Infertility in male and female.pptx for Nursing students

Infertility is a condition referred to unavailability to conceive after continue one year of regular coitus without using any kind of contraceptive and family planning methodology.

1. Infertility Presented By- Ankit Kumar Arya BSc Nursing 2 nd Year Bhaarath College of Nursing, Chennai-73

2. INTRODUCTION Infertility is the inability to conceive after at least 1 year of regular unprotected intercourse. Around 12-18 % of women are not pregnant after 12 months of trying to conceive. Approximately 15-201. of indian couples are infertile .

3. Definition “Infertility is the inability of sexually active, non- contracepting couple to active spontaneous pregnancy in one year" By-world health organization (WHO) Male Infertility Male Infertility refers inability to cause pregnancy in fertile female

4. ETIOLOGY Sperm Production problem:- Oligospermia (Very low numbers) Azospermia (No sperms) Chromosomal or Genetic Causes. Undescended Testes (failure of the testes to descend at birth) Infection Torsion(Twisting of testes in scrotum) Varicocele (Varicose veins in the testes) Medicines and chemicals. Radiation damage

5. 2. Blockage of Sperm Transport (Obstruction):- Infections Prostate related Problems Absence of vas deference Vasectomy

6. 3. Sexual Problems (erection problem):- Retrograde / Premature ejaculation
Failure of ejaculation
Erection dysfunction
Infrequent intercourse
Spinal cord injury
Prostate Surgery
Damage of Nerves
Certain medications

7. 4. Hormonal Problem:- Pituitaty tumors Congenital lack of LH/ FSH(pituitary problem from birth) Anabolic (Androgenic) steroid Abuse 5. Immunologic Sperm Antibodies 6. Others Vasectomy •injury or infection in the epididymis •Unknown Causes Medication:- •Certain medication can change sperm Production, function and delivery.These medication are most often given to treat health problems . Like- •Arthritis •Depression •Infections •Digestive Problem •High Blood Pressure •Cancer

8. PATHOPHYSIOLOGY

9. DIAGNOSTIC STUDIES History Collection Physical examination Semen Analysis Ultrasonography (Trans rectal Ultra- sound Trus ) Hormonal testing (FSH and L H) Genetic biopsy Urine Analysis

10. MANAGEMENT MEDICAL MANAGEMENT:- •Antibiotics •Gonadotropins •Anti Oxidants •Life Style Modifications TREATMENT MODALITIES:- • Treat the underlying causes •Rectal Probe:-For Treating Test and Seminal Vesicles. •Penile Vibratory Stimulation (PVS):- it’s a technique used to assist individual with erectile dysfunction or to induce ejaculation individual with ejaculatory dsyfunction .

11. SURGICAL TREATMENT MODULATION:- • Varicocele Treatments •Microsurgical Vasostomy •End to end anastamosis of epididymis • Vadoepididymostomy •ASSITED REPRODUCTIVE TECHNIQUES •Intrauterine insemination (IUI) • Invitro fertilization(IVF) • Invitro Cytoplasmic sperm injection (ICSI)

12. Med-SURG MANAGEMENT MED:- •Testicular ultrasound, serum acid or alkaline phosphate test. SURG:- • Biopsy contraindicated Removal of testis (orchiectomy) spermatic cord and inguinal contents With exam of nodes.

Teaching plan for TSE (Testicular self examination)

13. NURSING MANAGEMENT:- Encourage all males over 15 years of oge to perform PSE
Post OP
Monitor Vital signs and incisional drainage
Maintain stric asepsis when
changing dressings Encourage male clients older than age 15 to perform testicular & self-examination monthly. Provide opportunities For client to voice fear & Concerns. Provide opportunities for client to voice fear & Cancers.

14. Female infertility DEFINITION:- · Infertility refers to an inability. to conceive after having regular uprotected ser Infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. TYPES:- There are two kinds of infertility- Primary and secondary.
Primary infertility –Those who have never conceived. Secondary infertility: means that the couple has experienced a pregnancy before and failed to conceive later...
Globally, most infertile couples suffer from primary infertility.

15. CAUSE female infertility can be caused by a number of factors: 1. Damage to fallopian tubes:- Damage to the fallopian tubes (carry the eggs. From the ovaries to the uterus) can prevent contact between the egg and sperm. Pelvic Inflammatory disease (PID) Caused by various infections, endometriosis, pelvic surgery may lead to damage to fallopian tubes sexually transmitted infections (STIS) are the common cause of PIDs 2. Disturb ovarian function/hormonal Causes:- Synchronized hormonal changes occur during the menstrual cycle leading to the release of an egg from the ovary (ovulation) and the thickening of the endometrium (inner lining of the uterus) in preparation for the fertilized egg (embryo) to implant inside the uterus. difficulty in ovulation is seen in Following conditions.

16. Polycystic ovary syndrome (PCOS) polycystic Ovary syndrome is the common cause of female infertility. PCOS interferes with normal ovulation.
Functional hypothalamic amenorrhea:-Excessive physical (common in athletes) or emotional stress may result in amenorrhoea (absence of periods).
Diminished Ovarian reserve or premature Ovarian again:- women with diminished ovarian reserve may experience difficulty in conceiving, (though blood test will show elevated follicular stimulating hormones). Premature ovarian insufficiency :-
Female ovaries stop working before she is 40 years of age. The cause can be natural or it can be disease, surgery, chemotherapy or radiation.

