52%) Having an abortion when the mother is younger reduces the ensuing complications There are no legal restrictions on abortion – “The state has no business in the bedrooms of the nation” –Pierre Trudeau

23. Legal and Social Issues (USA) Supreme court decision in famous Roe vs. Wade case made abortions legal in the US – In the first trimester the woman has the right to make the decision – In the second trimester, the state can impose rules such as where she can have the abortion – In the third trimester, abortions are illegal unless the mother’s life is at risk