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Block 10 Week 3 > Infertility-Jacobs > Flashcards

Infertility-Jacobs Flashcards

1
Q

WHat is the definition of infertility?

A

inability to conceive a pregnancy after one year of enganging in sexual intercours w/out use of contraception and/or the inability to carry a pregnancy to live birth

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2
Q

How common is infertility?

A

1/6 couples

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3
Q

(blank)% of women and (blank)% of men considered infertility as the most upsetting experience of their lives

A

49%

15%

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4
Q

How is the medical treatment for inferitility characterized?

A

painful, embarrassing, time consuming, disruptive to schedules, and expensive

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5
Q

What feelings are associated with infertility?

A

Feelings of failure, shock, anger, loss, grief, sadness/depression, stress, loss of control, loss of meaning, and marital problems, estrangement can result

  • Emotional roller coaster
  • Problems may be subclinical
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6
Q

What percent of infertility cases are caused by a female factor? Male factor? combined factor? unexplained?

A

35% of female factor
35% of male factor
20% combined factor
10% unexplained

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7
Q

What are the female factors?

A

menstrual problems, blockage, structural problems, other

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8
Q

What are the male factors?

A

sperm, blockage, sexual functioning, other

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9
Q

What are the combined factors?

A

advanced age, miscarriages, STD’s, diabetes, smoking, alcohol/drugs, weight

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10
Q

What does the choice of infertility treatment depend on?

A

diagnosis and age

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11
Q

What do fertility drugs do? What are some problems with them?

A

regulate/stimulate ovulation

  • hormones have SEs
  • difficult to inject
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12
Q

What are the treatments for infertility?

A
  • fertility drugs
  • antibiotics
  • artificial insemination
  • surgical treatments
  • use of third parties
  • assisted reproductive technologies
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13
Q

What are the assisted reproductive technologies?

A
  • In vitro fertilization (IVF)
  • Gamete intrafallopian transfer (GIFT)
  • Zygote Intrafallopian Transfer (ZIFT)
  • Tubal Embryo Transfer (TET)
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14
Q

Assisted reproductive technologies may be used with (blank) techniques. What are these techniques?

A

micromanipulation techniques

  • intracytoplasmic sperm injection (ICSI)
  • Assisted hatching
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15
Q

What are the common emotional reactions to infertility?

A 
Some people have little/no difficulty
Surprise
Denial
Stress/Anxiety
Anger
Guilt/Negative Self-Image
Isolation
Sadness and Grief
Questioning existential, spiritual, religious beliefs
Other reactions: jealousy, resentment, loss of control
Acceptance and resolution
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16
Q

T or F
Most couples assume they will be able to have children (“when, not if”)
Birth control gives a sense of control over fertility
Challenging beliefs: “If I work hard enough I’ll achieve my goal”
Successful people may experience failure for the first time
Societal expectations promote procreation
Some couples are relieved to get a diagnosis that explains inability to have a child

A

T

17
Q

T or F
some patients have denial, In the following way:
Couple may be otherwise healthy
Couple may be young
May refuse evaluation of fertility
May blame the other partner (Steve and Jen)
May question lab/exam results
May accuse doctors of just wanting to make more money
May discount/deny importance of having a child
May distract with other activities: work, hobbies
May present difficulties if one partner is in denial and other is not

A

T

18
Q

What are the causes of stress in infertility?

A

Stress of medical treatments and costs
Stress at many stages, like at diagnosis and treatment
Stress during the “two week wait”
Anticipatory anxiety
Stress with failed treatments (starting their period)
Stress related to miscarriages
Stress related to other emotional reactions (e.g., isolation, depression, grief, marital distress)
Further stress: Does stress cause infertility or does infertility cause stress?

19
Q

T or F

there is no definitive studies showing that stress causes infertility

A

T

20
Q

What are the causes of anger in infertility?

A

Loss of control (fertility, emotions, medical treatments, costs, lack of insurance)
Feeling “cheated” out of fertility
Angry at your own body, for being “defective”
Anger at self for past perceived “sins”
Angry at your partner
Angry at family, friends for insensitive comments
Anger over unwanted pregnancies, abortions, child abuse

21
Q

Why do infertility patients have guilt/negative self-image?

