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1、Infertility Gu WeiKey Words of the Cchapter Infertility Artificial Insemination In Vitro Fertilization and EmbryoTransfer (IVF-ET) Gamete Intrafallipian Transfer (GIFT)Infertility represents a major life crisis to couples especially women. Infertility women experiences the stress in her lifetime. In
2、fertility nursing is a specialty, but general practice nurses also meet couples who are seeking help or have had treatment for Infertility in varied settings. Nurses in working in the perioperative area may care for these couples during diagnostic or therapeutic surgery. Nurses is in urology setting
3、s often see men who are being evaluated for infertility. In the emergency department, nurses may car for women who are having a spontaneous abortion of a had- won pregnancy. Definiition Infertility is generally defined as the inability to conceive after 2 years of regular sexual intercourse without
4、contraception. Infertility is classified as primary Infertility and secondary Infertility. Primary Infertility is defined as the inability to conceive after one or more successful pregnancies. Fecundity is the ability to participate in the production of a child. Fecundability is the chance of becomi
5、ng pregnant per month of exposure. The criterion of 2 years in the definition is based on statistics for a normal population of couples who are not using contraception. On the bases of these estimate, about 87.7% of all sexually active couples conceive in the first year, approximately 94.6% in the s
6、econd years. Causes of InfertilityThe main causes of Infertility include male factor, female factor and both male and female partners. Factors related to the female partner account for 60% of Infertility problems; factors related to the male partner account for an additional 30%; and a combination o
7、f factors related to both male and female partners account for another 10%.Problems Related toThe Female PartnerProblems with fertility associated with the female partner can be grouped with respect to the fallopian tubes factor, the ovulatory factor, the cervical factor and the vaginal factor. The
8、Fallopian Tubes Factor It is the most popular factor related to infertility. Tubal obstruction may occur because of scarring and adhesions following reproductive tract infections. Infections such chlamydia and gonorrbea are responsible for many cases of Infertility form tubal obstruction. Endometrio
9、sis is the implantation of uterine endometrium, or nodules, outside the uterus. Tubal obstruction also can result from a ruptured appendix or abdominal surgery in which infection was involved and adbesions formed. In addition, the fallopian tubes and other reproductive organs may have congenital ano
10、malies that disrupt normal function. The conditions that cause obstruction also may interfere with normal motility within the fallopian tube. Poor movement of the fimbriated (distal) end of the tube may prevent the pickup of the ovum from the ovarian surface after ovulation. Abnormal action of the c
11、ilia within the tube prevents normal transport of the ovum toward the uterine cavity. The Ovulatory Factor The ovulatory factors contributing to female infertility includes problems related to ovulation and hormonal activity. anovulation is the most serious cause of infertility in women because no o
12、va are present to be fertilized. Anovulation may occur from a genetic abnormality. It may occur not as a primary ovarian problem but as an imbalance of hypothalamus-pituitary-ovarian interplay caused by a condition such as hypothyroidism. Chronic or excessive exposure to x-rays or radioactive substa
13、nces may be involved . general ill health or poor diet may contribute to poor ovarian function. Ovarian tumors may produce anovulation duo to feedback stimulation on the pituitary. Disruption of hormone secretion or the ovarian response to hormone section can be caused by many factors such as crania
14、l tumors, stress, obesity, anorexia, systemic disease, and abnormalities in the ovaries or other endocrine glands.The Uterus Factor Tumors such as fibromas (leiomyomas) may be a cause of infertility in that they block fallopian tubes or limit the space available for effective imp lation. A congenita
15、lly deformed uterine cavity may also limit implantation sites, but this is a rare occurrence. Inadequate endometrium formation resulting from poor secretion of estrogen or progesterone from the ovary is the main cause of infertility due to a uterine factor (the primary factor here is actually ovaria
16、n). The Cervical Factor Stenosis or congenital malformations of the cervix or uterine cavity may repeated loss of a normal embryo or fetus. These malformations may prevent normal implantation of the fertilized ovum or normal prenatal growth of the placenta or fetus. Infection or malformation of the cervix (erosion) may cause such changes in the cervical mucus that spermatozoa cannot penetrate it easily or survive in it. A tight
