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Infertility (Risk factors (BOTH:Age, tobacco use, alcohol use ,being…
Infertility
Risk factors
BOTH:Age, tobacco use, alcohol use ,being overweight, being underweight, exercise issue
Female:endocrine(throid,prolactin hormone,D/M,adrenal gland dysfunction- anovulation, immunologic infertility-prduction of sperm antibodies; PCOS, tubal problems-tubal blockage; uterus-malformation of uterus; cervix-acidic cervical mucus, incompetent cervix
Male:Disturbance in spermatogenesis, obstruction in the seminiferous tubules,ducts or vessels preventing movements of spermatozoa;Qualitative, quantitative changes in seminal fluids preventing sperm motility; problems in ejaculation;deposition preventing spermatozoa from being placed close enough to woman cervix
Assessment
3.Investigation
1.Body basal temp (BBT)-sudden rise 0.5-1 degree indicates ovulation
Serum hormone testing-FSH, progesterone,TSH,prolactin, testosterone (male)
3.Hysterosalpingogram (HSG)-detect uterine or tubal abnormalities,sedation or anesthesia
4.Laparoscopy
5.Semen analysis-ejaculates into specimen container;
azoospermia
-no sperm;
oligozoospermia
-low sperm count;
Asthenozoospermia
-poor sperm motility
Physical examination
1.History taking
Type of fertility
Primary-inability to conceive after one years trying with regular unprotected sex
secondary-inability to conceive again after last birth depite unprotected regular sex
Etiology
ovarian problems, tubal/pelvic pathology(most common).sperm problems(also most common), unexplained
Treatment
-ovarian stimulation; intrauterine insemination, Assissted reproductive technique-IVF; intracytoplasmic sperm injection, artificial insemination
Complications-OHSS, multiple pregnancy, ectopic pregnancy,bleeding/infection;physical,finamcial and emotional stress
Psychological implication
Shame,guilt,blame,stages of grief,marital difficulties
Address the psychological factors, discuss the couples feelings,facilitate communication between couples, refer them to coping and support group,counselling, provide educational info-procedures,investigations, treatments
Definition
; inability to conceive after 12 months or more of regular sexual intercourse without contraception or inability to carry pregnancy to live birth.
Other term:
subfertility
-delay in conceiving