Jacobs > Infertility Flashcards
define infertility
the inability to conceive a pregnancy after ONE YEAR of engaging in sexual intercourse w/o contraception
&/or the inability to carry a pregnancy to live birth
how many couples are affected by infertility?
one in six
what is the unique predicament facing medical students & infertility?
many students put off having babies until they are settled & can provide an optimal life for a baby, but by the time you get settled, fertility has declined
what % of women and men consider infertility as the MOST UPSETTING EXPERIENCE OF THEIR LIVES?
49% of women
15% of men
what is the downside to medical treatment of infertility?
invasive painful embarrassing time consuming disruptive to schedule \$\$\$\$$
what feelings can result from infertility?
failure shock anger loss grief sadness/depression stress loss of control & meaning marital probs estrangement
what are the 4 main causes of infertility?
- female factor
- male factor
- combined
- unexplained
what is the breakdown of % of each cause of infertility?
- female 35%
- male 35%
- combined 20%
- unexplained 10%
what are the 3 main female factor infertility causes?
- menstrual probs
- blockage
- structural probs
what are the 3 main male factor infertility causes?
- sperm
- blockage
- sexual fxn
what are the 7 main combined factor infertility causes?
- advanced age
- miscarriages
- STDs
- diabetes
- smoking
- alcohol/drugs
- weight
what does the choice of treatment for infertility depend on?
diagnosis & age
why would you give a (female) pt fertility drugs?
to regulate or stimulate ovulation
what are the 2 downsides to fertility drugs?
- hormones have side FX
2. difficult to inject
what are the 6 main treatments for infertility?
- fertility drugs
- abx
- artificial insemination
- surgical RX
- use of third parties
- assisted reproductive technologies
what are the 2 types of sperm you can use for artificial insemination?
husband’s sperm = AIH
donor sperm = AID
what are the 2 types of insemination?
intrauterine = IUI intracervical = ICI
what are the 5 assisted reproductive technologies for treatment of infertility?
- IVF
- gamete intrafallopian transfer (GIFT)
- zygote intrafallopian transfer (ZIFT)
- tubal embryo transfer (TET)
- micromanipulation
what are the 2 micromanipulation techniques?
- intracytoplasmic sperm injection (ICSI)
2. assisted hatching (to have a baby lizard)
how do most couples schedule their life & fertility treatments?
life is usu scheduled around fertility treatments
it’s pretty disruptive
T/F: most couples assume they will be able to have kids (i.e. “when, not if”)
TRUE
in what ways can a couple experience surprise at infertility?
- successful ppl experiencing first failure
2. societal expectations
T/F: some couples are relieved to get a dx that explains their inability to have a baby
true
T/F: denial happens in response to the possibility of infertility
true
what is a unique challenge of denial?
it can present difficulties if one partner is in denial & one is not
what is the debate w/ stress & infertility?
kind of a chicken & egg deal
infertility definitely causes stress
but stress does NOT definitively cause infertility
what are the 9 (ugh sorry) common emotional rxns to infertility?
- surprise
- denial
- stress
- anger
- guilt/neg self-image
- isolation
- sadness/grief
- questioning beliefs
- acceptance & resolution
how should a clinician approach feelings of guilt w/ infertility?
fertility has nothing to do with worthiness
no scientific connection btwn “sins” & infertility so “atoning” won’t help
how can infertility lead to estrangement?
marital conflict
gender diffs
a partner’s wish for secrecy
how should a clinician handle isolation d/t infertility?
educate pts about how common infertility is
encourage social support
T/F: full-blown depression is common w/ infertility
FALSE
sadness is common, but full-blown depression is not
how can sex be affected by infertility & RX (5 ways)?
- regulated & monitored
- may feel a demand to perform
- may feel like work & not fun
- not spontaneous
- postcoital tests may cause pressure
when do pts accept & resolve their infertility?
only after previous painful feelings are acknowledged & worked through
T/F: acceptance & resolution = getting over infertility
FALSE
might not include getting over it
treatment for infertility should involve a (__?__) approach
BPSS
what should you educate an infertile couple about?
- medical aspects of infertility
- fertility treatments
- dispel myths about causes (i.e. punishment for sinning)
what should you do with your pts emotional rxns to infertility?
- normalize & validate responses
- consider bibliotherapy, online resources
- refer to therapy
- encourage social support
T/F: pts emotional rxns may be subclinical
true
T/F: you shouldn’t bother asking about spiritual beliefs when evaluating infertility
FALSE
you should! refer to religious community if appropriate
what book should you use for bibliotherapy?
coping w/ infertility
