Nursing Reproductive Health > Infertility > Flashcards

Infertility Flashcards

Review reasons for infertility and how to treat it. (62 cards)

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1
Q

What defines infertility for someone less than 35 years old?

A

Inability to conceive after 12 months of unprotected sex.

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2
Q

What defines infertility for someone greater than 35 years old?

A

Inability to conceive after 6 months of unprotected sex.

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3
Q

Define:

Primary infertility

A

Inability to conceive for someone that has never been pregnant.

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4
Q

Define:

Secondary infertility

A

Inability or difficulty to conceive for someone that has had a successful pregnancy.

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5
Q

Define:

Fecundity

A

Ability to achieve a live birth.

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6
Q

Why do we assess the medical and surgical history for a client who is having infertility problems?

A

Medical conditions and past surgeries can affect the clients ability to conceive.

Examples would be hypertension, diabetes mellitus or endocrine disorders.

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7
Q

Why do we ask about sexual intercourse for a client who is having infertility problems?

A

Because how often intercourse occurs and with who can affect the client’s ability to conceive.

Examples would be not having sex during ovulation and having sex with an unhealthy individual.

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8
Q

Why do we ask about gynecological history for a client who is having infertility problems?

A

Because infections or abnormalities of the cervix or uterus can affect the client’s ability to conceive.

Examples would be STIs or pelvic inflammatory disease.

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9
Q

Why do we ask about obstetric history for a client who is having infertility problems?

A

Because previously being able to get pregnant or never being pregnant can affect the client’s ability to conceive.

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10
Q

Why do we ask about past fertility issues for a client who is having current infertility problems?

A

Because how long the client has been having problems can affect how we treat the problem.

Examples would be how long this has been occurring, a month? A year? Several years? Previous partners?

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11
Q

Why do we ask about where a client lives, works and plays when having infertility problems?

A

Because the client can be exposed to toxins or teratogens that can affect the ability to conceive.

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12
Q

Why do we ask about substance use for a client having infertility problems?

A

Because alcohol, smoking, drugs, cannabis and medications can affect the client’s ability to conceive.

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13
Q

Why do we ask about weight gain or weight loss for a client having infertility issues?

A

Because being underweight or overweight can affect the client’s ability to ovulate due to hormone changes.

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14
Q

Why is a pelvic exam done for a client having infertility problems?

A

To palpate the uterus to check for any structural abnormalities that could prevent conception.

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15
Q

Why are hormone levels obtained for a client having infertility problems?

A

Because abnormal hormone levels can affect the client’s ability to conceive.

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16
Q

Which hormone levels are obtained for a female client having issues with infertility?

A
  • estrogen
  • progesterone
  • luteinizing hormone (LH)
  • follicle stimulating hormone (FSH)
  • TSH (thyroid level)
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17
Q

What is a post-coital test for a client having infertility problems?

A

Female client is exposed to sperm and the vaginal environment is tested to see if the sperm are still alive after they are exposed to cervical mucus.

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18
Q

Why is an ultrasound done for a client having infertility problems?

A

To see the shape of the uterus to check for any abnormalities.

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19
Q

Why would a hysterogram or hysteroscopy be done for a client having issues with infertility?

A

To see the shape of the uterus, fallopian tubes, and ovaries to make sure the tubes are open or for any abnormalities such as polyps or tumors that could affect implantation.

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20
Q

What is the #1 cause of infertility issues in a female client?

A

Ovulatory disorders.

The client is not ovulating at all or is inconsistent with ovulation.

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21
Q

What is the #2 cause of infertility issues in a female client?

A

Endometriosis: when scar tissue forms from abnormal menstruation.

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22
Q

What are some ovulatory factors that prevent pregnancy?

A
  • Ovaries or eggs are abnormally formed and ovulation does not occur
  • Polycystic ovarian syndrome

Abnormal formation could have occurred much earlier in life.

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23
Q

What are some hormonal factors that prevent ovulation?

A
  • Pituitary or hypothalamus disorders
  • Adrenal gland disorders
  • Increased prolactin that suppresses GnRH
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24
Q

What are some structural issues that prevent pregnancy?

