INFERTILITY (Surgery, MPP-pdf).Ghana Baptist University

INFERTILITY

1. GROUP 2 PRESENTING ON
INFERTILITY
LECTURER: MADAM RACHEAL NYARKOH

GHANA BAPTIST UNIVERSITY COLLEGE,
ABUAKWA CAMPUS
SCHOOL OF HEALTH AND ALLIED SCIENCES
DEPARTMENT OF NURSING
NURSING MANAGEMENT OF SURGICAL
CONDITION I
NURSING 237

2. OUTLINE
Definition of infertility

Types of infertility

Causes of infertility in male and female

Diagnostic procedure of infertility in male and female

Treatment of infertility

Recent advancement in infertility management

Ethical and legal aspects of Assisted Reproductive
Technology (ART)

Adoption as an alternative method for infertility
treatment

Role of Nurse in infertility

3. INFERTILITY

4. INFERTILITY

5. DEFINITION
Infertility is defined as a failure to
conceive within one or more years
of regular unprotected coitus.

6. TYPES OF INFERTILITY

Primary infertility

Secondary infertility

7. Primaryinfertility:
Primaryinfertilityisatermusedtodescribea
couplethathasneverbeenabletoconceivea
pregnancyafteraminimumof1yearof
attemptingtodosothroughunprotected
intercourse.

8. Secondary infertility:
Secondary infertility is the inability to
become pregnant or to carry a baby to
term after previously giving birth to a
baby.

9. CAUSES OF INFERTILITY

10. MALE INFERTILITY FACTORS

Defective spermatogenesis

Obstruction of the efferent duct system

Failure to deposit sperm high in vagina

Errors in seminal fluids.

11. FEMALE INFERTILITY FACTORS

Ovarian factors

Tubal factors

Uterine factors

Cervical factors

Vaginal factors

12. OTHER FACTORS

Generalfactors : age

Lack of knowledge of coital technique

Immunological factors Congenital

Thermal factor

Infection

General factors

Endocrine

Genetic

Latrogenic

Immunological factors

13. DIAGNOSTIC PROCEDURE

14. PROCEDURES FOR MALE

General physical examination and medical
history

Semen analysis

Scrotal ultrasound

Hormone testing

Post-ejaculation urinalysis

Genetic tests

Testicular biopsy

Specialized sperm function tests

Transrectalultrasound

15. DIAGNOSTIC PROCEDURE FOR FEMALES

ENDOCRINE SYSTEM TESTS

TESTS FOR PELVIC DISORDERS

TESTS RELATED TO THE CERVIX

16. ENDOCRINE SYSTEM TESTS

1) Basal Body Temperature Charting (BBT)
2) Endometrial Biopsy
3) Testing for Luteinizing Hormone
4) Ultrasonography
5) Testing the Health of the Ovaries
6) Laparoscopy
7) Other Female Endocrinology Tests

17. TESTS FOR PELVIC DISORDERS

Ultrasonographyand sonohysterography

Hysterosalphingogram

Hysteroscopy

Magnetic resonance imaging (MRI)

laproscopy

18. TESTS RELATED TO THE CERVIX
1) History of Sexual Intercourse
2) Tests for Sexually Transmitted Disease
3) Post-Coital Test
4) AntispermAntibody Tests

20. RESTORE FERTILITY THROUGH

Medication

Surgery

21. Medication

Clomiphenecitrate

Gonadotropins

Metformin.Metformin

Letrozole.Letrozole

Bromocriptine.Bromocriptine

22. Fertility restoration: Surgery

Laparoscopic or hysteroscopicsurgery

Tubal surgeries

23. RECENT ADVANCEMENT IN
INFERTILTY MANAGEMENT

24. Types Of ART Procedure In
Practice:

IUI : Intra uterine insemination

IVF –ET: In vitro fertilization & embryo transfer

GIFT : Gamete intra –fallopian transfer

ZIFT : Zygote intra –fallopian transfer

POST : Peritoneal oocyte& sperm transfer

SUZI: Sub zonal insemination Micro Assisted Fertilization
(MAF)

