Lecture 4: Infertility

Question 1

Who are Pacific peoples?

Answer 1

Diverse population of cultures from many - the 4th largest ethnic group in NZ

Question 2

What are the 3 Nesian regions?

Answer 2

Polynesian, Melanesia and Micronesia

Question 3

How many people does infertility effect in NZ?

Answer 3

1 in 6 couples

Question 4

What is infertility defined as?

Answer 4

the incapacity to fulfil pregnancy after a reasonable time of sexual intercourse

Question 5

What does the WHO say infertility is?

Answer 5

a disease of the male or female reproductive system that affects millions of people of reproductive age worldwide

Question 6

How is infertility ranked as a global severe disability?

Answer 6

5th highest

Question 7

How many couples worldwide are infertile?

Answer 7

50 million couples

Question 8

What is infertility in males most caused by?

Answer 8

Problems in the absence or low levels of ejection of sperm, weight, age and other contributing factors

Question 9

What is infertility in females most caused by?

Answer 9

Various abnormalities of the ovaries, uterus, fallopian tubes and endocrine system. Also PCOS and endometriosis.

Question 10

Pacific women vs NZ population fertility rate

Answer 10

Three births vs two births per women

Question 11

How many times as likely are pacific people to of of an unhealthy weight compared to NZ population?

Answer 11

2.5 times more likely

Question 12

What is an unhealthy BMI (40) recognised as?

Answer 12

Single biggest risk factor that results in poor health outcomes, reduced quality of life, increased health care costs and major contributor to infertility

Question 13

What is ART?

Answer 13

Assisted Reproductive Technology

Question 14

What is IVF-ET?

Answer 14

In Vitro fertilization-embryo transfer

Question 15

What is GIFT?

Answer 15

Gamete intrafallopian transfer

Question 16

What is ZIFT?

Answer 16

Zygote intrafallopian transfer

Question 17

What is FET?

Answer 17

Frozen embryo transfer

Question 18

When was the first IVF baby born?

Answer 18

1978

Question 19

How long must you have been having sex for to be eligible for ART?

Answer 19

unsuccessful after 12 months

Question 20

How old must the women be to be eligible for ART?

Answer 20

Must be under 40

Question 21

What BMI must the women have to be eligible for ART?

Answer 21

Less than 35 at first appointment and 32 and under at treatment start date

Question 22

How old must the man be to be eligible for ART?

Answer 22

Under 55

Question 23

What BMI must the man be to be eligible for ART?

Answer 23

Less than 40 at both first appointment and treatment start date

Question 24

How many children can you have to be eligible for ART?

Answer 24

If living at home at least half the time, cannot have 2 or more children (of any age, adoption or previous relationship)

Question 25

What residency must someone have to be eligible for ART?

Answer 25

Both parties must be NZ citizens, NZ residents or have a valid work visa for over 2 years

Question 26

What must both parties not do for minimum 3 months before treatment?

Answer 26

Smoke

Question 27

What is the eligibility criteria for single or lesbian women?

Answer 27

- 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

Question 28

What are examples of clear biological causes of infertility?

Answer 28

- Anovulation or very irregular periods (<20 or >42 days) - Known tubal infertility - Severe endometriosis

Question 29

What is the eligibility criteria for gay men?

Answer 29

Azoospermia

Question 30

When is the FSA typically after GP visit?

Answer 30

5 months on average from referral

Question 31

When does the orientation appointment occur after FSA?

Answer 31

Approx. 15 to 18 months from placement on waitlist

Question 32

When does treatment occur after waitlist?

Answer 32

Approx. 3-4 months from orientation appointment

Question 33

How long is the process of IVF?

Answer 33

Over a 2 year process for 1 cycle

Question 34

What are some main issues with health for infertility?

Answer 34

- Losing weight can be very difficult - Pacific peoples are generally heavier

Question 35

What are some main healthcare issues for infertility?

Answer 35

They want to feel at home and connected, the NZ healthcare system does not do this

Question 36

What is the spiritual influences on infertility?

Answer 36

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

Question 37

What are the socio-economic issues with infertility?

Answer 37

It is extremely inaccessible and expensive