A
  • infection in the endometrium lining
  • tumors
  • adhesions
  • endometriosis
  • inflammation
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25
Why do **structural issues** lead to infertility problems?
Because the sperm and egg will not be able to meet.
26
Why is more **difficult** to get pregnant after a dilation and curettage surgery?
Because after the uterine lining is scraped, **scar tissue** can form making implantation difficult.
27
Why does **thick, dry and sticky** cervical mucus cause infertility problems?
It **prevents** sperm from entering the uterus.
28
Why does **acidic** cervical mucus cause infertility issues?
Because sperm **can't survive** in an acidic environment.
29
What are **anti-sperm antibodies**?
Antibodies produced by a female that **attack sperm** and the sperm die.
30
What is the one main reason that a **male** may have infertility issues?
**Decreased** sperm count
31
What can cause a **decreased** sperm count?
* Lifestyle choices such as drugs, smoking, alcohol, medications or obesity * Exposure to toxins in the environment * Hormone imbalances * Exposure to excessive heat in the genitals
32
Why would a **semen analysis** be done for a client having issues with infertility?
To check if the male's sperm is **abnormal**.
33
What is **checked** when doing a semen analysis?
If the sperm is: * moving * how many heads * how many tails
34
Why would an **ultrasound** be done on the male reproductive organs when a client is having infertility problems?
To check for **structural abnormalities** in the penis, testes, vas deferens and scrotum.
35
Why would **genetic testing** be done with a client who is having issues with infertility?
To check for **chromosomal abnormalities** since this is a common cause of miscarriage.
36
What **hormone level** is measured in a male to check for issues with infertility?
Testosterone
37
Why does **decreased testosterone** level in males cause issues with infertility?
Decreased testosterone leads to a **decreased sperm count**.
38
What is the **#1 cause** of infertility in a male?
34% of causes of infertility in males is **unknown**!
39
What is the **#2 cause** of infertility in a male?
Varicocele ## Footnote *This is 17% of causes of male infertility.*
40
What is a **varicocele** in males?
An **enlargement of the veins** in the scrotum.
41
Why does a **varicocele** cause male infertility?
The enlarged veins can **warm up the sperm** which causes the sperm to die.
42
Why do **structural abnormalities** in male reproductive organs cause infertility?
Because the sperm is **unable to get through** the vas deferens and urethra. Then there is no way to fertilize an egg.
43
Why do **endocrine disorders** cause male infertility?
Because the endocrine system **controls hormones** which controls how the reproductive system works.
44
Why do **untreated STIs** cause male infertility?
Untreated STIs can **change the shape** of the sperm and **scar** any tubes.
45
Why does **obesity** cause male infertility?
Obesity leads to: * **higher temperatures in the scrotum** that then kills sperm * fat tissue can **disrupt hormone function**
46
Why does **steroid use** in males cause male infertility?
Steroids **prevent proper sperm** shape and transport.
47
Why is it **important** to ask about medications, herbal use, and substance use for clients experiencing male infertility?
Because many of these substances can cause sperm to **not develop** properly.
48
What are some **non-pharmacological strategies** for infertility for both males and females?
* psychosocial support * nutrition * exercise * CAM ## Footnote *We want to make sure the clients are as healthy as they can be!*
49
What are some **treatments** for female infertility?
* correction of hormone imbalance * surgical correction
50
What is **clomiphene citrate** and **letrozole** for?
To stimulate **ovulation** in a female client that is having issues with infertility.
51
Why would **metformin** be given to a client that is having issues with infertility?
To **prevent insulin resistance**, which is a cause of infertility.
52
What **hormone** can be given to help sustain a pregnancy by stabilizing the endometrium lining?
Progesterone
53
What is the **risk** of using clomiphene?
**Multiple eggs** are released leading to twins, triplets or even more!
54
What is **artificial insemination**?
When **sperm is collected externally** and then introduced into the vagina or uterine cavity to make it easier for the sperm and egg to meet.
55
What is **invitro fertilization**? | (IVF)
When the oocyte is removed, placed in a petri dish, add sperm to the dish and have conception occur in the dish.
56
What is **intracytoplasmic sperm injection**?
A type of IVF where **sperm is directly inserted** into an egg.
57
When is a **donor** egg or donor embryo used for infertility?
When the client(s) are **unable to use** their own egg or embryo to produce a child.
58
What is a **gestational carrier**?
When a couple is able to donate a sperm, but not an egg. A **third person will supply the egg**.
59
What is a **surrogate**?
When a couple donates both the egg and sperm, but a **third person will carry out the pregnancy**.
60
What are some **complications** of fertility treatments?
* ectopic pregnancy * multiple gestation * miscarriage
61
How do we care for **transgender or same sex** couples that are seeking fertility treatment?
With respect.
62
If a couple or person decides to **stop** fertility treatment, how should the nurse respond?
With **psychological support** and therapeutic communication.
Nursing Reproductive Health
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