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- [Instructor] The human sexual
response is actually similar

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but yet at the same time
different in males and females.

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Both males and females
will have the same idea

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of excitement, a plateau,
the orgasm, and resolution.

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But the difference is in
the male sexual response,

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the orgasm is a point marked
by ejaculation of semen.

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Once the ejaculation
of semen has concluded,

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the male goes into refractory period.

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A period where he will not really have

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any sexual response at that point.

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While on the female side of
things for sexual response,

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the female orgasm is more marked by

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a rhythmic muscular contraction.

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These rhythmic muscular
contractions are actually meant

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to take the ejaculated semen

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and help pull it towards
the uterine cavity.

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By pulling it towards the uterine cavity

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is the females body's way of trying to

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bring the sperm up into the uterus,

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so that it can travel up
into the uterine tubes

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for fertilization.

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Remember the whole idea of
the human sexual response

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is for procreation,

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egg and sperm fertilizing for an embryo.

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With fertilization is
looking at having had

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several hundred million
sperm per ejaculates,

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they're all trying to find

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that potentially one ovulated egg.

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Now with all those
sperm, that huge number,

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only one sperm will
actually penetrate the egg.

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Now the picture you see here

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you can see dozens if
not hundreds of sperm

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all around this egg.

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But yet only one will be allowed inside.

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The way it works is,

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once one's sperm penetrates
the outer layer of the egg

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the egg goes through a chemical reaction,

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which actually seals the
entire outside surface,

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making it impossible for
any other sperm to enter.

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Now is there the rare chance
that you get two sperm in

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at the exact same time?

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Yes.

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That's a very unusual,
very rare circumstance.

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So we're talking about fertilization,

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also mentioned about
birth control methods.

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Now birth control methods
range from very simple

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to not have intercourse,

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to very complicated with
surgical sterilization.

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There's a whole series
of methods in between.

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In the case of a surgical sterilization,

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the male side of things, is a vasectomy.

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The vasectomy will actually go in and cut

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the ductus deferens or the vas deferens.

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But it's important not just to cut

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but also to seal the two ends.

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What this causes to occur
is the sperm that's produced

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in the testes now cannot leave
the testes or epididymis.

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Therefore if they can't leave

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there's no way for the sperm
to enter into the semen

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or the ejaculate.

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In the case of a female,

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it's tubal ligation,
or getting tubes tied.

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What happens now is the
uterine tubes are being cut

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and both sides are tied off.

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This prevents an oocyte, or an egg,

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from leaving the ovary and
actually reaching the uterus,

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just is blocked or stopped.

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Now in both these situations
vasectomy and tubal ligation,

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sure is a 99.8 or something
like that percent successful.

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There's always those unusual circumstances

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where the sealing of the ductus deferens

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or the tying of the
uterine tubes comes undone.

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And somehow the two ends
end up getting back together

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a la for one continuous tube.

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Now the chances of that
are very very small,

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but that's why it's not 100% perfect.

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Now the one that is 100% though,
a hysterectomy in females.

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In the case of a hysterectomy

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the oviducts are physically sealed off

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and the uterus can be removed.

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So this point there is no
way for a pregnancy to occur.

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One more common methods
though is birth control pills.

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Most the birth control
pills are dealing with

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a kind of combination of
synthetic progesterone

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or synthetic estrogen.

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The idea is to keep those levels higher,

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preventing FSH and LH.

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If you prevent FSH and
LH, there's no ovulation.

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And if there's no ovulation

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obviously there's no egg to fertilize.

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You also have some
hormones being injected,

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so these injections, instead
of being a pill a day,

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injections are once a month,
or once every three months,

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or you can now push it
once every six months.

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The patch.

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It's a simple patch to be worn
throughout a cycle period.

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So the Ortho Evra patch is one example.

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It might be worn for 30 days,

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now looking into patches

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that are going for 90 days this point.

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Again it's a slow release of hormones

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entering through the skin.

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There's a vaginal ring.

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Now this vaginal ring, is
basically again releasing hormones

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but now within the body.

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So all these are dealing with hormones,

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but all in different methods.

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Some other birth control
methods are things like IUDs,

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or the intrauterine devices.

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Now these intrauterine devices

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are typically actually
small plastic inserts,

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they might have a little bit
of metal in them sometimes.

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But the idea is this
IUD is actually creating

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a small mount of inflammation
inside the uterus.

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By creating this small
amount of inflammation

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it actually prevents the fertilization,

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because the uterus itself

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is not preparing fertilization.

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Some of the IUDs also have
small amounts of hormones

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and this very small trickle of hormone

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can help prevent fertilization.

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There are diaphragms,
or called cervical caps.

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Now the diaphragm or cervical
cap is actually meant

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to prevent the sperm from
entering through the cervix.

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So it's literally a cap
that goes over the cervix,

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preventing any entry.

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Spermicides.

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The spermicides are literally a chemical

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that is meant to kill sperm.

