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Impotency, Sterility and Mtp

  1. IMPOTENCE: inability of a person to perform sexual intercourse.
    It cannot be placed as a defense for rape.
    The question of impotence may arise in

A- civil cases

B- criminal cases

1. nullity of marriage

4. adultery

2. divorce

5. rape

3. adultery

6. unnatural sexual offences

  1. STERILITY: inability of the male to beget children and in the female, the inability to conceive children.

A question of sterility arises in

1. disputed paternity and legitimacy

2. suits of adoption

  1. FRIGIDITY: inability to start or maintain the sexual arousal pattern in the female.
  2. QUOAD: an individual who may be impotent with any particular woman (QUOAD – as regards) but not with others.
  3. VAGINISMUS: involuntary spasm of pereneal muscle so that sexual intercourse is not possible. Treatment is psychotherapy.
    1. a female who has not experienced sexual intercourse.
    2. vagina is tight and narrow.
    3. hymen may or may not show rupture.
    4. Causes of rupture:
      1. Accidental (it doesn’t rupture by riding, jumping and dancing)
      2. Masturbation
      3. Sola pith introduced into the vagina.
    5. Tear of hymen caused by sexual intercourse or by foreign body is situated postero laterally. i.e., 5 or 7 O’ clock position.
    6. Defloration: loss of virginity.
    1. ovum is removed from the ovary of the woman and is fertilized outside the body.
    2. The blastocyst * is returned to the uterus which gets implanted in the endometrium.
    with the semen of the barren woman’s husband is carried out in a woman. Surrogate birth is not legalized in India.
    1. MTP Act was passed in 1971.
    2. Indications:
      1. Social : failure of contraceptives in a married * woman.
      2. Eugenic : child borne with serious physical or mental abnormalities
      3. Therapeutic : if continuation of pregnancy endangers life.
      4. Humanitarian : if pregnancy is the outcome of rape.
      1. Termination of pregnancy is allowed only up to 20 wks.
      2. For termination of pregnancy b/w 12-20 wks, 2 doctors must concur that there’s an indication.
  8. Methods:
    1. Abortifacient drugs:
      1. Ecbolics – they increase uterine contraction. E.g. ergots
      2. emmenagogues – they increase the menstrual flow. E.g. sanguinarine
    2. Abortion sticks: calotropis, plumbago rosea, Nirium odorum, zeylancia.
    3. Syringing
    4. 4. Rupture of membranes
      1. Dilatation of cervix
      2. Cupping
    1. It is artificial introduction of semen into the vagina, cervix or uterus to produce pregnancy.
    2. 1 ml of semen is deposited by means of syringe in or near cervix.
    3. Legal problems of artificial insemination:
      1. Adultery (donor and recipient cannot be held guilty of adultery under sec 497 IPC).
      2. Legitimacy: such a child is illegitimate, if the semen is taken from sperm bank and the child needs
      3. To be adopted legally.
      4. Consent of both husband and wife is required for A.I. *
      5. If A.I. is due to impotence and not sterility, it can be a ground for divorce.
  • Indications:
    1. Husband is impotent.
    2. Husband is sterile.
    3. Rh incompatibility b/w husband and wife.
    4. Husband is suffering from hereditary disease
    5. Husband is unable to deposit semen in the vagina due to hypospadias.
  1. Pre-natal Diagnosis Technique Regulation & Prevention of Misuse act 1994
    1. Prenatal diagnosis technique Shall be conducted only for:
      1. Chromosomal anomalies
      2. Genetic metabolic disease
      3. Sex linked genetic disorders
      4. Haemoglobinopathies
      5. Congenital anomalies
  • No test should be done by the medical personnel except in the following conditions:
    1. Age of the pregnant women > 35 yrs.
    2. Pregnant women has undergone two or more spontaneous abortion or fetal loss.
    3. The pregnant women has been exposed to potentially teratogenic agents such as drugs, radiation, infection and chemicals.
    4. Pregnant women who has family history of mental retardation or physical deformities such as plasticity or any other genetic disease.

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