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)