Infertility

Front 1

Male infertility factors

Back 1

Poor sperm quality, quantity or both.

Absent sperm (Azoospermia)

Problems with sperm motility

Immunological factors.

Front 2

Female infertility factors

Back 2

Blocked fallopian tubes

Ovulation problems

Endometriosis and other pelvic factors

Cervical factors

Immunological factors.

Front 3

Female risk factors

Back 3

Overweight, hormonal imbalances, uterine fibroids, tubal blockages, cervical stenosis, poor oocyte quality, chromosomal abnormalities, uterine congenital anomalies, immune system disorders, chronic illnesses, STIs, Endometriosis, turner syndrome, exposure to chemo agents, smoking and alcohol, psychological stress, multiple miscarriages, age, history of PID.

Front 4

Male risk factors

Back 4

Exposure to toxic substances, cigarette or marijuana use, heavy alcohol consumption, use of prescription drugs for ulcers and psoriasis, exposure of genitals to high temps, hernia repair, obesity, cushing syndrome, frequent long distance cycling or running, STIs, crytorchidism (when the testes do not drop), mumps.

Front 5

Nursing assessment female

Back 5

Assessment of ovarian function, reproductive hx, urine LH levels, clomiphene citrate challenge test, assessment of pelvis, pap smear, cervical culture, pelvic U/S, hysterosalpingogramp, laparoscopy.

Front 6

Nursing assessment male

Back 6

Reproductive hx, semen analysis (healthy and mature sperm, number of sperm, ability to penetrate egg), normal sperm count is 20 million/ml with >50% motility.

Front 7

PCOS

Back 7

Ovaries are full of cysts that will not mature and ovulate. They produce androgens so acne and hair growth may be a problem. Androgen causes alteration in insulin use so the woman may be on glucophage. She may also take Clomid.

Front 8

Uterine fibroids

Back 8

are often benign. Can be removed surgically. Grow because hormones fuel them. May have to take baby out early.

Front 9

Cervical infertility

Back 9

Involves inability of the sperm to pass through the cervix due to damage of the cervix: inadequate or inhospitable cervical mucus, cervical narrowing or stenosis, cervical infections (STI), immune attack of sperm or "sperm allergy".

can affect uterine lining and cause it to be unable to implant, which lead to ectopic pregnancy.

Front 10

Meds r/t infertility

Back 10

NSAIDS: ibuprofen or aspirin long term use can make conceiving difficult.

Chemo: can cause ovarian failure.

Neuroleptic med: for psychosis, can cause missed periods or infertility.

Spironolactone: treats heart failure but can cause irregular periods and inferility.

Illegal drugs. bla bla bla.

Front 11

Uterine/fallopian tube infertility

Back 11

Blocked tubes, disruptions in normal pelvic anatomy (endometriosis, block, scarred or distorted tubes, fibroids), and thin/abnormal uterine lining like anatomic problems/abnormal shape.

Front 12

Age-related infertility.

Back 12

Women who are 35, 95% will get preg after 3 yrs of unprotected sex. Women who are 38, 75% will get preg after 3 yrs of unprotected sex.

-Ovaries become less able to release eggs.

-she has a smaller number of eggs left.

-Her eggs are not as healthy.

-She is more likely to have health conditions that can cause fertility problems.

-She is more likely to have a miscarriage.

Front 13

Diagnostic testing

Back 13

Go from less invasive to more invasive procedure.

Male is easier to dx, physical examination, U/S, semen analysis, home ovulation predictor kits, clomiphene challenge test, hysterosalpingography, laparoscopy.

Front 14

Who is CCCT recommended for

Back 14

Recommended for pts 38 years or older, pts with unexplained infertility, prior hx of ovarian surgery, poor response to fertility medications, pts with symptoms suggestive of decreased ovarian reserve (such as shorter menstrual cycles)

Front 15

What is CCCT?

Back 15

Is a method of assessing the age-related decline in fertility or "decreased ovarian reserve." It is the most comprehensive test.

Front 16

ICSI is often recommended if...

Back 16

The male partner has a very low spermcount. Other problems with the sperm have beenidentified, such as poor morphology (abnormally shaped) and/or poor motility(poor swimmers).

At previous attempts at in vitrofertilization (IVF) there was either failure of fertilization or anunexpectedly low fertilization rate.

The male partner has had avasectomy and sperm have been collected from the testicles or epididymis (spermreservoir).

Other situations where the sperm count iszero and donor insemination is not wanted.

The male partner does not ejaculate anysperm but sperm have been collected from the testicles.

The male partner has had problemsobtaining an erection and ejaculating. This includes men with spinal cordinjuries, diabetes and other disorders.

Front 17

NI

Back 17

ØEncourage couplesto express and discuss their feelings and recognize infertility as a major lifestressor. ØAssist the couple to consider options, and provideeducation to assist in decision-making.ØExplain roleof genetic counselor, reproductive specialist, geneticist, and pharmacist inproviding psychosocial andmedical care.

ØMonitor for adverse effects associated with medications totreat female and male infertility.ØAdvise thatthe use of medications to treat female infertility may increase the risk ofmultiple births by more than 25%.

ØProvide information regarding assisted reproductive therapies(in vitro fertilization and embryo transfer, intrafallopian gametetransfer, surrogate parenting, and reproductive alternatives such as adoption).

ØMake referrals to grief and infertilitysupport groups