Jacobs > Infertility

Question 1

define infertility

Answer 1

the inability to conceive a pregnancy after ONE YEAR of engaging in sexual intercourse w/o contraception
&/or the inability to carry a pregnancy to live birth

Question 2

how many couples are affected by infertility?

Answer 2

one in six

Question 3

what is the unique predicament facing medical students & infertility?

Answer 3

many students put off having babies until they are settled & can provide an optimal life for a baby, but by the time you get settled, fertility has declined

Question 4

what % of women and men consider infertility as the MOST UPSETTING EXPERIENCE OF THEIR LIVES?

Answer 4

49% of women

15% of men

Question 5

what is the downside to medical treatment of infertility?

Answer 5

invasive
painful
embarrassing
time consuming
disruptive to schedule
\$\$\$\$$

Question 6

what feelings can result from infertility?

Answer 6

failure
shock
anger
loss
grief
sadness/depression
stress
loss of control & meaning
marital probs
estrangement

Question 7

what are the 4 main causes of infertility?

Answer 7

1. female factor
2. male factor
3. combined
4. unexplained

Question 8

what is the breakdown of % of each cause of infertility?

Answer 8

1. female 35%
2. male 35%
3. combined 20%
4. unexplained 10%

Question 9

what are the 3 main female factor infertility causes?

Answer 9

1. menstrual probs
2. blockage
3. structural probs

Question 10

what are the 3 main male factor infertility causes?

Answer 10

1. sperm
2. blockage
3. sexual fxn

Question 11

what are the 7 main combined factor infertility causes?

Answer 11

1. advanced age
2. miscarriages
3. STDs
4. diabetes
5. smoking
6. alcohol/drugs
7. weight

Question 12

what does the choice of treatment for infertility depend on?

Answer 12

diagnosis & age

Question 13

why would you give a (female) pt fertility drugs?

Answer 13

to regulate or stimulate ovulation

Question 14

what are the 2 downsides to fertility drugs?

Answer 14

1. hormones have side FX

2. difficult to inject

Question 15

what are the 6 main treatments for infertility?

Answer 15

1. fertility drugs
2. abx
3. artificial insemination
4. surgical RX
5. use of third parties
6. assisted reproductive technologies

Question 16

what are the 2 types of sperm you can use for artificial insemination?

Answer 16

husband’s sperm = AIH

donor sperm = AID

Question 17

what are the 2 types of insemination?

Answer 17

intrauterine = IUI
intracervical = ICI

Question 18

what are the 5 assisted reproductive technologies for treatment of infertility?

Answer 18

1. IVF
2. gamete intrafallopian transfer (GIFT)
3. zygote intrafallopian transfer (ZIFT)
4. tubal embryo transfer (TET)
5. micromanipulation

Question 19

what are the 2 micromanipulation techniques?

Answer 19

1. intracytoplasmic sperm injection (ICSI)

2. assisted hatching (to have a baby lizard)

Question 20

how do most couples schedule their life & fertility treatments?

Answer 20

life is usu scheduled around fertility treatments

it’s pretty disruptive

Question 21

T/F: most couples assume they will be able to have kids (i.e. “when, not if”)

Answer 21

TRUE

Question 22

in what ways can a couple experience surprise at infertility?

Answer 22

1. successful ppl experiencing first failure

2. societal expectations

Question 23

T/F: some couples are relieved to get a dx that explains their inability to have a baby

Answer 23

true

Question 24

T/F: denial happens in response to the possibility of infertility

Answer 24

true

Question 25

what is a unique challenge of denial?

Answer 25

it can present difficulties if one partner is in denial & one is not

Question 26

what is the debate w/ stress & infertility?

Answer 26

kind of a chicken & egg deal infertility definitely causes stress but stress does NOT definitively cause infertility

Question 27

what are the 9 (ugh sorry) common emotional rxns to infertility?

Answer 27

1. surprise 2. denial 3. stress 4. anger 5. guilt/neg self-image 6. isolation 7. sadness/grief 8. questioning beliefs 9. acceptance & resolution

Question 28

how should a clinician approach feelings of guilt w/ infertility?

Answer 28

fertility has nothing to do with worthiness | no scientific connection btwn "sins" & infertility so "atoning" won't help

Question 29

how can infertility lead to estrangement?

Answer 29

marital conflict gender diffs a partner's wish for secrecy

Question 30

how should a clinician handle isolation d/t infertility?

Answer 30

educate pts about how common infertility is | encourage social support

Question 31

T/F: full-blown depression is common w/ infertility

Answer 31

FALSE | sadness is common, but full-blown depression is not

Question 32

how can sex be affected by infertility & RX (5 ways)?

Answer 32

1. regulated & monitored 2. may feel a demand to perform 3. may feel like work & not fun 4. not spontaneous 5. postcoital tests may cause pressure

Question 33

when do pts accept & resolve their infertility?

Answer 33

only after previous painful feelings are acknowledged & worked through

Question 34

T/F: acceptance & resolution = getting over infertility

Answer 34

FALSE | might not include getting over it

Question 35

treatment for infertility should involve a (__?__) approach

Answer 35

BPSS

Question 36

what should you educate an infertile couple about?

Answer 36

1. medical aspects of infertility 2. fertility treatments 3. dispel myths about causes (i.e. punishment for sinning)

Question 37

what should you do with your pts emotional rxns to infertility?

Answer 37

1. normalize & validate responses 2. consider bibliotherapy, online resources 3. refer to therapy 4. encourage social support

Question 38

T/F: pts emotional rxns may be subclinical

Answer 38

true

Question 39

T/F: you shouldn't bother asking about spiritual beliefs when evaluating infertility

Answer 39

FALSE | you should! refer to religious community if appropriate

Question 40

what book should you use for bibliotherapy?

Answer 40

coping w/ infertility