ICSI: Intra –cytoplasmicsperm injection/insemination
Methods of sperm recovery :

TESE : Testicular sperm extraction

MESA: Micro surgical epididymalsperm aspiration

PESA: Percutaneousepididymalsperm aspiration

25. Intrauterine Insemination (IUI):
is a fertility treatment that involves placing
sperminside a woman’s uterus to facilitate
fertilization. The goal of IUI is to increasethe number
of sperm that reach the fallopian tubes and
subsequentlyincrease the chance of fertilization. IUI
provides the sperm an advantage by giving it a head
start but still requires a sperm to reach and fertilize the
egg on its own

26. In Vitro Fertilization and Embryo
Transfer (IVF-ET)

27. GIFT(Gamete Intra –Fallopian
Transfer)

28. ZIFT( Zygote intra –fallopian
transfer)

29. POST: Peritoneal oocyte&
sperm transfer

In this method, sperm and eggs are directly
placed into the peritoneal cavity near the
fallopian tubes, under ultrasound guidance,
immediately after transvaginalultrasound
guided egg collection has been performed.

30. ICSI: Intra –cytoplasmicsperm
injection/insemination

31. Methods of sperm recovery :

Testicular Sperm Extraction (TESE)
TESE is often used to diagnose the cause of
azoospermia. It can also get enough tissue for sperm
extraction. The sperm can be used fresh or frozen
(“cryopreserved”). TESE is often done in the urologist's
office with a nerve block. A nerve block is an
anestheticinjected into nerves to treat pain. The nerve
block will "turn off" a pain signal from a specific
location; in this case, from the testis. Or, TESE can be
done under anesthesiain a surgical center. It involves
one or several small cuts in the testes.

32. Testicular Sperm Aspiration (TESA)
TESA is also sometimes called Testicular Fine
Needle Aspiration (TFNA). TESA can be used
to diagnose or treat azoospermia. It can also
be used to collect sperm from the testicles.
It's often done with a nerve block. A thin
needle punctures the skin and testis to
gently pull out sperm. No other cuts are
needed.

33. Microsurgical EpididymalSperm
Aspiration (MESA)
MESA uses a surgical microscope to
help retrieve sperm from the
epididymistubes. MESA can retrieve
lots of healthy sperm that can be
saved and frozen for later.

34. PercutaneousEpididymalSperm Aspiration
(PESA)
PESA, like TESA, can be done many times at low
cost and without a surgical cut and is especially
suited for obstructive azoospermia. a needle
attached to a syringe into the epididymisto
gently remove fluid. Sperm may not always come
out this way. Sometimes a surgical process is
needed

35. ETHICAL AND LEGAL ASPECTS
OF ASSISTED REPRODUCTIVE
TECHNOLOGY (ART)

36. Artificial Insemination
surrogate Motherhood
In-vitro Fertilization

37. Artificial Insemination
accept the impregnation of one's wife by the
sperm of a third person as it doesn't make the
child one's own and is looked down upon as
illegitimate even in man made laws. The donation
is, however, always made anonymously so that
the father could not be traced by the child, nor
can the father elect to make contact with the
child, potentially disrupting a harmonious family.

38. surrogate Motherhood
Surrogacy throws up another problem of post
partum blues if the mother and the baby bonds.
Ethically also subrogation raises many issues like
tempering with the normal process of
procreation, undermining the institution of
marriage and family life, treating children as
objects of sale etc.

39. In-vitro Fertilization
Donation of sperms and ova, and the use of
surrogate motherhood to bear the child are both
contrary to the unity of marriage and the dignity
of procreation of human being. Furthermore
these procedures lend themselves to
commercialization and exploitation when people
are being paid for sperm, ova and for surrogate
motherhood The in-vitro fertilization is acceptable
within limits.

