INFERTILITY
INCIDENCE
-infertility: couples who do not achieve pregnancy after 1 year of regular, unprotected sex when women is less than 35; or 6 months if women older than 35
-Affects about 10% to 15% of reproductive-age couples
-Four goals when providing care:
Provide the couple with accurate information
Assist in identifying the cause of infertility
Provide emotional support
Guide and educate about forms of treatment

FACTORS ASS. W/INFERTILITY
Assessment of Female Infertility
Ovarian factors
Tubal and peritoneal factors (tubes can capture ovum, transport sperm to ovum & transport fertilized embryo to uterus)
Uterine factors (receptive to implantation & nourishing the growth & development)
Vaginal-cervical factors (cervix sufficiently open to allow semen to enter the uterus)
Increases with age, particularly in women 40 years and older
Assessment of Male Infertility
Hormonal factors
Testicular factors
Factors associated with sperm transport
Idiopathic male infertility
-sperm viable in woman’s tract for 3 – 5days.
-oocyte can be successfully fertilized for 12 – 24 hrs after ovulation
POC for Infertility
-ht./wt./ BMI
-hx of infections
-s/s of androgens excess like excess body hair or pigmentation
-if over 35 – assess “ovarian reserve”
-male – semen analysis – 2 analyses is performed

-Psychosocial considerations
-Nonmedical treatments
-Herbal alternative methods
-Medical therapy
-Surgical therapies
Assisted reproductive therapies (ART)
-Major stressor to couple, decreased self esteem, period of grieving or sense of loss. Couples may feel loss of closeness or decreased desire for sex/intimacy
Assisted reproductive therapies
-In vitro fertilization-embryo transfer (IVF-ET)
-Gamete intrafallopian transfer (GIFT)
-Zygote intrafallopian transfer (ZIFT)
-Ovum transfer (oocyte donation)
-Therapeutic donor insemination (TDI)
-Embryo hosting
-Assisted embryo hatching
Reproductive alternatives
-Surrogacy
-Preimplantation genetic diagnosis
-Adoption
-Cryopreservation of human embryos
Contraception
-Intentional prevention of pregnancy
-Birth control is the device or practice to decrease the risk of conceiving
-Family planning is the conscious decision on when to conceive or avoid pregnancy
-May still be at risk for pregnancy
-Nearly half of all U.S. pregnancies are unplanned
Fertility Awareness Methods (FAMs)
-Rely on avoidance of intercourse during fertile periods
-FAMs combine charting menstrual cycle with abstinence or other contraceptive methods
-Natural family planning (period abstinence)
-Calendar rhythm method
Barrier Methods
Barrier methods
Spermicides
Condoms, male (STI protection)
Vaginal sheath (STI protection)