contraceptives Flashcards
Primary Infertility
Lack of conception despite unprotected intercourse after 12 months (<35 years) ~OR~ 6 months (>35yrs)
Secondary Infertility
Inability of a woman to conceive who was previously able to do so.
Components Required for Normal Fertility
FEMALE
Female Favorable cervical mucus Patent fallopian tubes Normal ovarian function No obstruction between ovary & uterus Endometrium functional Adequate reproductive hormones
Components Required for Normal Fertility
MALE
Male
Testes produce sperm of normal quality, quantity, motility
Unobstructed genital tract
Normal genital tract secretions
Ejaculated sperm deposited in female genital tract to reach cervix
Causes of Infertility
Discovering which cause of infertility affects a particular couple is the basis of fertility care.
Causes are shared, almost equally, by men and women.
Mixed-factor infertility involves multiple causes, with some belonging to the man and some to the woman.
increases a woman’s risk of infertility?
Age Smoking Excess alcohol use Stress Poor diet Athletic training Being overweight or underweight Sexually transmitted infections (STIs) Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency
Infertility: Female Assessment
History and Physical Height, weight, BMI History of Infections, especially STI’s Menstrual History Cycle Regularity; ovulation Premenstrual and menstrual symptoms Bimanual exam of internal organs X-Ray: fallopian/uterine tubal patency Labs: urine and blood FSH (follicle-stimulating hormone) Estradiol Progesterone Supplements and Immunizations
Factors Affecting Males
Hormonal Disorders
Eg. Congenital, tumors, trauma, illnesses, drug use, obesity, diabetes
Testicular Factors
Eg. Congential, undescended, varicocele, hypospadias, STI’s,
trauma, torsion
Sperm Transport
Eg. Drug, STI’s, disfunctions r/t ejaculation
Idiopathic Male Infertility
10-15% men in prime reproductive age are affected
What increases a man’s risk of infertility?
Heavy alcohol use
Drugs
Smoking cigarettes
Age
Environmental toxins, including pesticides and lead
Health problems such as mumps, serious conditions like kidney disease, or hormone problems
Medicines
Radiation treatment and chemotherapy for cancer
Infertility: Male Assessment
History and Physical Semen Analysis (minimum of two samples) Hormone Analyses Testosterone Gonadotropins FSH LH (luteinizing hormone) Sperm Penetration Assay Scrotal or Transrectal Ultrasounds
Many types: IVF, donor eggs or sperm
Options vary with setting, maternal age
Does not always work Very expensive Insurance- diagnostics and IVF only in some states Often takes years Takes a toll.....physical and emotional
Nursing Care: Counseling
Need to know personal preferences religious beliefs health status, age, contraindications lifestyle - cost, number of partners, access to provider future childbearing plans
What percentage of pregnancies are planned?
Sexual History
Are you sexually active now?
Age at 1st sexual activity?
Are you presently sexually active with > 1 partner?
What is your sexual orientation?
Nonprescription
Behavioral methods Continuous abstinence Outercourse Fertility awareness Continuous breastfeeding Barrier Male (external) condom Female (internal) condom Sponge Spermicide
Prescription
Hormonal Pill Patch Ring Shot Implant Barrier Diaphragm & Caps IUD/IUS