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So obviously kill a sperm,
there's no way of having them

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reach the uterine tubes.

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Condoms.

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The condom is both male and female.

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Male condom is meant to trap the sperm,

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or trap the ejaculates
before it even really leaves

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the male system to fire.

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So to trap it right at
the end of the male penis.

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While the female condom
is gonna be inserted

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into the female vaginal canal

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it's also meant to
catch or trap any sperm,

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preventing it from
leaving the vaginal canal.

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There's a few other natural alternatives.

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There's different methods of
withdrawal, or rhythm method.

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Now are any of these 100% foolproof?

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No.

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Everyone has practiced,

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everyone takes certain amount
of knowledge of how it works.

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The problem with a lot
of the natural methods

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is even with the natural methods,

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sometimes the ovulation cycle
might be a little bit off

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a day or two early.

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It's very hard to know that.

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In the case withdrawal,

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the idea is to remove the
penetration of the penis

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before the actual ejaculate occurs.

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Well there's also a little
bit of a pre-ejaculate,

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that mucus from the bulbourethral gland.

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Sometimes that can contain some sperm.

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And that can starts quite a
bit before the actual orgasm.

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There are these morning after pills.

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Well if this is if nothing
was used the nothing before,

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or the day before, whenever it happened,

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and all of a sudden realizing
that this might be a problem

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because ovulation is
happen at the same time.

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The morning after pill is
meant to prevent or stop

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any potential fertilization.

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There's the idea of abortion.

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Now there's early stage
and late stage abortions.

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Now this becomes very
controversial from state to state

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and person to person.

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But in the case of abortion,

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that is when the pregnancy has started

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so the fertilization has occurred

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but then there's a mesh
that goes in and removes,

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or terminates the pregnancy.

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In the future, well who
knows what's happening.

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They're looking at vaccines
that cause birth control,

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looking at male birth control pills,

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ways of preventing the
actual production of sperm.

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Now are either of these
ones viable for now?

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No, but there's things
that are being looked at.

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Some possibilities that
might be happening.


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But on the other side,

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sometimes there's problems conceiving.

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Where a couple may want to
actually conceive a child,

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but they can't, the idea of infertility.

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Now there's many different
causes of infertility.

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On the male side of things,

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it could be the number of
sperm are just too low.

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The quality of the sperm are not there.

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Maybe they're not as
motile as they should be,

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they can't move as easy.

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Maybe they're partially defective,

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the actual tail is not moving properly.

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Then there's the idea of
pelvic inflammatory disease.

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It can cause scarring,

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it can cause a blockage of the oviducts

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or the uterine tubes there,

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could have unusual levels of FSH or LH.

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If they're not increased
at the right times

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it would not trigger ovulation to occur.

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Irregular menstrual cycles.

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So instead of each month
having a 28 day cycle,

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or 29 day cycle,

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sometimes it's longer,
sometimes it's shorter,

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making it very hard to conceive
and know what's going on

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and what's occurring.

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Endometriosis, decreased
reproductive capacity, miscarriage,

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I mean the list goes on and on and on.

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Unfortunately there is no one answer,

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one easy way to figure out
why a couple is infertile.

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If a couple is infertile,

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through their medical practice

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they'll go through the
doctor and go through tests,

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go through different ideas
of what could be causing it.

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Sometimes it can be resolved.

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Unfortunately, sometimes it can't be.

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Now some ways of enhancing fertility.

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There's the possibility of
artificial insemination.

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In this case sperm are
being inserted or implanted

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into the female system,

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allowing the sperm hopefully
to find an oocyte or egg.

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There's in vitro fertilization,

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where the oocytes, or eggs,

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are taken from a female,

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fertilization's occuring
outside the body in a test tube.

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Those fertilized eggs are
then put back into the female

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so she can have them in the uterine lining

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and carry them through gestation.

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There's GIFT, or gamete
intrafallopian transfer.

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Now in this case unfertilized
eggs as well as sperm

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are both placed right
into the uterine tube,

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or the fallopian tube.

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This allows the actual
fertilization to still occur

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within the female body

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just aiding by making sure
both parts, the egg and sperm,

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are in relatively the same location.

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And we have ZIFT, or zygote
intrafallopian transfer.

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In this case, you have a fertilized egg

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that's being placed back
up into the uterine tube,

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or the fallopian tube.

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So instead of taking that fertilized egg

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and putting it into the
uterus and implanting it,

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it's going back up into the uterine tube

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allow it to naturally
leave the uterine tube

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and hopefully implant
in the uterine lining.

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There's also other
fertility enhancing drugs.

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These drugs are meant to
increase amounts of sperm,

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or increase the development of eggs.

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The idea is to create a better chance

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of having egg and a sperm come together.

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There's a probability
of surrogate motherhood.

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Now the case of a surrogate,

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that's another female that is
carrying the fertilized egg

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and helping to carry it through gestation.