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Katie Schaut

on 22 February 2015

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Transcript of INFERTILITY

Katie Schaut, Emilee McAdams, Dragana Stanisic, Aryn Sternweis, Andrea Peters
the inability to become pregnant after having unprotected sex for over a year
Normal Steps in Pregnancy:
Infertility can occur when there is a problem in the normal steps of pregnancy.
1. Ovulation - egg released from ovary
2. Fertilization - sperm penetrates the egg
3. Implantation - fertilized egg travels through the fallopian tube and attaches to uterine wall
Men Can Be Infertile Too...
Male infertility affects 10-15% of couples who attempt at pregnancy
Most times it is when the male partner has difficulty producing fully developed sperm
Common Causes:
a) sperm disorders
b) varicoceles (dilated scrotal veins)
c) retrograde ejaculation
d) obstruction blocking passageway
e) hormones
f) genetics
g) medication
Treated with: surgery, in-vitro, medications, intrauterine insemination, or sperm injections
Pharmacological Interventions
Cooper-Hilbert, Ph.D, B. (n.d.). Infertility. Retrieved February 12, 2015, from http://www.aamft.org/imis15/aamft/Content/Consumer_Updates/Infertility.asp

Eisenberg M.D., M.P.H., E., & Kennedy Shrive M.D., E. (Eds.). (2012, July 16). Infertility Fact Sheet. Retrieved February 12, 2015, from http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html

Fast Facts About Infertility. (2014, April 16). Retrieved February 12, 2015, from http://www.resolve.org/about/fast-facts-about-fertility.html

Gregory, Andrew (Photographer). (2014, September 5). Retrieved February 5, 2015, from http://www.mirror.co.uk/news/uk-news/1-5-child-deaths-could-4167506

Infertility Evaluation. (n.d.). Retrieved February 11, 2015, from http://www.coastalfertilityspecialists.com/Diagnosis/Infertility-Evaluation.aspx

Infertility: Fast Stats. (2015, February 6). Retrieved February 12, 2015, from http://www.cdc.gov/nchs/fastats/infertility.htm

Infertility Medications. (2014, September). Retrieved February 5, 2015, from http://www.americanpregnancy.org/infertility/infertility-medications/

Leke, R.J., Oduma, J.A., Bassol-Mayagoitia, S., Bacha, A.M., & Grigor, K.M. (1993). Regional and geographical variations in infertility: effects of environmenta, cultural, an socioeconomic factors.
Environmental Health Perspectives, 101
(Suppl 2), 73-80. Retrieved February 10, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1519926/

Lowdermilk, D. (2012). Infertility. In Maternity & women's health care (10th ed.). St. Louis, MO: Mosby.

Lucidi, R. (2014, September 29). Polycystic Ovarian Syndrome. Retrieved February 11, 2015, from http://emedicine.medscape.com/article/256806-overview#a0101

Male Infertility. (2013, July). Retrieved February 5, 2015, from http://www.urologyhealth.org/urology/index.cfm?article=102

Meczekalski, B., Podfigurna-Stopa, A., Warenik-Szymankiewics, A., & Genazzani, A. (2014). Functional hypothalamic amenorrhea: Current view on neuroendocrine aberrations.
Gynecological Endocrinology, 10, 4-11

Millennium Medical (Photographer). (2013, December 9). Phlebotomy Diagnostics [digital image]. Retrieved from

