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Understanding Women's Health: Fertility, Infertility, and Diagnostic Approaches

This comprehensive guide delves into women's health with a focus on fertility and infertility. It covers critical aspects such as the menstrual cycle phases, ovulation, cervical mucus changes, uterine structure, and the role of hormones. Explore both female and male components of infertility, diagnostic studies, and psychological factors that may affect couples facing infertility. Learn about hormonal therapies, medications, and the importance of informed support for couples on their journey to conception. Gain insights into effective treatments and educational resources to navigate infertility challenges.

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Understanding Women's Health: Fertility, Infertility, and Diagnostic Approaches

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Presentation Transcript

  1. Introduction • http://www.youtube.com/watch?v=qjSZf43yf7k

  2. Women’s health Fertility and Infertility Developed by D. Ann Currie , R.N., M.S.N. 2012

  3. Fertility • Menstrual cycle • Ovulation • Cervical mucous • Uterine structure • Hormones • Fallopian tubes

  4. Menstrual Cycle • Follicular phase-days 1-14 of the cycle • Menstrual phase (Menses) • Proliferative phase • Luteal phase-days 15-28 of the cycle • Secretory phase • Ischemic phase

  5. Ovulation • Mature ovum comes out of the follicle

  6. Cervical Mucus • Becomes more plentiful,thinner,and more stretchy consistency, and forms columns during ovulation to facilitate the transport of the sperm into the uterus

  7. Uterine Structure • Normal shape and myometrium • Placement of fertilizated ovum for successful implantation • Unicornate • Septate • Bicornate

  8. Uterine Types

  9. Hormones • Estrogen • Progesterone • FSH-Follicle stimulating hormone • LH-Lutenizing hormone

  10. Fallopian Tubes • Patent • for sperm to reach ovum • for fertilized ovum to reach uterus

  11. Male Component • Sperm- • Morphology-50% must have normal shape • Count->20 million per ml. • Motility-50% must have normal motion patterns • Testosterone • Erection • Ejaculation

  12. Infertility • Primary infertility- the individual has never conceived • Secondary infertility- the individual was able to get pregnant but now can not conceive.

  13. Female component • Various factors • Ovulation- failure to ovulate • Body fat under 14% will result in irregular menses,amenorrhea,or failure to ovulate • Decrease in pituitary hormones of FSH or LH will result in fail to ovulate • Structure of uterus - malformation of uterus

  14. Female Components • Antibodies in vaginal or cervical mucus against sperm • Scarring or blockade of fallopian tubes • Smoking • Other

  15. Male Components of infertility • Sperm- lack of sperm, problems with shape, size,count, or motility • Lack of testosterone • Unable to maintain erection • Failure to ejaculate • Scrotal temperature • Drug use-ETOH,marijuana,cocaine, smoking

  16. Male Components • Mumps during teen years or adulthood • Developmental factors

  17. Common Diagnostic Studies with Infertility • Female- • Basal Body Temperature(BBT) • Serum Hormone Testing • Postcoital Exam • Endometrial biopsy • Hysterosalpingogram • Laparoscopy

  18. BBT • Temperature taken prior to arising from bed each morning • sudden dip in temperature prior to ovulation followed by a rise of 0.5 -1.0degrees F which indicates ovulation. • Fertility awareness includes BBT and cervical mucus changes to detect ovulation

  19. Serum Hormone Testing • FSH • LH

  20. Postcoital Exam • Couples are instructed to have intercourse 8-12 hours prior to the exam-1-2 days before ovulation • 10ml syringe with catheter attached is used to collect a specimen of the secretions from the vagina • the secretion is examined for s/s of infection,number of active or nonmotile sperm,sperm-mucus interaction

  21. Cont • Consistency of cervical mucus.

  22. Endometrial Biopsy • Obtaining an endometrial tissue sample • lithotomy position or feet in stirrups • paracervical block • catheter into uterine to obtain sample • to check the luteal phase

  23. Hysterosalingogram • To detect uterine or tubal abnormalities • Sedation or anesthesia • iodine-based radio-opaque dye is instilled through a catheter into the uterus and tubes to outline these structures and x-ray is taken • procedure should not be scheduled during menses or at time of ovulation

  24. Laparoscopy • Under general or epidural anesthesia • used to visualize the structures in the pelvis or to do surgical procedures

  25. Male diagnostic studies for infertility • Sperm analysis-client ejaculates into container • no ejaculation for several days prior to test • specimen must be tested within 1/2-1 hr after ejaculation. • Serum hormone testing • Structural defects

  26. Psychological Factors associated with infertility • Many couples will experience • Shame • Guilt • Blame • Stages of Grief • Marital difficulties

  27. The nurse should • Address the psychological factors • discuss the couples feelings • facilitate communication between the couple • provide information to the couple on resources for coping and support groups and or professional counseling

  28. Educational needs of the infertile couple • The educational needs of the couple with infertility problems is extensive. • They will need to know about test/exams- preparation for the test, what it is, how it is done,meaning of the results of the assessment or tests. • They will need to know about tx- surgeries, medications, and maybe assigned reproductive technologies.

  29. Hormonal therapy • Used for induction of ovulation • for therapy • for preparation for in vitro fertilization

  30. Medications • Used to achieve induction of ovulation in cases of anovulatory menstrual cycles • or to achieve multiple ova prior to in vitro fertilization • Clomiphene citrate( Clomid,Serophene) • Pergonal • Humegon • Repronex

  31. Medications • Fertinex • HCG • Risks of ovulation induction- multiple births, ovarian hyperstimulation -enlarged ovaries,abdominal distention,pain,and occasionally ovarian cysts

  32. Sperm washing • For intrauterine insemination

  33. Artificial insemination • Sperm collected within after ejaculation is inserted via a catheter into the uterus/vagina • Donor sperm- identity of donor is confidential if sperm bank is used or the couple may know the donor

  34. In vitro fertilization (IVF) • Multiple ova are harvested • ova are then mixed with sperm in petri dish • up to 4 embryos are placed in uterus • extra embryos can be frozen for implantation at a later time. • Hormone are used- FSH, progesterone

  35. Other procedures • Gamete intrafallopian tranfser (GIFT) • Tubal embryo tranfser(TET) • Zygote intrafallopian transfer(ZIFT) • Micro-epididymal sperm aspiration(MESA) • Percutaneous epididymal sperm aspiration (PESA)

  36. Nurse’s Role with infertility • Education • Support • Resource • Advocate

  37. QUESTIONS

  38. Thank You • http://www.youtube.com/watch?v=STnoSnWOLwA

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