40. ADOPTION AS AN ALTERNATIVE
METHOD FOR INFERLITY
TREATMENT

41. Adoption is the infertile couples consider
one of the alternative methods for resolving
their infertility
ADOPTION PROCEDURE

42. TYPES OF ADOPTION IN GHANA BY LAW
1)In-Country Adoption
2) Intercountry Adoption

43. In-CountryAdoption
Is the process by which a person may be adopted in Ghana by
a person who is ordinarily resident in Ghana.

44. REQUIREMENT FOR IN-COUNTRY ADOPTION PARENT

The adoptive parent must be between the ages of 25 years
and 55 years, or at least 21 years older than the child at the
time of placement.

The adoptive parent habitually resident in Ghana.

A registered medical practitioner from an authorized
health institution must declare the adoptive parent
medically fit.

They must not have any criminal background.

They must have a sustainable source of income or means of
livelihood.

They must pledge to uphold and support the basic right of
the child as provided under the Children’s Act.

45. 
Intercountry Adoption
This occurs when a person residing in a different country seeks
to adopt a child from Ghana and bring them to their country of
residence.

46. REQUIREMENT FOR INTERCOUNTRY ADOPTION PARENT

The adoptive parent must be between the ages of 25 years and 50
years, or at least 21 years older than the child being adopted.

A registered medical practitioner from an authorized health
institution must declare the adoptive parent medically fit.

The prospective adoptive parent should possess high moral
character and demonstrate proven integrity.

The prospective adoptive parent must be eligible to adopt
according to the laws of their own country.

The prospective adoptive parent should demonstrate the
capacity to provide care and support the child.

The prospective adoptive parent must subscribe to the basic
rights of the child as outlined in the relevant Act.

The prospective adoptive parent should be a resident of a
country that is a party to the 1993 Hague Convention or has a
bilateral agreement with Ghana.

47. Adoption laws in Ghana

The Children’s Act 1998 (Act 560), as amended by
the Children’s (Amendment) Act 2016 (Act 937).

The Adoption Regulations 2018 (L.I.C.I.42, 2360)

The Adoption Rules, 2003 (C.I. 42)

The High Court (Civil Procedure) Rules, 2004 (C.I.
47)

48. ROLE OF NURSE IN INFERTILITY

Receiving the patient and family, and make them
accessible and comfortable for counseling

Fertility nurse specialist provide care for the
individuals and couples before, during, and after
fertility treatment

Nurses need to obtain history as a prenatal,andother
relevant information regarding patients of reports

Give physiological support throughout the counseling.

Collect other information about tests reports and
documents.

49. Conti..

Establish plan of care with family and coordinate care
with other health care professionals.

Maintain privacy and confidentiality of all cases.

Performing inseminations

Ensure follow-upatsupportive services to individual
and family during counseling

50. Conclusion
Although infertility in common in
both male and female, the latest
treatment methods and techniques
have proven to be effective
treatment method

51. THANK YOU

52. GROUP MEMBERS

SAKINATU NUHU ADAMS = NUR-24-098.

DELPHINE SANU = NUR-24-146

FATIMA ISSAH = NUR-24-097

GLORIA ATTA OWUSUA = NUR-24-233

ASAMOAH BRIDGET = NUR-24-144

ACHIAA ESTHER = NUR-24-036

EKYIA LINDA = NUR-24-236

PATRICIA APPIAH = NUR-24-216

MARY FOSUAA BADU = NUR-24-138

DOROTHY ASANTE = NUR-24-234

JOSEPHINE ODURO KYEI = NUR-24-235

HASSANA MUSTAPHA = NUR-24-263

JOSEPHINE ABEREMA ESSIEN = NUR-24-226

HANNAH COBBINAH = NUR-24-232

ANNING MARY = NUR-24-249

ASARE FLORENCE = NUR-24-240

PAULINA OSEI ACHEAMPOMAA = NUR-24-205

OPPONG SEKYERE CONSTANCE = NUR-24-037

ROSE KUMA = NUR-24-132

AUGUSTINE OFORI MANU = NUR-24-173

THEODORA PADIKI NARH = NUR-24-068