Infertility, Contraception, and Abortion
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
Infertility
Incidence
Affects about 10% to 15% of reproductive-age couples Four goals when providing care:
•
•
•
•
Provide the couple with accurate information
Assist in identifying the cause of infertility
Provide emotional support
Guide and educate about forms of treatment
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
2
Factors Associated with Infertility
Assessment of female infertility
Ovarian factors
Tubal and peritoneal factors
Uterine factors
Vaginal-cervical factors
Other factors
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
3
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
4
Factors Associated with Infertility
(Cont.)
Assessment of male infertility
Hormonal factors
Testicular factors
Factors associated with sperm transport
Idiopathic male infertility
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
5
Care Management
Assessment of female infertility
Test or examination
•
•
•
•
•
•
•
Evaluation of the anatomy
Detection of ovulation
Hormone analysis
Ultrasonography
Endometrial biopsy
Hysterosalpingography
Laparoscopy
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
6
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
7
Care Management (Cont.)
Assessment of male infertility
Semen analysis
Hormone analysis
Scrotal ultrasound
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
8
Care Management (Cont.)
Plan of care and implementation
Psychosocial considerations
Nonmedical treatments
• Herbal alternative methods
Medical therapy
Surgical therapies
• Assisted reproductive therapies (ART)
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
9
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
10
Care Management (Cont.)
Assisted reproductive therapies
In vitro fertilization–embryo transfer (IVF-ET)
Gamete intrafallopian transfer (GIFT)
Zygote intrafallopian transfer (ZIFT)
Ovum transfer (oocyte donation)
Therapeutic donor insemination (TDI)
Embryo hosting
Assisted embryo hatching
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
11
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
12
Care Management (Cont.)
Reproductive alternatives
Surrogacy
Preimplantation genetic diagnosis
Adoption
Cryopreservation of human embryos
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
13
All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
14
Contraception
Intentional prevention of pregnancy
Birth control is the device or practice to decrease the risk of conceiving
Family planning is the conscious decision on when to conceive or avoid pregnancy
May still be at risk for pregnancy
Nearly half of all U.S. pregnancies are unplanned All Elsevier items and derived items © 2014, 2010, 2006, 2002, Mosby, Inc., an imprint of Elsevier Inc.
15
Care Management
A multidisciplinary approach to assist the woman in choosing an appropriate contraceptive method Ideally the method should be safe, readily available, economical, acceptable, and simple to use Contraceptive choice must meet personal, social, cultural, and interpersonal needs
All Elsevier