Conception and Contraception

Conception

Conception is the process of becoming pregnant. Conception happens when a man’s sperm
fertilises a woman’s egg. Most women ovulate each month; this is when an egg is released by
the ovaries. For women with a 28-day menstrual cycle, ovulation typically occurs on day 14.
During intercourse the man will ejaculate and sperm will be passed from the testicles via the
penis into the woman's vagina and then beyond into the woman’s uterus (or womb). During a
male ejaculation, there are anywhere between 60 million and 500 million sperm that take part
in the big race to reach the egg. Most of these sperms will die on their journey. Only about
100 to 200 of the sperms will arrive at the fallopian tubes which connect the woman’s uterus
to the egg. Only if a sperm reaches the egg can fertilisation happen. If an egg is not fertilised
then it starts to break up and dies and is released through the woman’s vagina. This is what
makes up a woman’s ‘period’ each month. Once one sperm is successful and penetrates the
egg then the sperm will lose its tail and its head will increase in size. This entrance creates
’activation’ in the egg and it too begins to enlarge. If the egg has been fertilised it will move
to the uterus and attach itself to the uterine lining, a process called implantation. The cells
are called a zygote. The cells will begin to divide which will lead to the development of an
embryo and hopefully produce a baby in nine months time!

Contraception

 Contraception is the use of various devices, drugs, agents, sexual practices, or surgical
procedures to prevent conception or pregnancy. ‘Contra’ comes from the ‘latin’ word for
against. So contraception means anything that works ‘against’ conception.

 There are many forms of contraception and they work in different ways but all are
about preventing the sperm from fertilising the egg or stopping the fertilized egg from being
implanted, for example the "morning-after pill"

 Some like the condom block the way so the sperm can’t get through. These are known
as ‘barrier’ methods of contraception. Others work by preventing the body from ovulating
or releasing eggs or by stopping sperm from surviving in the uterus.

 Contraception enables people to choose when they want to have a baby.



A health care provider can advise on the range of contraceptive methods available.

Traditional birth control methods

 Celibacy or sexual abstinence means avoiding sexual intercourse. Prevents STIs

 Fertility awareness: Also called natural family planning, fertility awareness means
avoiding sex when the woman is most fertile. The most reliable way to do this is to
watch for changes in cervical mucus and body temperature. To use this method
correctly, it’s best to get training from a health care professional.

Pros: No drugs or devices, inexpensive.

 Withdrawal is when the man removes the penis from the vagina so that ejaculation
occurs outside the vagina. In theory, this prevents the sperm from being deposited in
the vagina. Research suggests that about 1 in 3 couples who use this method will
experience an accidental pregnancy within 12 months.

Birth control devices

A range of devices are available for both men and women to use with the aim of preventing
pregnancy.

Male or female condom

 The male condom is a mechanical barrier that prevents pregnancy by stopping sperm
from entering the vagina. It is placed over the penis before sexual intercourse begins.
A condom is made of polyurethane or latex. It can also help to prevent the spread
of sexually transmitted infections (STIs).

Pros: Widely available, protects against most STDs, inexpensive (under $0.50 each).

 The female condom is made of polyurethane. The female condom has a flexible ring
at each end. One fixes behind the pubic bone to hold the condom in place, while the
other ring stays outside the vagina. It can be put in place up to 8 hours before sex.
Users grasp a flexible, plastic ring at the closed end to guide it into position. It's
somewhat less effective than the male condom.

Pros: Widely available, some protection against STDs, conducts body heat better than a male
condom.

The diaphragm
 A diaphragm is a rubber, dome-shaped device that is placed over the cervix. It fits
into place behind the woman's pubic bone and has a firm but flexible ring that helps it
press against the vaginal walls. Combined with spermicide, it is a very effective
contraceptive device.

Pros: Relatively inexpensive

Cons: Must be fitted by a doctor, no STD protection. Cannot be used during your
period due to a risk of toxic shock syndrome.

Cervical Cap
 A cervical cap is a thimble-shaped latex rubber barrier device that fits over the cervix
and blocks sperm from entering the uterus. Similar to a diaphragm but a cervical cap
is smaller. The cap should be about one-third filled with spermicide before inserting.
It stays in place by suction.

Pros: Can stay in place for 48 hours, inexpensive.

Cons: Must be fitted by a doctor, no protection against STDs. Can’t be used during
your period.

Birth Control Sponge

 Birth Control Sponge is made of foam and contains spermicide. It is placed against
the cervix up to 24 hours before sex. The sponge is about as effective as the cervical
cap, with a failure rate of 16% for women who have never had children and 32% for
 those who have. But unlike the diaphragm or cervical cap, no fitting by a doctor is
required.

Pros: No prescription, effective immediately.

Cons: Difficult to insert correctly, no STD protection. Can't be used during your period.

