6. 6
Infertility Preliminary
Investigation
• Information about most fertile times for
intercourse
• Explanation of basic infertility workup
• Basic assessments
– Ovarian function
– Cervical mucus adequacy
– Semen analysis
– Tubal patency
– General condition of pelvic organs
9. 9
• If lack of ovarian function is suspected
– Basal body temperature recording
– Hormonal assessments (FSH, LH, progesterone)
– Endometrial biopsy
– Transvaginal ultrasound
• If cervical problems are suspected
– Ferning capacity of cervical mucus
– Spinnbarkeit – increase in mucus elasticity & viscosity
– Presence of antisperm antibodies
Indications for Tests and
Treatments for Infertility
10. 10
Indications for Tests and
Treatments for Infertility
• If tubal or uterine problems are suspected
– Hysterosalpingography
– Hysteroscopy
– Laparoscopy
• If male’s fertility is suspected
– Semen analysis
– Screening for antisperm antibodies
14. 14
Treatments for Infertility
• Indications for in vitro fertilization (IVF)
– Infertility from tubal factors
– Mucus abnormalities
– Male infertility
– Male & female immunologic infertility
– Cervical factors
15. 15
Infertility Psychological Reactions
• Development of lack of spontaneity of
sexual intercourse
– Constant attention to temperature charts
– Instructions about their sex life from an
outsider
• Feelings of loss of control
• Feelings of reduced competency
• Loss of status and ambiguity as a couple -
infertility often becomes central focus for
role identity
16. 16
Infertility Psychological Reactions
• Sense of social stigma
– Feelings of guilt or shame
• Stress on marital and sexual relationship
– Heighten feelings of frustration or anger
between partners
• Strained relationship with healthcare
providers
17. 17
Nurse’s Roles in Infertility
• Counselor
– Supports the couple as they make decisions
– Provide comfort, sympathetic ear
– Helps the couple to recognize feelings
– Facilitates the free expressions of feelings
– Facilitates partner communication
– Nonjudgmental approach
– Establish rapport - elicit relevant information
from couples
18. 18
Nurse’s Roles in Fertility
• Advocate
– Helps the couple identify alternatives
– Helps the couple to understand motives
– Provides resources
– Gives infertile couples a sense of control
• Educator
– Provides accurate information
– Gives extensive and repeated explanations
– Ensures couples have written instructions
– Helps them to understand the process
19. 19
NCLEX Question
A client calls the fertility clinic to schedule a
hysterosalpingogram. Which does the nurse instruct
the patient to do?
a)Schedule the procedure on the 10th day of her
ovarian cycle.
b)Avoid prostaglandin synthesis inhibitors 48 hours
before the procedure.
c)Remain NPO for 8 hours prior to the procedure.
d)Schedule the procedure 4 days after ovulation.