Chapter 5
Infertility, Contraception, and Abortion

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Infertility
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Incidence
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Affects about 10% to 15% of reproductive-age couples Four goals when providing care:
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Provide the couple with accurate information
Assist in identifying the cause of infertility
Provide emotional support
Guide and educate about forms of treatment

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Factors Associated with Infertility
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Assessment of female infertility
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Ovarian factors
Tubal and peritoneal factors
Uterine factors
Vaginal-cervical factors
Other factors

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3

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Factors Associated with Infertility
(Cont.)
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Assessment of male infertility
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Hormonal factors
Testicular factors
Factors associated with sperm transport
Idiopathic male infertility

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Care Management
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Assessment of female infertility
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Test or examination
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Evaluation of the anatomy
Detection of ovulation
Hormone analysis
Ultrasonography
Endometrial biopsy
Hysterosalpingography
Laparoscopy

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6

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Care Management (Cont.)
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Assessment of male infertility
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Semen analysis
Hormone analysis
Scrotal ultrasound

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Care Management (Cont.)
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Plan of care and implementation
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Psychosocial considerations
Nonmedical treatments
• Herbal alternative methods

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Medical therapy
Surgical therapies
• Assisted reproductive therapies (ART)

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9

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Care Management (Cont.)
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Assisted reproductive therapies
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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

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11

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Care Management (Cont.)
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Reproductive alternatives
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Surrogacy
Preimplantation genetic diagnosis
Adoption
Cryopreservation of human embryos

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13

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Contraception
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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
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Care Management
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A multidisciplinary approach to assist the woman in choosing an appropriate contraceptive method Ideally the method should be safe, readily available, economical, acceptable, and simple to use Contraceptive choice must meet personal, social, cultural, and interpersonal needs

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