Infertility in the community Flashcards
(20 cards)
Requirements for Conception
• Production of _________ and _________
• _________ tubes that allow _________ to _________ the ________
• The sperms ability to _________ and _________ the egg
• _________ of the _________ into the uterus
• Finally a healthy pregnancy
healthy egg ; sperm
Unblocked tubes ; sperm ; reach
the egg
penetrate ; fertilize
Implantation ;embryo
Infertility applies to couples who fail to achieve __________ after _______ of _________ without any ________.
a pregnancy
1 year; regular coitus
contraception
Primary infertility
– a couple that _____________________
• Secondary infertility
– infertility that occurs after ___________
regardless of _________
has never conceived
previous pregnancy
outcome
Fertility and duration of marriage for
couples without contraception
• _______% of pregnancies occur within 1 month
• >______% of pregnancies occur within 6 months
• ______% of pregnancies occur within 9 months
• _____% of pregnancies occur within 12 months
• _____% of pregnancies occur within 18 months
25%
60%
75%
80%
90%
Causes of infertility
• Only _____% of couples will suffer from infertility due to anatomical, genetic, endocrinological and immunological
causes.
5%
Causes of infertility
95%
All remainder are largely because of preventable conditions that include:
• _________________due to STIs, non STIs & parasitic diseases.
• Health care practices — _______ practices
• Exposure to ________ in the diet and in the environment
• Cultural and social factors like _____ at marriage, ______________ , _______ marriage
• Use of alcohol, tobacco & caffeine etc
• No cause found in ______% of infertile couples
Genital tract infections
Unhygienic ; toxins
age ;female genital mutilation
consanguineous
5-15%
Factors affecting infertility
• AGE OF WOMAN: After _________ there is slight decline in fertility and some women may take longer to conceive.
• AGE OF MAN: Although age does not affect sperm capabilities but it does affect the __________ and ___________ thus (directly or indirectly?) affecting the reproductive performances.
late 30’s
sexual functions ; coital frequency
indirectly
• COITAL FREQUENCY: Frequency of coitus is _____tively related with the frequency of pregnancy.
positively
Factors affecting infertility
• TIMING OF INTERCOURSE: Sperm survives for ___________ in genital tract, where as ovum survives only for
___________ and the window time for fertilization is only ___________, so for fertilization to occur sperm should be available in genital tract shortly after
___________.
• DOUCHING: Douching of vagina soon after intercourse can ________ sperms.
48 - 72 hours
12 - 24 hours
few hours
ovulation
destroy
Factors affecting infertility
PREVIOUS OR CURRENT DRUG USE: ________ , _________ , phenothiazines, monoamine oxidase inhibitors, methyldopa, cimetidine, and toxins like
________ and ________ can interfere with ovulation, change semen quality and reduce sperm count.
– Some drugs, alcohol, tobacco and exposure to radiation can cause pregnancy __________ . Drugs like _________, __________ may affect ejaculation.
narcotics ; anticancer
arsenic ; lead
pregnancy wastage
guanethidine ; methyldopa
Menstruation
• Ovulation occurs ______ times per year
• Menstrual cycles on average are ______ with ovulation around day _____
13-14
28 days
14
Menstruation
• Luteal phase
– dominated by the secretion of _________ released by the ___________
• Progesterone causes
–________ of the endocervical mucus
– _____eases the basal body temperature (_____° F)
• __________ of the corpus luteum causes a fall in progesterone and the onset of menses
progesterone
corpus luteum
Thickening; Incr; 0.6
Involution
A history of regular menstruation suggests regular _________
ovulation
The majority of ovulatory women experience
– _______ of the ________
– ________eased vaginal ________
– ________ ________
-mild ___________
-slight weight _____
-_______ changes
– fullness of the breasts
– decreased vaginal secretions
– abdominal bloating
peripheral edema
gain; mood
Absence of PMS symptoms may suggest ???
anovulation
______________ is an inexpensive and
accurate way to diagnose ovulation
Basal body temperature
Prevention of infertility
• Up to date knowledge of treatment of all ________ and ________
• ________ choice influences the risk of PID and infertility
• Education on ________ and ________ of STI especially in young people
• Education of the community to ensure that all individuals have access to treatment of STIs
• Encouragement of ________ or ________ use for sexually active young people. Avoid ________ in these cases of youth.
STI ; PID
Contraception ;treatment ; control
abstinence ; condom
IUD
Important facts to protect fertility
• Avoid having _________ sexual partners
• Avoid _________ leading to unwanted pregnancy and abortion
• Avoid _________ treated sexually transmitted infections
• Avoid _________ in adolescents and youth
• Correct _________ of male infants
multiple ; pre marital sex
poorly ; intra uterine device
undescended testes
Important facts to protect fertility
• Vaccinate children with _______ , _______ and _______ vaccine
• Avoid unhealthy habits (_______ and _______)
• Prepare pregnancy by improving pregnancy knowledge and regular prenatal checks
• Be aware that female fertility declines sharply after _______ years of age
mumps, measles and rubella
smoking ; drugs
35
Management of infertility at PHC level
• History taking of couple and confirming that the attending couple fits in the criteria of infertility
• Physical examination of clients
• ? First line investigations
• Counseling on fertile period
• Referral to higher level of management
Dorrrr
