Nursing Care

of the Family
Having
Difficulty
Conceiving a
Child
š Infertility is defined as the inability to conceive (or
impregnate) after one year of regular vaginal
intercourse without the use of any form of
contraception( if a woman is older than 35, usually
infertility is diagnosed after 6 months of not being
able to conceive.

š Women and men who delay pregnancy may

experience infertility because of the decreasing
quality of their ova and sperm (Coccia & Rizzello,
2008).
 Primary
TYPES OF • No previous conception

INFERTILITY/ Secondary
SUBFERTILITY • There has been a previous viable
pregnancy but the couple is unable
to conceive at present.

Sterility
• Inability to conceive .Problems
diagnosed, management done, no
pregnancy.
 A L E
F E M Y
I L I T
E RT
IN F R S
T O
FAC
FACTORS THAT CAUSE FEMALE SUBFERTILITY
•Limited production of FSH or LH, which interfere with ova
growth.
•Anovulation (Clomiphene Citrate-Clomid is given)
•Problems of ova transport through the fallopian tubes to
the uterus.
•Uterine factors, such as poor endometrial development.
•Cervical and vaginal factors, which immobilize
spermatozoa.
•Poor nutrition, increased body weight, and lack of
exercise.
 Semen Allergy

Generalized
Known as itching
Produces Hives
human
antibodies
seminal
which kill or Swelling or
plasma blisters
disable
hypersensiti
sperm cells
-vity Vaginal
redness
 A LE
M I T Y
T I L
F E R S
IN T O R
FAC
Low Sperm Count
(Oligospermia)
The causes of low sperm count include,
but are not limited to, the following:
• Overheating of the testicle
• Stress (emotional, psychological,
and physical)

Low Sperm Motility

• the sperm’s capacity for

swimming forward and
penetrating the egg is
diminished.
Abnormal Sperm Germ-Cell Aplasia
Shape azoospermic (devoid of
A very large round head sperm cells).
An extremely small pinpoint head
A tapered head
A crooked head
Two heads
OBSTRUCTION
• Seminiferous tubule obstruction
• Mumps orchitis, Epididymitis, Epispadias

and hypospadias

Ejaculation Problems
• Erectile dysfunction
• Premature ejaculation
 Abnormal Semen

šYellow or greenish
šRed or brown
šStrong fowl odor
šAbnormally thick ejaculate
šLow volume
šWatery ejaculate
FERTILITY ASSESSMENT
 Fertility Testing for Woman
Ovulation Test

Ovulation Cervical
Serum
Ovulation determina- Mucus
progeste-
monitoring tion by test Assess-
strips
rone test
ment
 Sonohysterography
• Inspect the uterus

Hysterosalpinography
• Inspect uterus and fallopian tube

TUBAL PATENCY TESTING

 PROCEDURE

Uterine Hysteroscopy Laparoscopy

Endometrial
Biopsy
 Sperm penetration
assay and antisperm Fertility
antibody testing
Testing for
Man
Post-coital test
 Infertility Management

Reducing
Increasing
the
sperm Hormone
presence Surgery
count and therapy
of
motility
infection
Advance Reproductive Techniques
 IVF (In Vitro Fertilization)

šDESCRIPTION:
šEggs are retrieved and fertilized in
vitro
šone or more embryo(s) are placed
in the uterus.
šINDICATION:
šfallopian tube occlusion and
endometriosis.
šsperm abnormalities
GIFT (Gamete intrafallopian transfer/fertilization)

DESCRIPTION:

Spermatozoa and eggs are placed directly into the

fallopian tubes where fertilization can occur.

INDICATION:

Infertility due to endometriosis and cervical mucus

disorders.
Zygote intrafallopian transfer (ZIFT)

DESCRIPTION:

Fertilized eggs are placed in the fallopian tubes at a

certain stage of embryo development (zygote).

INDICATION:

Can only be practiced if fallopian tubes are healthy.

ICSI
(Intracyto- plasmic Sperm
Injection)
DESCRIPTION:

Single sperm is selected and

injected into an egg.

INDICATION:

Male infertility when very few

normal sperm are available
MESA (Microsurgical Epididymal Sperm Aspiration)

šDESCRIPTION:
š Spermatozoa are retrieved directly from
the epididymis (area in the testes where
spermatozoa mature and are stored).
šINDICATION:
šSevere male infertility. Absence of sperm
TESE (testicular
sperm extraction)
DESCRIPTION:
šBiopsy of the testes is performed
in order to obtain spermatozoa
directly from testicular tissue.

INDICATION:
šSevere male infertility.
šAbsence of sperm in epididymis.
 šSurrogate mothers- a woman carries a
pregnancy to term for an infertile
Alternative couple.
Childbirth šAdoption
šChild-free living
 Quiz

1. Type of infertility where a woman had never been pregnant despite diagnosis and
management that was done
2. -3. Give 2 factors that causes female infertility
4 – 5. Give 2 factors that causes male infertility
6. This is a female fertility test where you monitor your monthly period and cervical mucus
7. In vitro fertilization is : inside the fallopian tube or outside the fallopian tube fertilization
8. In vivo fertilization is: inside the fallopian tube or outside the fallopian tube fertilization
9. GIFT is the acronym for______________________
10. TESE is the acronym for______________________