Lecture 4: Infertility Flashcards
Who are Pacific peoples?
Diverse population of cultures from many - the 4th largest ethnic group in NZ
What are the 3 Nesian regions?
Polynesian, Melanesia and Micronesia
How many people does infertility effect in NZ?
1 in 6 couples
What is infertility defined as?
the incapacity to fulfil pregnancy after a reasonable time of sexual intercourse
What does the WHO say infertility is?
a disease of the male or female reproductive system that affects millions of people of reproductive age worldwide
How is infertility ranked as a global severe disability?
5th highest
How many couples worldwide are infertile?
50 million couples
What is infertility in males most caused by?
Problems in the absence or low levels of ejection of sperm, weight, age and other contributing factors
What is infertility in females most caused by?
Various abnormalities of the ovaries, uterus, fallopian tubes and endocrine system. Also PCOS and endometriosis.
Pacific women vs NZ population fertility rate
Three births vs two births per women
How many times as likely are pacific people to of of an unhealthy weight compared to NZ population?
2.5 times more likely
What is an unhealthy BMI (40) recognised as?
Single biggest risk factor that results in poor health outcomes, reduced quality of life, increased health care costs and major contributor to infertility
What is ART?
Assisted Reproductive Technology
What is IVF-ET?
In Vitro fertilization-embryo transfer
What is GIFT?
Gamete intrafallopian transfer
What is ZIFT?
Zygote intrafallopian transfer
What is FET?
Frozen embryo transfer
When was the first IVF baby born?
1978
How long must you have been having sex for to be eligible for ART?
unsuccessful after 12 months
How old must the women be to be eligible for ART?
Must be under 40
What BMI must the women have to be eligible for ART?
Less than 35 at first appointment and 32 and under at treatment start date
How old must the man be to be eligible for ART?
Under 55
What BMI must the man be to be eligible for ART?
Less than 40 at both first appointment and treatment start date
How many children can you have to be eligible for ART?
If living at home at least half the time, cannot have 2 or more children (of any age, adoption or previous relationship)
What residency must someone have to be eligible for ART?
Both parties must be NZ citizens, NZ residents or have a valid work visa for over 2 years
What must both parties not do for minimum 3 months before treatment?
Smoke
What is the eligibility criteria for single or lesbian women?
- If they have clear biological causes of infertility
- Age, BMI, smoking
- If not pregnant after at least 12 cycles of donor insemination, 6 of which must be in a NZ certified clinic
What are examples of clear biological causes of infertility?
- Anovulation or very irregular periods (<20 or >42 days)
- Known tubal infertility
- Severe endometriosis
What is the eligibility criteria for gay men?
Azoospermia
When is the FSA typically after GP visit?
5 months on average from referral
When does the orientation appointment occur after FSA?
Approx. 15 to 18 months from placement on waitlist
When does treatment occur after waitlist?
Approx. 3-4 months from orientation appointment
How long is the process of IVF?
Over a 2 year process for 1 cycle
What are some main issues with health for infertility?
- Losing weight can be very difficult
- Pacific peoples are generally heavier
What are some main healthcare issues for infertility?
They want to feel at home and connected, the NZ healthcare system does not do this
What is the spiritual influences on infertility?
A lot of pacific people are religious
- Science is a dilemma as it challenges the belief and trust in god
- Long held beliefs are now being challenged
What are the socio-economic issues with infertility?
It is extremely inaccessible and expensive