A

Guilt and self blame for infertility, esp. in unexplained infertility
Punishment for past transgressions
May punish self to atone for sins and receive forgiveness
Guilt at putting partner through infertility treatment, esp. when it is your “fault”
“My infertility must mean I’m not worthy to be a parent, or that I wouldn’t be a good parent, or that I’m not meant to have children”
Educate patients that fertility has nothing to do with worthiness, and that there’s no scientific connection between previous “sins” and infertility

22
Q

Why do infertility patients feel isolated/estranged?

A
  • shame may lead to isolation
  • martial conflict, gender differences
  • secrecy
  • incessive and insensitive questions about fertility
  • painful feelings may lead to avoidance of progenent women, babies and children, baby showers, holidays, etc
  • societal conflict (not following traditional life course)
  • many suffer alone and in silence
  • educate pnts about how common infertility is, encourage social support
23
Q

What are the potential losses associated with infertility?

A

natural conception, pregnancy, control, security and faith, self-worth, relationship satisfaction, hopes, your dream child, life goals, future plans, being a biological mother/father, miscarriage.

24
Q

What causes grief and sadness in infertility patients?

A

Seeing reminders of fertility
Failed treatments
Lack of support (spouse, friends, family), alienation

25
Q

IN infertility, what can saddness turn into?

A

depression, but full-blown depression is not common

26
Q

It is important for patients that are sad and grieving to do what?

A

grieve losses and potential losses

27
Q

Why can infertility cause relationship problems?

A
  • arguing over med tx
  • arguing over expenses of tx
  • different rxns to infertility
  • different coping styles
  • sex is regulated and monitored (may feel a “demand to perform” and may feel like “work”, postcoital tests may cause pressure)
28
Q

What are the existential, spiritiual and religious questions infertility couples have?

A

Why me?”
“Why do bad things happen to good people?”
“It’s not fair!”
“How can a ‘good God’ allow this to happen?
Infertility may be perceived as a punishment from God
“I must not be worthy to be a parent”
Being a parent can bring “status” in society, can be a marker of “adulthood.” How to get status otherwise? How to fit in?
Cultural, religious complications
Not following “the will of God”

29
Q

Infertile couples feel jealous of the (blank) and feel bad about that.
THey resent people who get pregnant easily.
They experience loss of control …. why?

A

fertile world

  • inability to control their own fertility
  • must expose private details and pats to doctors
  • medical tx require close monitoring
  • tx is expensive
  • meds have SEs
30
Q

What stage is this:
Comes after previous painful feelings are acknowledged and worked thorugh. May not mean getting over it.
Considering options: ARTs, use of donors, adoption, child free living
Infertility can make people stronger, and create more intimacy in relationships

A

Acceptance and resolution

31
Q

Tx of infertility should involve a BPSS approach. So what should you do?

A

-educate couple about medical aspects of infertility and fertility tx (dispel myths about causes of infertility)
-evaluate/screen for common emotional rxns (normalize and validate responses, may be sub-clinical, consider bibliotherapy, online resources, referral to therapy)
-encourage social support
-ask about spirtual/religious rxns
(refer to religious community if appropriate)

32
Q

T or F

there is evidence-based bibliotherapy for infertility

A

T

33
Q

(blank) adopted existing evidence-based tx for anxiety, depression, marital disord and grief to the experience of infertility. It was shown to be effective in a longitudinal (blank) with 115 patients

A

CWI

RCT

34
Q

What shouldnt you do when you have an infertility patient?

A

DONT

  • talk about people you know with infertility
  • tell me God is in control or has a plan
  • Tell me to pray harder
  • pity or patronize me
  • avoid me, it makes me feel rejected, different
  • tell others, unless you have asked permission
  • offer unsolicited advice or suggestions
  • resent how my infertility affects you
  • ask personal questions or give advice
  • assume its a “female” problem
35
Q

What should you do when talking to an infertility patient?

A

DO

  • let me tak about mine and listen
  • show me gods love
  • pray for and with me
  • show compassion
  • keep normal contact with me
  • honor my privacy
  • support my choices
  • remember, this is about me
  • curtail curiosity
  • respect its personal

Block 10 Week 3 (9 decks)

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