Infertility

zygote intrafallopian transfer (ZIFT)

After in vitro fertilization the ova are placed in one uterine tube during the zygote stage

True or false: ART increase the risk of ectopic pregnancies

True

Complete bicornuate uterus and vaginal septum

Vagina has a septum running through it (essentially it is broken in half) Makes implantation and growth difficult

Varicocele

Varicose vein of the scrotum

How long are ova viable?

24 hours

Infertility affects about ______ of reproductive-aged couples. This ______ with age, particularly in women older than _______ years

15%, increases, 35

Donor embryo (embryo adoption)

A donated embryo is transferred to the uterus of an infertile woman at the appropriate time (normal or induced of the menstrual cycle

In vitro fertilization - embryo transfer (IVF-ET)

A woman's eggs are collected from her ovaries, fertilized in the laboratory with sperm, and transferred into her uterus once normal embryo development has occured

Postcoital Test (PCT)

An examination that evaluates the cervical mucus, sperm motility, sperm-mucus interaction, and the sperm's ability to negotiate the cervical mucus barrier. Also called Sims-Huhner test.

How does steroid use affect male fertility?

Anabolic steroids can cause erectile dysfunction and infertility. Also, this medical can reduce testicular size.

When caring for a woman scheduled for a hysterosalpingogram, the nurse should do which of the following? A. Ensure that the woman is in the secretory phase of her menstrual cycle. B. Explain to the woman that the test can result in an enhanced ability to conceive. C. Recognize that uterine cramping may indicate uterine perforation. D. Realize that referred shoulder pain may be a result of coronary artery blockage with debris from the uterus.

B

Lifestyle and sexual practices can affect fertility. Which of the following practices could enhance a couple's ability to conceive? A. Male wears boxer shorts instead of briefs B. Female assumes a supine position with hips elevated for 1hour after intercourse C. The woman should refrain from douching D. The man should be on top during intercourse

C

How do laptops on lap affect male fertility?

Can increase scrotal temperature which decreases the sperm count

How does wearing tight underwear affect male fertility?

Can increase scrotal temperature which results in decreased sperm count

how do long hot baths affect sperm?

Can temporarily impair sperm production

A nurse is providing instruction to a couple undergoing zygote intrafallopian trasfer (ZIFT). The nurse is aware that instruction has been effective when the woman states a. "My egg will be fertilized and then placed into my uterus" b. "My husband's sperm will be inserted into my uterus" c. "My husband's sperm and my egg will be placed into my fallopian tube" d. "A fertilized egg will be placed into my fallopian tube"

D

Ultrasonography for female infertility diagnosis

Done transvaginally to see pelvic structures

Explain why woman should refrain from douching

Douching can change the normal flora and the pH in the vagina, making the environment hostile to the sperm

Laparoscopy

Endoscope that is entered into abdominal incision to view the pubic structures. Done under general or local anesthesia. One of the last resorts.

Endometrial biopsy

Examination of the lining of the uterus to asses its response to progesterone and to detect secretory changes and receptivity to implantation

hysterosalpingography

Examination of uterine cavity and tubes using radiopaque contrast material instilled through the cervix. It is often used to determine tubal patency and to release a blockage if present

How does heavy metal exposure affect male fertility?

Exposure to lead or other heavy metals may also cause infertility

Assessment of male infertility

History, physical examination, semen analysis, ultrasonography

Sperm Immobilization Antigen-Antibody Reaciton

Immunologic test to determine sperm and cervical mucous interaction and compatibility

partial bicornuate uterus

Implantation and growth difficult

Preimplantation genetic diagnosis

In assisted reproductive technology, the determination of genetic abnormalities in the embryo before it is transferred to the uterus

Infertility

Inability of a couple to conceive after at least 1 year of regular unprotected intercourse.

What brain structure must be intact in both men and women in order for the formation of the sperm or ova to occur?

Intact hypothalamic pituitary adrenal axis

How does obesity affect male fertility?

Leads to hormonal imbalance that reduces male fertility

bicornuate uterus

Malformed uterus having two horns. Implantation and growth difficult

Multifetal reductions

Multiple fertilized eggs are implanted, if multiple take then they will be selectively reduced

Aside from aging, what increases the risk of infertility in females?

Obesity, polycystic ovarian syndrome, excessive strenuous exercise on a regular basis, thyroid dysfunction

Gamete intrafallopian transfer (GIFT)

Oocytes are retrieved from the ovary, placed in a catheter with sperm, and immediately transferred into fimbriated end of the uterine tube.

Primary infertility vs. secondary infertility

Primary: Applies to a woman who has never been pregnant Secondary: Applies to a woman who has been pregnant before but now is having difficulty

Surrogate mothers/embryo hosts

Process by which a woman is inseminated with the semen from the infertile woman's partner and then carries the baby until birth

Plan of care and interventions for infertility

Psychosocial - major life stressor; can disrupt relationships Nonmedical - diet, habit changes; weight loss Complementary and alternative measures - herbal remedies, stress management, yoga, nutrition, exercise Medical - correcting pre-existing factors, ovarian stimulation

Intracytoplasmic sperm injection (ICSI)

Selection of one sperm cell that is injected directly into the egg to achieve fertilization

Therapeutic donor insemination

Sperm from a person other than the male partner are used to inseminate the female partner

Causes of male infertility

Structural and hormonal disorders -undescended testes, hypospadias, varicole, low testosterone levels, azoospermia (no sperm cells produced, oligospermia, substance abuse, obesity

Subfertility vs. sterility

Subfertility is the prolonged time to conceive while sterility is the inability to conceive

Fecundability

The probability of achieving a pregnancy in 1 menstrual cycle, is a more accurate label because it recognizes varying degrees of infertility.

Assisted hatching

The zona pelludica is penetrated chemically or manually to create an opening for the dividing embryo to hatch and to implant into the uterine wall

Intrauterine insemination (IUI)

a form of assisted reproduction in which sperm are injected directly into a woman's uterus

Azoospermia

absence of sperm in the semen

How does smoking affect sperm?

can significantly decrease both sperm count and sperm motility

Unicornuate uterus

congenital malformation of the uterus that results in a uterus with one horn. Very difficult to carry pregnancy to term

Assessment of female infertility - diagnostic tests

detection of ovulation, hormone analysis, ultrasonography, hysterosalpingography, hysteroscopy, laparoscopy

Endometriosis

endometrial tissue located outside the uterus. Severe abdominal and pelvic pain that intensifies just before menstruation

Assisted reproductive therapy (ART)

fertility treatments in which both eggs and sperm are handled

Female infertility causes

hormonal and ovulatory factors, tubal and peritoneal factors, uterine factors (developmental anomalies; endometriosis), vaginal-cervical factors

Semen Analysis

microscopic examination of ejaculated fluid

Endometriosis hallmark sign

pain during intercourse

oligiospermia

scanty production and expulsion of sperm

Infertility implies ___________, a prolonged time to ___________. ___________ refers to an inability to conceive. ___________ applies to a woman who has never been pregnant. ___________ applies to a woman who has been pregnant in the past.

subfertility, conceive, sterility, primary infertility, secondary infertility

Hysteroscopy

visual examination of the uterus (uterine cavity)