*NURSING > STUDY GUIDE > Week-6-Infertility-Fetal-Development-AP-of-Pregnancy-Chapter-9-12-13.docx[full document] graded A+ (All)

Week-6-Infertility-Fetal-Development-AP-of-Pregnancy-Chapter-9-12-13.docx[full document] graded A+

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Week #6: Infertility, Conception and Fetal Development, A&P of Pregnancy—Chapter #9, 12, 13 1 Infertility— Chapter #9 - Affects about 10%-15% of the reproductive-age population (quality of life... ) Subfertility: prolonged time to conceive (implied) Sterility: inability to conceive - Increases with age - Issues with both genders as age increases - Diagnosis and treatment of infertility require physical, emotional, and financial investment Factors Associated with Infertility Female infertility (Box 9-1) - Congenital or developmental factors o Hormonal and Ovulatory factors o Tubal/peritoneal factors o Uterine factors: Anomalies, Adhesions, STIs (Endometriosis) o Vaginal: Cervical factors  pH—Alkaline cervical mucous required, vaginal fluid is 4-5 acidic  Isoimmunization: developing antibodies to sperm o Other factors: obesity, dysfunctional thyroid, nutritional deficiencies Male infertility (Box 9-2) o Can be caused by structural and hormonal disorders  Undescended testes  Hypospadias  Varicocele  Low testosterone levels- workplace exposures?  Azoospermia- no sperm produced  Oligospermia- few sperm produced  Substance abuse Care Management Assessment of female infertility  Detection of ovulation  Hormone analysis  Ultrasonography  Timed endometrial biopsy  Hysterosalpingography (instillation of radiopaque contrast material)  Hysteroscopy  Laparoscopy  Timed endometrial biopsy Assessment of male infertility  Semen analysis-- Ultrasonography Assessment of the couple  Post-Coital test (PCT)  Timed intercourse Plan of care and Interventions o Psychosocial o Nonmedical (modest weight loss 5-10% ↑ fertility) o Herbal alternative measures o Medical—review meds…  Clomiphene citrate,  FSH,  HCG,  Progesterone,  Metformin, etc. o Surgical Assisted reproductive therapies (ARTs) *don’t memorize* o In vitro fertilization–embryo transfer (IVF-ET) o Intracytoplasmic sperm injection (ICSI) o Preimplantation genetic diagnosis (PGD) o Cryopreservation of human embryos o Gamete intrafallopian transfer (GIFT) o Zygote intrafallopian transfer (ZIFT) o Oocyte donation o Embryo donation o Surrogate mothers/embryo hosts o Therapeutic donor insemination (TDI) o Adoption Key Points - Infertility: inability to conceive and carry a child to term gestation - Infertility affects 10%-15% of otherwise healthy adults and increases as woman ages, especially after age 40 - In the U.S., about 40% of infertility related to female causes; 40% male causes; 20% unexplained causes - Common etiologic factors include decreased sperm production, ovulation disorders, tubal occlusion, and endometriosis - Investigation of infertility is conducted systematically and simultaneously for male and female - Relationship dynamics, sexuality, and ability to cope with psychologic and emotional effects caused by diagnostic procedures and treatment of infertility must be considered - Most infertility cases are treated with conventional medical and surgical therapies; less than 3% treated with in vitro fertilization - Reproductive alternatives for family building o IVF-ET o GIFT o ZIFT o Oocyte donation [Show More]

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