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Reproductive Health

The term "reproductive health" and reproductive health includes both

good ability of individuals and couples to procreate normally, both physiological than psychological (The WHO defines ^,.

Summary

1 Factors known to reproductive health
2 Conditions
3 Pregnancy and Health
4 Male Fertility
5 Female Fertility
6 Governance Worldwide
7 ICPD
- 7.1 Objectives of the Millennium Development Goals
8 Foresight
9 See also
10 Notes and references

Factors known to reproductive health

Human fertility depends on various factors;

aspects of genetic ,
nutrition ,
medication
alcoholism and exposure to certain drugs
sexual behavior , and thus aspects cultural and socio-psychological, emotional and contextual (quality of life and conditions ...)
Factors Endocrinology , the time factor, the economy , lifestyle and emotions.
environmental aspects of so-called " environmental health "The fertility of mammals can be affected by exposure (possibly in utero or before puberty ) to certain pollutants , may be of some heavy metals and other reproductive harm or - even at very low dose - some endocrine disruptors , which can be direct or indirect factors deletion of spermatogenesis or affect the formation of the genital tract (male or female) when these pollutants affect the embryo.

Reproductive health is a complex area because of the number and variety of cocktails of pollutants that can induce synergy , potentiation or direct effects before, during or after the moment of fertilization.

Terms

As stated by the UN through the ICPD in 1994, reproductive health, also implies a healthy environment ( environmental health ), that everyone has the possibility of sexual satisfaction and the ability and freedom to choose to reproduce when he wishes and the number of times as he wants.
It is an implicit dimension of the right of men and women to be informed and have access to safe, effective, affordable and acceptable access to means of fertility control of their own choosing and the right of access care services and appropriate health that allow women to drive the most of their maternity (pregnancy, childbirth, breastfeeding ...) and provide couples with the chance of having a healthy infant .

The Yogyakarta Principles are taken even the Hormone Therapy and sexual reassignment surgery such as human reproductive health in Principle 9.

Pregnancy and Health

Factors of health for the mother include

good conditions for family planning
that the mother is at least 18 years before trying to have children improves maternal health and child .
If another child is desired, it is considered safer and healthier for the mother and the child that followed, to wait at least 2 years after previous birth before attempting to conceive a child (but not over 5 years). .

Male Fertility

Trend continued decline of spermatogenesis
_{(In rich countries)}
_{Click on the blue triangle to the next or previous image}

Each yellow dot represents the average rate of sperm produced per mL of semen as measured by a survey. It has steadily declined in the second half of the twentieth century. This phenomenon seems to have accelerated in France even in the years 1970 : In 20 years, sperm donors of CECOS Paris have lost - on average - 40% of their sperm (-2.1% / year) rate sperm from 89 10 ⁶ / mL semen in 1973 to 60 10 ⁶ / ml in 1992.
After adjustment (age and duration of sexual abstinence ) on these 20 years, each new generation (by calendar year of birth) lost 2.6% of sperm from the cohort born in the previous year, and the rate of motile sperm decreased by 0.3% per year, and that of normal form sperm decreased by 0.7% per year.
Meanwhile, the proportion of spermatozoa moving normally dropped by 0.6% per year and that of normally shaped sperm decreased by 0.5% per year

At this rate, in 2070 (in the countries from which the study) throughout the male population should be infertile , and since 2025 , the sperm would be enough to fertilize a couple can do without an assisted fertilization. This trend can only be indicative, however, because the cause is still poorly understood, and could perhaps have been corrected in the coming decades, before a fatal threshold.

Male fertility depends on the quantity and quality of sperm, which depends heavily on the functional quality of the genital tract and reproductive, and in particular seminiferous tubules containing germ cells and Sertoli cells. Both types of cells are being established in the embryo and grow under the action of testosterone.
Exposure of the fetus or the embryo to some toxic substances ( uranium , for example) or endocrine disruptors or other products known reproductive toxic to humans can affect this process irreversibly to the future adult. They may also inhibit the proper migration of the testis or induce severe malformations of the penis making reproduction difficult.

