Infertili ty

University of Duhok Faculty of medicine School of nursing 2011_2012

Click to edit Master subtitle style Prepared by students :

Raveen Ismail Abdullah Hayman Ahmad A. Aryan Yousif

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My objectives

Simple introduction about infertility and human reproductive anatomy Infertility causes and diagnosis Infertility treatment Nursing care plan for patient with infertility Patient education
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Introduction

Infertility is the failure of a couple to become pregnant after one year of regular, unprotected intercourse. Infertility is not always woman's problem both men and women can have problems that cause infertility..

About one-third of infertility cases are caused by women's problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture 4/28/12

Female reproductive system

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Male reproductive system

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Definition

Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.

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Infertility can happen if there are problems with one of pregnancy steps :
A woman must release an egg from one of her ovaries (ovulation). The egg must go through a Fallopian tube toward the uterus (womb). A man's sperm must join with (fertilize) the egg along the way. The fertilized egg must attach to the inside of the uterus (implantation).

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Male Sperm

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Female ovary

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Classification

primary infertility :have never been able

to conceive, after1year no previous pregnancy

Secondary infertility :is difficulty

conceiving after already having conceived

Voluntary infertility : the couples have

never tried to conceive or they used contraception to avoid conceiving.

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Symptoms infertility

inability to become pregnant after one year of unprotected intercourse painful emotions in one or both partners. The other symptoms depend on the cause of infertility

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Infertility causes in female

1.

Pelvic inflammatory disease (PID) Endometriosis

2.

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Infertility causes in female

3. Polycystic ovary syndrome(PCOS)

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Infertility causes in female

4. Premature ovarian failure(early menopause ) 5. Uterine fibroids

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Infertility causes in female

6. Elevated prolactin levels(hyper prolactinemia) 7.Oogenesis disorder caused by hypothalamus disorder . 8.Hypothalamus disorder 9. Inborn genital tract abnormalities. 10. Sextual transmitted disease STDs such as (Chlamydia) 4/28/12

Infertility causes in male

1.

Sperm disorder

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Infertility causes in male

2. Spermatogenesis disorder 3. Inborn genital tract abnormalities 4. Systemic disease such as cancer 5. varicocele 6. Endocrine disorder such as (D.M) 8. Chromosome abnormalities
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1.Age

Factors affecting infertility in both male ,female

2.Smoking 3.Alcohol and caffeine use 4. Environmental factor such as marijuana, stress ,nervousness 6.Cancer treatment (radiation ,chemotherapy..etc ) 7. poor diet ,obesity may interfere with infertility 8. Use of certain drugs for example (cimetidine) tagamet
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Diagnosis
both male and female partners are tested if pregnancy fails to occur after a year of regular unprotected sexual intercourse. Fertility testing should be performed if a woman is over 35 years old or if either partner has known risk factors for infertility. 1.Medical History and Physical Examination 2. Menstrual history 3. lifestyle issues (smoking, drug and alcohol use, and caffeine consumption) 4. any medications being taken
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Diagnostic tests for female infertility

1.Laparoscopy:
its surgical procedure. It requires general anesthesia and is performed in an operating room. The surgeon makes a very small incision below the belly button and inserts an instrument called a laparoscope.
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Diagnostic tests for female infertility

2.Hysteroscopy:
inserting flexible or rigid tube (hysteroscopy) into the vagina and advanced through the cervix to reach the uterus. A fiber optic light source and a tiny camera in the tube allow the doctor to view the cavity. The uterus is filled with saline or carbon dioxide .

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Diagnostic tests for female infertility

3.Hysterosalpingography:
is an X-ray test placing a device through the cervix to inject dye into uterus and tubes .

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Diagnostic tests for female infertility

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5.

Blood, urine tests to evaluate hormone levels Clomiphene Challenge Test : the
doctor measures FSH on day 3 of the cycle

6.

Tissue Samples: the doctor may

take tissue samples of the uterus 1 2 days before a period.

7.

Tests for Autoimmune Disease

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such as hypothyroidism ,D.M

Diagnostic tests for male infertility

Semen analysis determining

(shape ,count, motility) of sperm

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Normal Semen analysis

Volume than 2ml or equal PH Concentration more than 20 million Morphology WBC 30%normal more than Fewer than one million 4/28/12 more 7.2_7.8

Diagnostic tests for male infertility

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Diagnostic tests for male infertility

Testicular biopsy

Taking a biopsy from testicular tissue for diagnosing the cause of infertility for example :abnormal growth ,tumors ..etc

blood test to determine hormone level

such as :LH,FSH,PRL,testosterone..

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Infertility Treatment
Medications used to treat infertility in women include :
1.

Clomiphene citrate( clomid ) Human menopausal gonadotropin FSH follicle-stimulating hormone Metformin( glucophage) Gonadotropin-relaesing hormone bromocriptine
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2.

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Infertility Treatment

What is assisted reproductive technology (ART)?

Assisted reproductive technology (ART) is a group of different methods used to help infertile couples. ART works by removing eggs from a woman's body. The eggs are then mixed with sperm to make embryos. The embryos are then put back in the woman's body.

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Infertility Treatment
Common methods of ART include:
1.

intrauterine insemination (IUI):

artificial insemination: In this procedure, the woman is injected with specially prepared sperm. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.

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Infertility Treatment

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Infertility Treatment
2. In vitro fertilization (IVF)
means fertilization outside of the body.

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Infertility Treatment
3. Intracytoplasmic sperm injection (ICSI)
a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or Fallopian tube.

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Nursing care plan

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Nursing care plan

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Nursing care plan

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Nursing care plan

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patient education
Lifestyle Changes
1.

Maintain a healthy weight. Women who are either over- or underweight are at risk for fertility failure, including a lower chance for achieving success with fertility procedures. Stop smoking. Smoking may increase the risk for infertility in both men and women. Everyone 4/28/12 should quit.

2.

Resources

www.resolve.org -- National Infertility Association www.asrm.org-- American Society for Reproductive Medicine www.sart.org-- Society for Assisted Reproductive Technology www.theafa.org -- American Fertility Association
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Thank you
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