1.
PRESENTED BY
LAMNUNNEM HAOKIP
MSC (N) 1ST YEAR
UNDER THE SUPERVISION OF
DEBIKA MA’AM

2.
DEFINITION
• Infertility is "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 (and there is no other
reason, such as breastfeeding or
postpartum amenorrhea).

3.
TYPES
PRIMARY
SECONDARY
INFERTILITY

4.
• PRIMARY INFERTILITY: It denotes those couples who
have never conceived even once.
• SECONDARY INFERTILITY: It indicates previous
pregnancy but failure to conceive subsequently.

5.
RISK FACTORS FOR INFERTILITY
• Age: A women over 35 years of age and men over 40
years of age.
• Diabetic person.
• Eating disorders, including anorexia nervosa and
bulimia.
• Excessive alcohol use.
• Exposure to environmental toxins such as leads and
pesticides.
• Over exercising.
• Radiation therapy or other cancer treatments.

6.
CAUSES OF INFERTILITY
FLIP CARDS

7.
WOMEN:
Ovulation disorders
• Premature ovarian failure (before the age of 40).
• Polycystic ovarian syndrome.
• Hyper-prolactinemia.
• Poor egg quality.

8.
Uterus and fallopian tube
• Any surgery .
• Sub-mucosal fibroids.
• Endometriosis.
• Previous sterilization treatment.
• Salpingitis

9.
Vaginal factors
• Atresia (Partial or complete).
• Septum of vagina.
• Narrow introitus.
Medications
• NSAID’s (aspirin and ibuprofen).
• Chemotherapy.
• Radiotherapy.
• Illegal drugs.

10.
MEN
Defective spermatogenesis
• Congenital: Undescended testes where the vas
deferen is absent.
• Hypospadias: Failure to deposit sperm high in vagina.
• Thermal factor: Rise in body temperature due to
varicocele, big hydrocele, tight undergarments.

11.
• Infection: Mumps orchitis after puberty.
• Loss of sperm motility( asthenozoospermia and
abnormal sperm morphology).
• Iatrogenic: Radiation, cytotoxic drugs, nitrofurantoin
etc.

12.
Obstruction of efferent ducts
• Obstructed by gonococcal or tubercular infections.
Surgical trauma during vasectomy.
Failure to deposit sperm high in vagina
• Erectile dysfunction
• Ejaculatory defects.

13.
DIAGNOSTIC
PROCEDURES OF
INFERTILITY
CHART

14.
MALE
• History and physical examination: Age, duration of
marriage, contraception used, any sexual
dysfunction.
• Semen Analysis: Helps to show the level of sperm
production and whether sperm are functioning well.
• Transrectal Ultrasound: A probe is placed in the
rectum it beams a sound waves to the nearby
ejaculatory ducts. It is use to see the structures of
ejaculatory ducts or seminal vesicles are poorly
formed or blocked.

15.
• Testicular Biopsy: If a semen shows very low number
of sperm or no sperm, testicular biopsy is needed.
• Hormonal profile: This is to check how well the
testicles make sperm and also can rule out major
health problems.

16.
WOMEN
• History and physical examination: Age, duration of
marriage, previous surgical and medical history
(Obstetrics), any contraceptives practice, any sexual
problems.
• Hysterosalpingogram(HSG): This is an x-ray procedure
to see if the fallopian tubes are open or not and to see
the uterine cavity.
• Laparoscopy and Chromopertubation: For detection of
tubal patency, block, motility, any changes in the
endometrium, PCOS.

17.
• Transvaginal Ultrasonography: An ultrasound probe
is placed in the vagina to check the uterus and
ovaries for any abnormalities such as fibroids and
ovarian cysts.
• Ovarian reserve testing: To find out whether the
women can produce an egg of good quality and how
well is the ovaries are responding to hormonal
signals from the brain.

18.
INFERTILITY COUNSELING
• Infertility counselling deals with the psycho-social
impact of infertility in terms of- intervention,
treatment and after-effects of both successful and
unsuccessful treatments. It also involves therapeutic
work to help patient cope with the consequences of
infertility and treatment.

19.
OBJECTIVES AND NEED OF INFERTILITY COUNSELLING
• Informed consent.
• To offer coping strategies to couples.
• To facilitate decision making.
• To offer preparation for procedures.
• To help client in achieving a better quality of life.
• To provide genetic counselling.

20.
COUNSELING SERVICES:
• IVF-group discussion by staff.
• Third party reproduction for both donors and
recipients.
• Therapeutic counselling.
• Assessment and follow up

21.
NURSES RESPONSIBILITIES
• Make the patient or couple comfortable with the
counseling.
• Obtain history of both the couples
• Explain the plan of care and treatment
• Maintain confidentiality
• Ensure follow up care

22.
BIBLIOGRAPHY/REFERENCE
• Annamma Jacob, A comprehensive textbook Midwifery and
Gynaecological Nursing, 4th Edition. Jaypee Brothers. pg no.
857-866.
• DC Dutta’s, Hiralal Konar, Textbook of Gynecology, 7th Edition.
Jaypee Brothers. pg 186-209.
• Lily Podder, Fundamentals of Midwifery and Obstetrical
Nursing. ELSEVIER. pg 295-310.
• https://www.urologyhealth.org/urology-a-z/m/male-
infertility
• https://www.mayoclinic.org/diseases-conditions/female-
infertility/diagnosis-treatment/drc-
20354313#:~:text=Fertility%20tests%20may%20include%3A,
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