The average number of sperm

The average number of sperm produced per mL of semen varies among regions and countries, for reasons still poorly understood.
If one considers that the Swedish correspond to a European average of spermiograms performed in a large sample of Swedish youth whose semen was studied, gave the following results:
For an average testicular volume (median average) of 29 mL (and more precisely from 13 to 53 mL as individuals), the average volume of semen produced was 3.2 mL (0.3 to 8.4 mL by individuals), the semen was collected after an average period of abstinence of 67 h (median average, corresponding to an abstinence from 12 to 504 h depending on the case) contained 54x10 ⁶ spermatozoa (from 0.1 to ⁶ depending on individuals 390x10 ), with a total number of sperm per ejaculate 167x10 ⁶ (0.5 to 1.200x10 ⁶⁾.

The genetic quality of the DNA carried by sperm

Gene carried by the sperm and encoding the receptor for fibroblast growth factor 3 (FGFR 3). Its mutations increases with donor age, and are correlated to the risk of achondroplasia , or dwarfism. The rate of sperm carrying the mutation increases of 2% for each year of age.

It depends on the quality of the reproductive system, which depends on the individual's DNA (the genome could potentially be initially carrying deleterious mutations). It also depends on age and factors of environmental health.
The genome carried by the sperm deteriorates gradually with donor age, increasing the risk of sterility , of unsuccessful pregnancies , of dwarfism the child and possibly other genetic diseases affecting children. And, for some abnormalities, some populations produce sperm more damaged than others .
Various studies , especially in North America have focused on men considered healthy have shown that:

the number and motility of sperm declined with donor age;
the ability of sperm to swim in a straight line also decreases with donor age and this so strongly correlated with the rate of DNA fragmentation;
More donor is older, the more the DNA carried by the sperm is impaired. For example, according to Andrew Wyrobek, a gene involved in the achondroplasia (encoding the receptor 3 of the growth factors of fibroblasts , or FGFR 3), also involved in dwarfism is notably more often and more and more injured with the donor age, with an average increase of 2% per year of age mutations of this gene. The increase in the number of mutations (lower integrity of chromatin , genetic mutations , and aneuploidies ) is already observed in young men, the early childbearing years, and continues throughout life.
The men later were reproducing more difficulty conceiving, and "could also increase the risk of having children with genetic problems," and "reduce their chances of having viable offspring healthy" according to Andrew Wyrobek of LLNL and Brenda Eskenazi specialist in public health . This would explain the most common genetic defects passed on by older men are not the same as those sent by women (who are aging increase the risk of having a child with the Down syndrome and other forms of trisomies or monosomies - such as Klinefelter syndrome , Turner syndrome, triple X syndrome, or their descendants - who are associated with various types of infertility or irreversible defects (physical and neurological) of the descendant. These risks are not correlated with age of father.
Some genetic abnormalities are more frequent among children of older men, but only among certain groups of men . This is for example the case of Apert syndrome (congenital disfiguring and severe); The mutated gene responsible for this syndrome (FGFR2) increases with age in spermatozoa of a group of men recruited in the center City of Baltimore by researchers at Johns Hopkins Medical Center, while no age-related effect was found in another group of men recruited in California .

This suggests that ethnic factors, environmental and / or socio-economic might aggravate the effects of age on the genetic quality of sperm .
This also means that the quality genomic sperm can not be assessed only by testing a single sperm or too few sperm, especially since the donor is older .

