Nursing Assessment For Infertility

Infertility is seen as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (2009). Infertility can be caused at birth or it can be developed over time due to various factors. It is commonly seen as a female’s issue or the female’s fault. However, according to the American Society for Reproductive Medicine (2015), in 40% of couples with infertility, the female partner is either the sole or a contributing cause of infertility; in 40%, the male partner is either the sole or a contributing cause of infertility; and in the remaining 20% there are no identifiable reasons, which is labeled as unexplained infertility. There are copious factors

that can play into the cause of infertility. Females who suffer with this condition typically have problems ovulating, while the males have trouble producing sperm. For both males and females, genetics, environmental factors, and lifestyle choices can have a part in causing these issues.
Nursing Assessment for Infertility
During the nursing assessment, it is vital to obtain information to help pinpoint the issues that could be causing infertility.

The patients current medical status, signs and symptoms, past medical problems, and family history should all be assessed by the nurse. When this information is given, medical professionals have a better idea of what the patient is likely experiencing and what the care plan should be.

Female Infertility

Important information to take note of when caring for the female patient includes the following: the patient is 35 years or older, experiences irregular menstruation or none at all, has had previous miscarriages, has painful menstruations or has been diagnosed with endometriosis.

Genetics. Women can be born with a genetic problem that causes infertility without it being known until reproduction is attempted. However, if other women within a family have experienced the same issues like endometriosis or premature menopause, the patient is at an increased risk for similar problems.

Disrupted ovarian function. A disruption can lead to an absence of ovulation, also known as anovulation. These disruptions can be caused by numerous

conditions.
Polycystic ovarian syndrome.

According to Bergh, women with PCOS experience absent or infrequent menses, infertility, pain, acne, and excess hair growth, and ultrasound images show enlarged multicystic ovaries (Bergh). Lab findings typically show an increase of testosterone, which causes the acne and increased hair growth, and insulin resistance. Insulin resistance causes an abnormal response in the ovary that results in an increase in the amount of circulating androgens that lead to hyperandrogenism (fritz and speroff). PCOS is now known as the leading cause of infertility in women. Unfortunately, there is no cure for this syndrome, but changes in lifestyle and prescribing medications help alleviate the symptoms.

Decreased egg count. With a normal functioning ovary and reproductive system, eggs will diminish at an expected rate over time. However, eggs can be depleted at a rate that is much greater than what is expected. As the CDC explains (2017), natural reproduction is still possible with this condition but fewer eggs are available to use.

Amenorrhea. Amenorrhea is also known as the absence of a menses. Abnormal weight, stress, excessive exercising, and eating disorders are the common causes for this condition. Amenorrhea in these cases can be reversed with lifestyle changes that help promote

fertility.
Tubal blockage. The fallopian tubes are where fertilization takes place, and it’s what helps transport the egg to the fallopian tube. The tube can become blocked for various reasons preventing fertilization. According to Stevenson, the biggest contributor to tubal blockage is pelvic inflammatory disease, which is a serious complication of sexually transmitted infections (STIs) such as chlamydia and gonorrhea.
Male Infertility
Male fertility can be a complex process. To achieve pregnancy, sperm must be in good quality and healthy; there has to be enough sperm within the semen to actually reach the egg; the sperm has to be mobile enough to reach the end destination.