Infertility is the failure to attain a successful pregnancy after 12 or more months of regular unprotected intercourse. There are approximately 10 to 15 percent of US couples that are in their reproductive years and are infertile. For a female to be fertile it is necessary for there to be cervical mucus, a clear passage between the cervix and tubes, tubes must be patent with normal motility, ovulation and release of an ova must occur, no obstruction between ovaries and tubes, and endometrial preparation. There are many different causes of infertility for women, some of these are cervicitis, use of lubricants, Pelvic Inflammatory Disease, endometriosis, and STI’s just to name a few. Men need to have normal semen analysis, unobstructed genital tract, and normal genital tract secretions. They can also have infertility problems such as smoking tobacco or marijuana, alcohol abuse, malnutrition, medications such as aspirin and ibuprofen, constrictive clothing, premature ejaculations, and obesity. Signs and symptoms to look for in a female for infertility are irregular periods which could mean either too long of periods, too short of periods, or absent periods, this could indicate that there is no ovulation or ova being released, increased acne, changes in sex drive or desire, loss of hair or hair becoming thin, milky white discharge from nipples not related to breastfeeding, and painful sex. Signs and symptoms to look for in men for infertility are changes in sex drive, small, firm, and/or pain, lump and swelling in testicles, and problems with erections and/or ejaculation.
If a woman comes in with fertility problems the nurse should assess history such as medical, surgical, sexual, family reproductive, menstrual, and fertility. The nurse should also do a breast and pelvic examination on the patient, pap smear to evaluate the condition of the cervix, and draw blood to know lab values; lab values to be known include CBC, RH factor, serology, etc. Cultures and tests should be done to identify vaginal infections, evaluation for possible endometriosis. If a man comes in with infertility problems the nurse should assess medical, surgical, urologic, developmental, and sexual history. Labs should be drawn to know the CBC, serology, RH factor, and semen analysis. The size and consistency of the prostate and testicles should be evaluated. If complications are discovered during the assessment of a female or male, the nurse will need to intervene. In Vitro fertilization can be discussed with the patient, this is done by collecting a woman’s eggs from her ovaries, fertilizing them in a petri dish, then placing them in the woman’s uterus after normal embryo development has begun. Another option is Gamete Intrafallopian Transfer, this includes retrieval of oocytes, placement of oocytes in a catheter with fertile sperm, then placing them in the fimbriated end of the fallopian tube, it is then fertilized in the fallopian tubes like natural conception. Some other interventions and treatments of infertility include hormone administration, fertility drugs, donor sperm, donor eggs, and surrogacy. If interventions in place are not helping, adoption could be an option for this patient.
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