Infertility AWHONN Position Statement Assignment

Infertility is the inability to establish or produce a clinical pregnancy for 12 months of

participating in unprotected sexual intercourse. Women who are able to get pregnant but are

unable to stay pregnant may also be considered infertile. In many cases, problems with infertility

occur with ovulation or lack thereof. Sometimes, women with infertility problems might have

absent or irregular periods making ovulatory times harder to predict. Infertility in women can

include problems such as polycystic ovarian syndrome, endometriosis, uterine fibroids, thyroid

disease, pelvic inflammatory disease, ovarian cysts, abnormal menstruation, past ectopic

pregnancies, or celiac disease may all contribute in causing infertility. On the other hand, the

infertility may not be the woman’s problem, it can also occur in men. Infertility in men may have

some signs of hormonal problems such as sexual function with low sperm count or they may see

changes in hair growth. Regarding the nurse’s role in infertility, it is important for us to help

identify modifiable factors a woman can change such as maintaining a healthy weight, providing

smoking cessation education, controlling diabetes, awareness of environmental toxins, testing for

sexually transmitted diseases, reducing stressors, identifying substance abuse, or even

overexercising. A nurse also needs to listen to the concerns of their patient and try to help them

eliminate negative emotions of tension, panic, anger and anxiety. Nurses can also help in

providing thorough assessment of obstetric, physical, and emotional history, and nurses can

provide education and patient advocacy in helping the patient get to the next step in their

journey.

I think this topic is not spoken about enough, and many women in my family have

struggled with this, which is why I have chosen this topic for my paper. Infertility should not be

looked at as a burden, but rather a different course of action that needs to be taken to achieve the
goal of a pregnancy. According to the Association of Women’s Health, Obstetric and Neonatal

Nurses (AWHONN), they support the inclusion of all non-experimental infertility treatments as

covered benefits in both private and public health care insurance plans (2021). They also state

that infertility is a disease of the reproductive system, and treatment for it should not be

considered elective. Unfortunately, it is prevalent in the United States that racial, economic, and

geographic barriers exist regarding access to infertility services and treatments. Health insurance

coverage is also very limited with fertility treatment. Another problem with infertility, is the

effect it has on a woman’s mental health. The physical, emotional, spiritual, sexual, and financial

components are all affected by infertility, many times negatively. According to Wendy Ezzell,

she states that the most common mental health concerns that infertility patients have are

symptoms of depression and anxiety (2016). Every cycle tends brings on a new wave of different

emotions, self-esteem problems, or performance concerns. Especially with infertility struggles, it

is important to note that fertility treatments can become focused on procreation rather than

recreation, causing connections, especially emotional, to become more of a challenge. I think it is

largely important for mental health professionals to be consulted in infertility situations. This is

because infertility can and may be the first medical crisis a couple faces with each other, and

mental health professionals need to be part of the health care team. They need to be able to guide

patients through loss and grief that is associated with infertility, as well as tough decisions so the

couple does not have to face them alone. The best-case scenario with having a mental health

professional on board, is to the have a team that is behind the couple who are struggling with

infertility. This should provide the couple with the best care, the best chance to conceive, and the

best chance of keeping the pregnancy. Mental health can easily take a dark turn with infertility

since many couples can feel alone as it is something that is not spoken about. As a future nurse,
hopefully one day supporting women in health care, I think opening up the conversation about

infertility and the struggles that go along with it are extremely important, not only for the couple,

but for other people to see that they are not alone.

Overall, I strongly believe that insurance needs to be expanded to cover and provide

protection for couples seeking to become pregnant when they are having difficulties. Infertility

definitely aids in mental health struggles, and mental health professionals needs to be able to

broaden their scope of practice of understanding the different types of fertility counseling and

being able to effectively implement the right form of counseling (Ezzell, 2016). It is also

important for nurses who are providing care for women to stay current on issues that are related

to fertility preservation and infertility. Nurses also play a vital role in communicating, so it may

be necessary for nurses to go through a communication skills training regarding infertility. As

nurses, they can be looked at as counselors, and can help with stress that is put on infertility

situations between couples that are married or not married. Some suggestions a nurse can offer to

a couple regarding ways to cope with stress include practicing self-care, talking to others,

focusing on the present, checking for depression, or reaching out to a mental health professional.

Nurses can also suggest a diet that is low in trans-fat and more monounsaturated fat, which

includes foods like beans, fruit, avocados, sunflower seeds, salmon, etc., to help boost vitamins

in their systems. Other suggestions a nurse may offer is for the patient to consider working on

managing their stress levels, especially if they are related to work, and to be aware of any

environmental toxins that may be present. As infertility is looked at as a negative situation, the

nurse needs to be able to provide positive aspects around a woman’s cycle, as well as emotional

connection between the couple. I also hold on to the hope that infertility will continue to be

researched and more answers will be found for couples.

 References

AWHONN Position Statement (2021). Infertility treatment and fertility preservation. Journal of
Obstetric, Gynecologic & Neonatal Nursing, 50(1), 116–118.
https://doi.org/10.1016/j.jogn.2020.12.001

Ezzell, W. (2016). The impact of infertility on women's mental health. North Carolina Medical
Journal, 77(6), 427–428. https://doi.org/10.18043/ncm.77.6.427