Infertility

Question 1

What is Infertility

Answer 1

Inability to conceive 1 year after unprotected intercourse under 35 years of age or 6 months for over 35 years of age.

Question 2

What is the difference between primary and secondary infertility

Answer 2

Primary is defined to a patient that has never conceived and secondary for a patient who has conceived previously but is having trouble at the current time.

Question 3

How long can sperm last in a woman’s reproductive tract?

Answer 3

Sperm can remain viable for 3 to 5 days in a woman’s reproductive tract.

Question 4

When can a oocyte (egg) be fertilized?

Answer 4

Within 12-24 hours

Question 5

How should a nurse educate a couple seeking pregnancy?

Answer 5

The couple seeking pregnancy should be taught about the menstrual cycle and ways to detect ovulation. They should be counseled to have intercourse 2 to 3 times a week; or, times intercourse does not increase anxiety, they should be encouraged to engage in intercourse the day before and the day of ovulation. Fertility decreases markedly 24 hours after ovulation

Question 6

What is considered a normal sperm count for males? pH? What direction should sperm move in?

Answer 6

35 - 200 million; 7.2 (Basic); Sperm should have foward motility

Question 7

What is a primary sign/s(x) of retrograde ejaculation?

Answer 7

Cloudy urine

Question 8

How do you assess male ferility

Answer 8

Minimum of 2 analysis must be performed serveral weeks appart.

Question 9

What are sign and symptoms of uterine malformation or mullerian defects?

Answer 9

Ammenorrhea, irecurrent pregnancy pain, loss of normal functions.

Question 10

What infertility medication is used to directly stimulate ovarian follicle development? What is given in conjunction with this drug?

Answer 10

Menotropin (Injectable FSH/LH); Injected IM/SubQ; One injection of HcG is given to stimulate ovulation.

Question 11

What is HcG? How does it work?

Answer 11

HcG ascts on mature follicules to induce ovulation. Releases an egg. Given off in blood stream and urine after implantation.

Question 12

What is Clomiphene Citrate? What is often paired with Clomiphene to help fertility?

Answer 12

A medication that help a female to make more eggs/ eggs of better quality. Clomiphene promotes release of FSH/LH in pituitary NOT direct stimulation of ovaries. Metformin is often paired with Clomiphene to help with insulin resistance and HcG to release the egg.

Question 13

What are the advantages to Clomiphene? When do you take Clomiphene?

Answer 13

Clomiphene is Cheap. 1st line drug. Must take within the first 14 days of ovulatory cycle.

Question 14

What are the disadvantages of Clomiphene?

Answer 14

MUST be monitored with ultrasound, can develop an abundance of follicules. S/E: include vasomotor flushes, adb discomfort, N/V, breast tenderness, ovarian enlargement.

Question 15

What are the disadvantages and S/E of Menotropins?

Answer 15

Ovarian enlargement, Ovarian hyperstimulation, Local irritation @ injection site, multifetal gestation.

Question 16

How do GnRH agonist work and what are the S/E?

Answer 16

Suppresses LH and FSH function; it basically stops everything
S/E: nosebleeds, hot flashes, vaginal dryness, myalgia and arthralgia, headaches, mild bone loss

Question 17

How do progesterone shots effect pregnancy and what should you educate a patient about progesterone shots?

Answer 17

Progesterone shots are given to stimulate uterine lining and sustain pregnancy through the 1st trimester. Nurse must educate patient to soak injection fluid in warm water before administering injection. S/E include breast tenderness, H/A, local irritation of injection site.

Question 18

When is a post-coital test evaluated and what is being evaluated?

Answer 18

It is evaluated 6 - 12 hours after intercourse and a swab is taken and evaluates the cervical mucus and sperm functioning.

Question 19

What is a typical appearance of a person that has Turner’s syndrome? (45 X)

Answer 19

Short, broad, streak ovaries, amenorrhea (Spontaneous abortion elevates to a 95% chance of occuring)

Question 20

What is a typical appearance of a person that has Klinefelter’s Syndrome (47 XXY)

Answer 20

Commonly genectically male, tall, may have breasts and male genetalia.

Question 21

What is the difference between primatuy annovulation and secondary annovulation?

Answer 21

Primary is a defect in relation to the pituitary/hypothalamus and secondary is a defect in relation to anywhere else (PCOS, Anorexia, thyroid problems, etc.)

Question 22

What kind of health promotion/primary education can be taught to a patient regarding preconception care?

Answer 22

Nutrition: Healthy diet, folic acid, optimal weight
Exercise & Rest
Avoidance of substance abuse
Attending to family and social needs.

Question 23

When an assessment/education is being done on a patient in regards to preconception care, what are some risk factors to identify?

Answer 23

Chronic diseases (DM, HTN, Heart disease, asthma), HIV/AIDS, STIs, Vaccine records, Reproductive H(x), Unplanned pregancies and outcomes, Environmental conditions, Readiness for pregnancy, availiability of family or support system.

Question 24

What are interventions that sould be done/anticipated/taught for preconceptual care?

Answer 24

1. ) Cessation or reducation in substance abuse
2. ) Immunizations (Rubella, hepatitis)
3. ) Exercise
4. ) Genetic counceling, family planning services

Question 25

What are the major goals of prenatal care?

Answer 25

1. ) Define health status of mother & fetus
2. ) Determine gest. age of fetus and monitor fetal development
3. ) ID women @ risk for complications & minimize risk ASAP
4. ) Provide appropriate education & counseling
5. ) STIs can predispose to decrease fertility and are becoming more common.