Clomid and Serophene:
increase FSH production from the pituitary to stimulate ovulation
Synthetic Human Chorionic Gonadotropin:
IM injection to stimulate ovulation
Follicle Stimulating Hormone:
injection that stimulates follicle growth in the ovaries
Human Menopausal Gonadotropin:
injection including FSH & LH that stimulates ovaries to produce multiple eggs in one cycle
GnRH Agonists:
enables production of high quality eggs
GnRH Antagonists:
prevents premature ovulation
Infertility Statistics
Couples between the ages of 29-33 with a normal functioning reproductive system only have 20-25% chance of getting pregnant each month
Infertility can occur from problems with the female (33%), male (33%), or a combination of factors between the couple (33%)
10.9% of women (15-44 yrs. old) are unable to conceive or carry a baby to term
44% of women who have problems conceiving end up seeking medical aid, of those 66% are able to give birth with treatments given.
85-90% of couples with infertility are treated with drug therapy or surgical procedures
Physiological Causes of Infertility
Cultural Aspects
"In many cultures, childless women suffer discrimination, stigma, and ostracism."
"African Infertility Belt" across central Africa where fertility is prevalent
Socioeconomic status
India is reducing cost of hormones to increase pregnancy
Countries with high rates of STD's have increased infertility
Environmental Issues
Citations, please.
: any condition affecting any reproductive organ
1. Ovulation ->
women with irregular periods most likely do not ovulate, caused by:
a) Polycystic Ovary Syndrome (PCOS) *Most common cause of infertility
b) Functional Hypothalamic Amenorrhea (FHA)
c) Diminished Ovarian Reserve (DOR)
2. Fallopian Tube Patency ->
inflamed or blocked fallopian tubes, not allowing egg to travel to the uterus
3. Uterine Contour
Nursing Assessment
Female Assessment
Male Assessment
Complete a history including:
Duration of infertility
Past OB events
Menstrual and Sexual History
Surgical/Medical Conditions
Reproductive Hazards (drugs, alcohol, home, work, emotional stress)
Reproductive tract assessment
Urine/Blood tests and other diagnostic tests
Complete a history including:
Nutritional deficiency
Debilitating or chronic disease
Exposure to environmental hazards (radiation, heat, alcohol, drugs, tobacco)
Complete physical exam
Non-invasive tests

Mother or Nothing: The agony of infertility. (n.d.). Retrieved February 10, 2015, from http://www.who.int/bulletin/volumes/88/12/10-011210/en/

Polycystic ovary syndrome (PCOS). (2013, January 1). Retrieved February 11, 2015, from, http://www.mayoclinic.org/diseases-conditions/pcos/basics/definition/con-20028841

Pregnancy Test Photograph. Retrieved February 5, 2015, from https://whattoexpectwhenyouarenot.files.wordpress.com/2013/09/not-pregnant.jpg&imgrefurl

Reproductive Health. (2013, June 20). Retrieved February 11, 2015, from http://www.cdc.gov/reproductivehealth/infertility/#d

Reproductive Health: Infertility FAQs. (2013, June 20). Retrieved February 12, 2015, from http://www.cdc.gov/reproductivehealth/infertility/

Seccombe, M. (2013, March 12). What Happens When Half The World Stops Making Babies. Retrieved February 10, 2015, from http://www.theglobalmail.org/feature/what-happens-when-half-the-world-stops-making-babies/573/

Statistics Photograph. (2014). Statistics [digital image]. Retrieved February 8, 2015, from http://www.ahrinet.org/site/Resources/Statistics

Uterine Fibroid. (2014, November 25). Retrieved February 11, 2015, from http://www.nlm.nih.gov/medlineplus/uterinefibroids.html

What is Infertility? (2013) Planner [digital image]. Retrieved February 8, 2015, from http://www.birth.com.au/difficulty-conceiving/about-infertility#.VNOtuouyjFl​
Impact on patients, families, and community
Individual :
fear, anger, isolation, or possibly grief
Couple/Family :
- definite relationship changes.
- guilt or blame
EX: family events, intimacy, etc.
Community :
- decreased socialization
- possible decline in community population
Additional Physiological Effects on Infertility Include:
High Alcohol Use
Poor Diet
Athletic Training
Sexually Transmitted Infections
Hormonal Changes due to a variety of problems
Nursing Management
1) Collect Information
2) Encouragement
3) What Do You Already Know?
4) Interest to Resolve Issue
5) Support/Education
6) Talk About Your Feelings
Non-Medicinal Interventions
a) Lifestyle changes
i. hysterosalpingography
ii. laparoscopy
iii. reconstructive surgery

d) assisted therapy
i. In-Vitro
ii. gamete intrafallopian transfer
iii. zygote intrafallopian transfer
iv. oocyte donation
v. embryo donation
vi. surrogate
vii. donor insemination
e) adoption
c) surgery
b) herbal options
normal uterus -> uterine contour
Think About It...
How would you feel if you found out you were infertile?
Full transcript