.

PRESENTED BY:
Akancha Prassana
1st yr MSC.NURSING
LGM COLLEGE OF NURSING
Bhubaneswar
INFERTILITY
 INTRODUCTION
• Inability to conceive after at least one year of
regular sexual intercourse without contraception.
 DEFINITION

• Acc. To FIGO : Infertility is defined as “a failure to

conceive within 12 months of having sexual intercourse
with average frequency 2 to 3 times per week , without
the use of any form of birth control.”
 INCIDENCE
• 80% of couples achieve conception
within one year of having regular
intercourse.

• Another 10% will achieve the objective

by the end of second year
 INCIDENCE
• 2010:Approximately 10.5%of women
around world experienced secondary
infertility and 2% experienced primary
infertility.
• 2017:10-14% of indian female population
suffering with the problem
RISK FACTORS OF INFERTILITY
• Age more than 32 yrs
• Smoking
• Alcohol consumption
• Mental stress
 CON…

• Obesity
• Eating disorders
• Sexually transmitted
infections
• Exposure to some
chemicals
COMMON CAUSES OF INFERTILITY IN MEN

PRETESTICULAR CAUSE
TESTICULAR CAUSE
POST TESTICULAR CAUSE
DIAGNOSTIC EVALUATION
 SPECIFIC INVESTIGATION OF MALE
INFERTILITY

• HISTORY AND PHYSICAL EXAMINATION

• SEMEN ANALSIS
• BIOPSY OF TESTES
• CHROMOSOMIC STUDIES
• BLOOD TESTS FOR HORMONAL LEVELS
• TRANSRECTAL ULTRASOUND
 SPECIFIC INVESTIGATION OF
FEMALE INFERTILITY
• HISTORY TAKING AND GENERAL PHYSICAL EXAMINATION
• BLOOD TEST
• CERVICAL MUCUS
• HYPERSALPINGOGRAPHY
• ULTRASOUND SCANNING
• LAPROSCOPY
 MANAGEMENT
Management basically depends on cause. It is categorizes
into following categories:
• MEDICAL MANAGEMENT
• RECENT ADVANCED TECHNIQUES
• SURGICAL MANAGEMENT
 MEDICAL MANAGEMENT
Pharmacological therapy:
 CLOMIPHENE CITRATE: simple safest and coast effective
 DOSE: initial dose is upto 50 mg daily but can be inreased upto
250 mg daily
 MOA: It blocks estrogen receptors in hypothalamus that
results in increased in GnRH causing increased gonadotropin
secretion from pitutary
SIDE EFFECTS: Hot
flushes, N/V, headache,
visual symptoms and
ovarian hyperstimulation
 GONADOTROPHINS
• It stimulates follicular growth from which ovulation is expected to occur
within 36 hour.
• DOSE: 75iu IM/day from D2 to D5 and continued for 7-10 days
• MOA:
 ADJUNCTIVE THERAPY
• METFORMIN
• DEXAMETHASONE
• ELTROXIN
• BROMOCRIPTINE or CABERGOLINE
• HCG
 RECENT TECHNIQUES OF
INFERTILITY
• INTRAUTERINE UTERINE INSEMINATION
• IN VITRO FERTILIZATION
• GAMETE INTRA FALLOPIAN TRANSFER
• ZYGOTE INTRA FALLOPIAN TRANSFER
• INTRA CYTOPLASMIC SPERM INJECTION
• SPERM OR OVEM DONATION
• SURROGACY
INTRA UTERINE INSEMINATION
INVITRO FERTILIZATION
GAMETE INTRA FALLOPIAN
TRANSFER
ZYGOTE INTRA FALLOPIAN
TRANSFER
INTRA CYTOPLASMIC SPERM
INJECTION
OVUM OR SPERM DONATION
SURROGACY
 SURGICAL MANAGEMENT
• Laparoscopic ovarian drilling
• Wedge resection
• Utero vaginal surgery
• Tubal surgery
• Surgical removal of ovarian tumor
 NURSES ROLE
• Major responsibility for teaching and
providing emotional support throughout the
phase.
• Plays an important role in promoting
infertility which includes teaching teaching
of prevention of infections, early diagnosis
and treatment.
• Recognisizing and taking steps to deal with
psycho logic factors to better cope up with
situation.
SUMMARY
CONCLUSION
 BIBLIOGRAPHY
• Dutta D C; Textbook of Gynaecology ; Jaypee publication;6th edition; page No.;218-228
• Bennett Ruth v , Brown k linda ; Myles Textbook for Midwives;13th edition; page No.;
156-163
• Devi seetha; A textbook of midwifery and gynaecology; vijayam publication; 1st
edition; Page No.; 17.1-17.5
• Salhan sudha; Textbook of gynaecology; Jaypee publication; 1st edition; Page No.
126,459
• Martin A Elizabeth; A dictionary of Nursing; oxford university press; 5th edition; Page
No. 160,346, 451,478,511
• www.wikipedia.com
• www.slideworld.com