Intrauterine device (IUD)

 The intrauterine device (IUD) is a small, flexible T-shaped device that is placed in the
uterus by a physician. It stays in place as long as pregnancy is not desired. Three types
of IUD are available, with different time frames. They last for 3, 5 or 10 years.
m
Pros: Long-lasting, low-maintenance.
Cons: Irregular or heavier periods with ParaGard. More expensive upfront, may slip out, may
cause side effects.

Pharmaceutical methods of contraception

 The combined contraceptive pill is taken daily. It contains two
hormones, estrogen and progestin. The hormones stop the release of the egg,
or ovulation. They also make the lining of the uterus thinner. When used correctly,
about 3 in every 1,000 women will become accidentally pregnant in the first year.
 Progesterone only pill It contains the hormone progestogen but doesn't contain
oestrogen. You need to take the progestogen-only pill at or around the same time
every day. The progestogen-only pill thickens the mucus in the cervix, which stops
sperm reaching an egg. In can also stop ovulation, depending on the type of
progestogen-only pill you take.

 Emergency "morning after", may prevent pregnancy after intercourse. It prevents

ovulation, fertilization or implantation of an embryo. It is different from medical
abortion methods that act after the egg is already implanted in the womb. Emergency
 contraception can be used up to 72 hours after unprotected sex, but it is 95
percent effective during the first 24 hours, falling to 60 percent by 72 hours.
Emergency contraception should only be used when primary methods fail.
 Some people see it as a kind of abortion, because the egg may have already been
fertilized

"The pill" contains hormones and prevents ovulation.

Pros: More regular, lighter periods, no period depending on the type of pill
Cons: Cost ($0.50 per month), no STD protection. May cause side effects that include breast
tenderness, spotting, serious blood clots, and raised blood pressure. Some women should not
use birth control pills.

 The contraceptive patch is a transdermal patch applied to the skin. It releases

synthetic estrogen and progestin hormones. Evidence suggests that it is as effective as
the combined oral contraceptive pill. The patch is worn each week for 3 consecutive
weeks, generally on the lower abdomen or buttocks. No patch is worn in the fourth
week, to allow for the menstrual period. The patches are readily available.

Pros: More regular, lighter periods with less cramping, no need to remember a daily pill.
Cons: May cause skin irritation or other side effects similar to birth control pills. Does not
protect against STDs.

 The contraceptive vaginal ring is a flexible, plastic ring that releases a low dose of a
progestin and an estrogen over 3 weeks. The woman inserts the ring into the vagina
 for 3 weeks, and then she removes it for one week, during which she will experience a
menstrual period.

Pros: Lighter, more regular periods, only replaced once per month.
Cons: May cause vaginal irritation or other side effects similar to pills and the patch. Does
not protect against STDs.

 The contraceptive injection, or "the shot," is a progestin-only, long-acting,

reversible, birth-control drug. It is injected every 3 months. It stops the woman from
releasing an egg, and it provides other contraceptive effects.

 An implant is a rod with a core of progestin, which is released slowly. It is inserted

under the skin of a woman's upper arm. The implant is effective for 3 years.
Pros: Lasts three years, highly effective.
Cons: More expensive upfront (for exam, implant, and insertion), may cause side effects,
including irregular bleeding. Does not protect against STDs.

 .Spermicides comes in the form of foam, jelly, cream, or film that is placed inside the
vagina before sex. Some types must be put in place 30 minutes ahead of time.
Frequent use may cause tissue irritation, increasing the risk of infections and STDs.
Spermicides are most often used along with other birth control methods.A spermicide
kills sperm chemically. The product may be used alone, or in combination with a
physical barrier.

 A contraceptive sponge has a depression to hold it in place over the cervix. Foam is
placed into the vagina using an applicator. The foam is a spermicide that destroys the
male sperm, and the sponge acts as a barrier to stop the sperm from reaching the egg.

Permanent contraception: Sterilization

 Tubal ligation is a permanent form of female sterilization. The fallopian tubes are cut,
blocked, burned, or a combination of these methods, to seal them and prevent future
fertilization.

Pros: Permanent, nearly 100% effective.

Cons: Requires surgery, may not be reversible, expensive. Doesn't protect against STDs.

Tubal Implants is a newer procedure makes it possible to block the fallopian tubes without
surgery. Small implants of metal or silicone are placed inside each tube. Scar tissue
eventually grows around the implants and blocks the tubes. Once an X-ray confirms the tubes
are blocked, no other form of birth control is needed.
Pros: Permanent, no surgery, almost 100% effective.
Cons: Takes a few months to become effective. May raise the risk of pelvic infections,
irreversible, expensive

 Vasectomy is surgery to make a man sterile. The tubes through which sperm pass into
the ejaculate are cut or blocked. A vasectomy is sometimes reversible, but may lead to
a higher abundance of abnormal sperm, possibly resulting in lower fertility or birth
defects.

Effectiveness of contraception
http://www.webmd.com/sex/birth-control/ss/slideshow-birth-control-options