CHAPTER 8- FACILITATING REPRODUCTION

Infertility

 Eighty to eighty-five percent of normal couples will conceive after one year of frequent
intercourse. The absence of conception after a year of regular unprotected intercourse is
referred to as infertility. One in ten couples has infertility problems. It is equally frequent in
both males and females and is often permanent. The most common female causes are
unovulatory disorders, blocked fallopian tubes, and aging.
 The male causes include poor or absent sperms, and less commonly, impotence or inability
to ejaculate normally. The most modifiable risk factors for infertility are diet, lifestyle habits
(smoking or alcohol), STDs, drugs, exposure to environmental contaminants ( chemicals,
radiation, air pollution, and heavy metals), and disease. Less common causes include
genetic malformations of the reproductive tract and endocrine disorders. Less common
causes include genetic malformations of the reproductive tract and endocrine disorders.
 Many infertile couples only need proper timing and counseling. Some need correction of
lifestyle habits and treatment of health disorders. Others resort to modern assisted
reproductive technologies (ARTs). The adoption of a child born to different parents is
always a generous option for the infertile couple.
Assisted Reproductive Technologies (ARTs)

 All fertility treatments that use drugs to stimulate ovulation or involve handling of the egg,
the sperm or both are classified as ARTs. Majority of babies born by ART are healthy and
without complications. Health problems if present are multifactorial.
 In vitro fertilization (IVF) is the best known method of ART. It involves aggressive ovarian
stimulation, engineering fertilization in the laboratory with eggs and sperms from the
couple or from donors, embryo culture, selectively harvesting timely embryos for
implantation/embryonic transfer and embryo cryopreservation for future use.
 The main detriments to ART are religious reasons and cost. For Catholics, human beings can
only be conceived through sexual intercourse between married couples. Reproduction can
be facilitated by guidance, regulation of the menstrual cycle, and correction of underlying
disorders, but the role of parents can not be susbstituted and the sexual act can not be
replaced. As such, ART is not recommended by the Catholic Church. The storage of
cryopreserved embryos is an additional issue. These embryos are human beings
manipulated and used as a means to increase implantation or for research, and it violates
respect for them. The Protestant and Anglican churches do not allow IVF with gamete
donation and surrogacy (embryo implanted in a woman who is not the biologic mother).
Likewise, the costs run to hundreds of thousands of pesos. ART is not cheap.
 The success of ART depends on the cause of infertility, drugs administered, ART techniques
employed , age of patient and source of eggs. Its risks include multiple births, premature
 deliveries, adverse effects of hormones, stress, and anxiety of couples which may threaten
the stability of their marriage.

Fertility Preservation

 Fertility preservation refers to saving or protecting and individual’s reproductive tissues or

cells for procreation purposes. Men can freeze sperm samples for thawing out at later
dates and for use in IVF. Women can likewise freeze eggs or embryos for future use.
UNIT 111- STAGES IN THE REPRODUCTIVE LIFE

 A general pattern evolves as an individual advances from being an egg and sperm to a
fertilized egg, to a child, and to an adult, and then to an older person. This development
may not follow the same exact dates and pattern for everyone. Variations may result from
the effect of genes, environment and culture.
CHAPTER 9- FERTILIZATION TO BIRTH

Fertilization

 Humans have approximately 23,000 genes in 23 paired chromosomes. The genes

determine the characteristics that define the species as human and the traits inherited from
his/her parents
 Upon fertilization, the newly conceived zygote contains 23 pairs of chromosomes-one of
each pair coming from each parent. Twenty two pairs are matching chromosomes and the
remaining pair is the sex chromosome. If the sex pair is XX, the individual is genetically
female; if the pair is XY, the individual is genetically male. The Y chromosome contains the
testis-determining gene. Under its influence, male development occurs. In its absence,
female development is established.
Gonads

 Although the sex of the person is determined genetically at fertilization, gonads or genitals
do not immediately develop. During the first six weeks of development, the genital systems
in both male and female embryos are similar and potentially bisexual with two pairs of
genital ducts. Primordial germ cells originating from the epiblast migrate to invade the
urogenital ridge at the sixth week and induce the development of the gonads.
 The presence of the Y chromosome dictates developmental changes of the gonad to form
the testes. The testosterone produced by the testes influences the development of the
male ductal system and external genitalia. On the other hand, the absence of the Y
chromosome results in the formation of the ovaries. The absence of testosterone and the
 presence of estrogen from the placenta influence the development of the female internal
reproductive organs and external genitalia.
 The germ cells increase in number as the fetus develops until the infant is born.
CHAPTER 10- The Infant and the Child
Infancy (0-1 year old)

 For the infant, breastfeeding is beneficial. Through the mother’s milk, nutrients and
immunity are provided to the baby. Through her touch, the infant derives warmth and
security, leading to a better mother-infant bonding. No particular sexual behavior is
manifest at this stage.
Childhood (1-13 years old)

 During early childhood, the children’s sexual behavior relates to pleasure and comfort.
What starts as accidental self-discovery at two years of age progresses to a curious self-
exploration in the pursuit of pleasure in a three-year old. Adults in the child’s life, especially
the parents, mold the child’s acceptance of and comfort with his/her gender identity.
 At three to five years of age, the child begins to develop his/her own gender identity.
Curiosity spreads to others, and the child learns about the opposite sex. Children also play
“doctor,” a phrase used to describe children examining each other’s genitals. Adults,
especially parents, continue to mold children’s acceptance of and comfort with their
identity establishing the capacity for healthy sexual and emotional relationships in
adulthood.
 During school age, children develop an intuition about appropriate sexual behavior and
express preference for the same sex over the opposite sex. Emotional and physical
closeness between the children and their parents transfers to friends whom they may hug
and hold hands with.
 Towards the end of childhood, the hypothalamus directs the development of the secondary
sex characteristics through the hormones secreted by the ovaries and the testes. As
secondary sex characteristics begin to develop, the child becomes more aware of his/her
sex and learns to behave as expected.
End of Childhood

 The germ cells continue to increase in number. At the start of puberty, they undergo
meiosis (special cell division undergone by germ or sex cells) and develop to form the
mature spermatozoa in the male. Meanwhile, in the female, the primary oocytes formed
during latter months of pregnancy resume their meiotic division at puberty to form the
mature ovum.