17. 3.Uterine Causes:- Abnormal anatomy the presence of of the uterus; polyps and fibroids may lead to infertility. 4. Cervical Causes :- A small group of women may have a cervical condition in which the sperm cannot pass through the cervical canal due to abnormal mucus production or a prior cervical surgical procedure. FEMALE PARTNER:- •Detection of ovarian function – Hormonal assay (early follicular FSH and LH levels, and mid- luteal progesterone levels). Transvaginal ultrasonography is used for detection of ovulation in females and any abnormality in uterus and adnexa (adjoining anatomical parts of the uterus). •Evaluation of tubal patency :- Hysterosalpingography (HSG): It i a radiological procedure. The dye. Is injected in to the uterus through. The cervix and stultaneously X-Ray picture are taken to see one movement to dye into the abdominal cavity shows that tubes are patent.

18. Advanced investigations:- Hormonal pro assay:- Thyroid fungtion test, prolactin levels, testosterone and other test if polycystic ovary syndrome is suspected.
Laparoscopy is a surgical procedure used to visualize abdominal and pelvic organs (uterus, Fallopian tubes and ovaries).
Hysteroscopy in indicated for intrauterine space-occupying lesions detected on HSG Chromosomal karyotyping is used For suspected genetic disorders.

19. MANAGEMENT Management of infertility ranges from counseling and advice to medications and surgery. Counselling of both partners an important aspect in the management of infertility with medical and psychological support to the couple. counselling is provided for the healthy life style measures such as:- Healthy eating habits-
Adding more whole-grain products, fruits, vegetables.
Limiting Processed foods and foods with added sugar, eating, a diet low in cholesterol and saturated fats.
Promote regular exercise. No smoking (Avoid passive smoking)
Limit alcohol intake Maintain healthy weight Advice on rubella vaccination if seronegative
Treatment of Psycho-Sexual Problems

20. Specific treatment of disease that causes infertility whatever cause is detected during investigations relating to female or male partner, treatment is given accordingly.
When initial treatment don’t work, couple may decide for assisted reproduction technology. ASSISTED REPRODUCTIVE TECHNIQUES (ART) Intrauterine insemination (IUI) :- IUI is the placement of man’s sperm into a woman’s uterus using a long, narrow Tube. IUI may be used in the following Conditions:- Defects of Cervix
Low sperm count Sperm with low motility. Erection Problems in male partner Women who have scaring or defects of the cervix IUI is of Two Types:- • Artificial insemination by husband (AIH) • Donor Insemination (DI)

21. In Vitro Fertilization:- in this eggs and sperm are taken from the couple and are incubated together in a dish in a laboratory to produce an embryo. Gamete intrafallopian transfer (GIFT): In this procedure fortilization occur naturally after eggs and sperm are placed inside the fallopian tube. Zygote intrafallopian transfer (ZIFT): in ZIFT fertilized eggs are transferred to fallopian tube within 24 hr after fortilization . Intracytoplasmic sperm injection ( csi ): in this procedure single sperm is injected in to mature egg. It is used to treat sperm related infertility problems. Surrogate and gestational carriers – If a woman is unable to carry a pregnancy to term, the couple may choose a surrogate or gestational carrier.

22. Prevention:- Adopting a healthier life style through simple lifestyle changes may help to reduce the chances of infertility
Life Style Changes Include :- •weight management
•Eat balance diet
•Participating in moderate exercise •Making time for Leisure and enjoyment •Avoid illegal drugs such as marijuana or cocaine.
•Practice safe Sex •Age and fertility.

23. Nursing Diagnosis Anxiety related to the emotional distr ess and u ncertain i ty associated with infertility diagnosis and treatment. Risk for Impaired coping related to ongoing emotional stress and challenges experienced throughout the infertility journey . Deficient knowledge Related to limited understanding of specific fertility treatment options , their risks, benifits and success rates . Disturbed body image related to altered self-perception and self-esteem due to infertility Risk for impaired relations h ip Related to the strain of infertility on intimate relationships, as evidenced by decreased communication, emotional distance or sexual difficulties. Risk for Altered Parenting process related to the challenges and emotional impact of fertility treatments, adoption,or surrogancy on future parenting experiences . Risk for s ocial Isolation related to feeling for of exclusion, inadequancy or stigma associated with infertility, as evidenced by decreased social interactions, avoidance of social situations, or self-imposed isolation.

24. Summary:- Infertility is a complex condition that affecte both men and women. Heres summary Points regarding infertility. Male infertility :- Male infertility can result from issues such as low sperm count, poor sperm motility, abnormal sperm shape or blockages in the reproductive tract. Diagnosis involves semen analysis, hormone Testing, genetic testing and imaging studies. Treatment options include lifestyle changes. Medication, surgery or assisted reproductive techniques using donor sperm is necessary Female Infertility:- Female infertility can result From issues such as ovulation disorders, fallopian tube blockages, uterine abnormalities, hormonal imbalances, age-related decline in egg quality. Diagnosis involves hormonal testing, imagin studies,Laproscopy and ovarian reserve assessment. Treatment options include Lifestyle changes, medication, surgery or assisted reproductive. Techniques such as ovulation induction. IUI or IVF. Remember infertility can be Challenging and emotionally taxing experience. It is crucial to seek support. Both medical and emotional, throughout the process.

25. Bibliography Lakshmi Seshandri , Gita Arjun “ Essentials of obstetrics ” . Wolders Kluwer ( india ) Pvt. Ltd, New Delhi. Pg no- 429-431 “B runner & Suddarth's Textbook of Medical- surgical nursing ” 2 nd South Asian Edition Wolders Kluwer New Delhi, Pg no- 1477 - 1478

26. Assignment Write an assignment on Factors and incidents of Infertility in India

27. Assignment