The rate of cases of male subfertility

It also varies between regions, such as sperm quality .
sub-fertility may be induced in particular by excessive exposure to metals. For example, lead is known to decrease male fertility, the mercury also (used with more than four meals of fish per week to Hong Kong , consumers who had higher mercury levels in hair were the most affected ( also with skin problems and autism more common in children who have the highest mercury levels measured in blood, hair and urine) .
The Amerindians of Aamjiwnaang , a reserve located in the heart of the "chemical valley" of Canada , exposed to mercury , dioxins , HCBS or PCBs experience a change in the sex ratio of their children: Constanze MacKenzie, University of Ottawa showed that the ratio at birth rose from a boy to a girl in 1984 to a boy for two girls in 1999. In addition, the miscarriage rate is 39% against 25% usually and 23% of children under 16 suffer from ADHD (attention deficit hyperactivity disorder) instead of 4% typically.

Women's Fertility

It is linked to the correct conformation of the reproductive organs, a process which, as in the boy is in part acquired in utero , but also the functioning of hormonal cycles.
Unlike humans, the woman is fertile days per month ( fertile period ).

Some mutations in DNA, which induced by in utero exposure to a reproductive toxicant ( distilbene example) can affect the fertility of successive generations of descendants.

Governance Worldwide

the ICPD

Programme of Action of the ICPD in 1994 has approved a new strategy with emphasis on the linkages between population and development and focuses on meeting the needs of individual women and men rather than on achieving demographic targets .
The ICPD has reached consensus on four qualitative and quantitative objectives for the international community. The latter two have a particular interest in reproductive health:

Reducing maternal mortality: reducing maternal mortality and reducing disparities in maternal mortality within countries and between geographical regions, socio-economic and ethnic groups.
The access to reproductive and sexual health, including family planning: The council for family planning, prenatal care, safe delivery and postnatal care, prevention and appropriate treatment of infertility, prevention of abortion through improved access to contraceptives and sexual information and managing the consequences of abortion, treatment of reproductive tract infections, the fight against sexually transmitted diseases, promoting conditions reproductive health in particular through education, counseling on human sexuality, reproductive health and responsible parenthood. Sufficient and appropriate services for HIV / AIDS, breast cancer, infertility, childbirth and abortion should be made available to the entire population. Active discouragement of female genital mutilation (FGM) is also promoted.

The main key to this new approach is the empowerment of women must be given more choices with: increased access to educational services and health promotion of skills development, and better access to employment.
This program calls for family planning universally available (to be put in place by States before 2015).

Millennium Development

Universal access to reproductive health by 2015 is also one of the two targets of the Millennium Goal 5 (- Improve maternal health -) among the eight Millennium Development.
To monitor global progress towards achieving this goal, the United Nations agreed on the indicators follows (each State shall provide the UN):

- 5.3: Prevalence of contraception

- 5.4: Birth rate among adolescents

- 5.5: coverage of prenatal care

- 5.6 Unmet needs for family planning

According to the Progress Report on MDGs, regional statistics on the four indicators have improved or remained stable between 2000 and 2005 Forecasting

Reproductive health is gaining importance in the field of public health because of infertility problems are increasing, and the average production of sperm is shrinking in wealthy countries (only countries to be studied) at least since the second half of the tenth century (the rhythm of the last 30 years, in 2070, if the observed decline in rich countries were to continue, the average production of sperm will be close to zero .

Reproductive system human
Women	Vulva ( labia majora , labia minora , clitoris , whose cap ) Bartholin Glands Hymen Vagina uterus (the cervix ) Fallopian tubes Ovary Urethra Skene's Glands G Spot
Male	Scrotum Testes Epididymis spermatic cords Vas deferens Seminal vesicles Ejaculatory ducts Urethra Prostate Cowper's Glands Penis (including acorn , brake , foreskin , raphe )
See also: Human Sexuality

Organ systems
Circulatory system Gastrointestinal system Endocrine system Immune system - Integumentary system - Lymphatic system Muscular system Nervous system Skeletal system Reproductive system Respiratory system Urinary System

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Reproductive Health

Summary

Factors known to reproductive health

Terms

Pregnancy and Health