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PubMed2001

Characterization of patients presenting with male factor infertility in an equal access, no cost medical system.

OBJECTIVES: Demographic information on patients presenting for the diagnosis and treatment of male factor infertility has been limited in the past by the paucity of subspecialty trained providers and concentrated sequential patient information. Previously reported studies looking at the characteristics of patients being evaluated for male subfertility may represent a selected subset of patients able to access these services. The changes in the diagnostic modalities available in the 1990s and new diagnostic categories may also affect the characterization of patients seen with the diagnosis of male factor infertility. METHODS: A retrospective analysis was performed using a centralized database of patient records at a single military male infertility clinic. Seven hundred consecutive patients were studied to obtain information on patient and spouse age, race, length of subfertile period, medical history and examination, and laboratory evaluation. A single provider categorized the etiology of male factor infertility after the evaluation. RESULTS: The mean patient age was 36 years (range 17 to 68). The mean spouse age was 31.2 years (range 19 to 50). The mean subfertile period was 5.5 years (range 0.5 to 35). Of the 700 patients, 51% were white, 10% African American, 2% Hispanic, and 37% other/unknown. Eleven percent of the patients were active smokers. The most common etiologic category groups describing male subfertility were previous vasectomy (56%), varicocele (14%), idiopathic infertility (8%), and nonobstructive azoospermia (6%). CONCLUSIONS: An equal access, no cost medical system mirrors the demographics of the military population served. The clinical characteristics of patients presenting with male factor infertility have changed significantly during the past 30 years. Obstruction from a previous vasectomy is now the most common presenting complaint of patients visiting an infertility clinic. Vasectomy reversal may be more frequently requested when the cost is not a factor in providing fertility services. Idiopathic male factor infertility occurs in less than 10% of patients.

Adolescent↗

PubMed2001

Total antioxidant status of peritoneal fluid in infertile women.

OBJECTIVE: To determine whether impairment of the antioxidant systems of peritoneal fluid might be a factor responsible for infertility. STUDY DESIGN: Total antioxidant status was measured in peritoneal fluid obtained from 18 infertile women suffering from minimal or mild endometriosis, 23 patients with unexplained infertility, 12 women with tubal infertility and 13 fertile women. RESULTS: Total antioxidant status was significantly lower in peritoneal fluid from women with unexplained infertility (0.49+/-0.21 mmol/l) compared to both fertile patients (0.67+/-0.24 mmol/l, P=0.02) and women with tubal infertility (0.76+/-0.26 mmol/l, P=0.001). Peritoneal fluid total antioxidant status did not differ significantly between patients with endometriosis (0.61+/-0.2 mmol/l), tubal infertility and the fertile group (P>0.05). CONCLUSIONS: Our results suggest that low antioxidant status in peritoneal fluid may play a role in the pathogenesis of infertility.

Antioxidants↗

PubMed2001

Sperm morphology, motility, and concentration in fertile and infertile men.

BACKGROUND: Although semen analysis is routinely used to evaluate the male partner in infertile couples, sperm measurements that discriminate between fertile and infertile men are not well defined. METHODS: We evaluated two semen specimens from each of the male partners in 765 infertile couples and 696 fertile couples at nine sites. The female partners in the infertile couples had normal results on fertility evaluation. The sperm concentration and motility were determined at the sites; semen smears were stained at the sites and shipped to a central laboratory for an assessment of morphologic features of sperm with the use of strict criteria. We used classification-and-regression-tree analysis to estimate threshold values for subfertility and fertility with respect to the sperm concentration, motility, and morphology. We also used an analysis of receiver-operating-characteristic curves to assess the relative value of these sperm measurements in discriminating between fertile and infertile men. RESULTS: The subfertile ranges were a sperm concentration of less than 13.5 x 10(6) per milliliter, less than 32 percent of sperm with motility, and less than 9 percent with normal morphologic features. The fertile ranges were a concentration of more than 48.0 x 10(6) per milliliter, greater than 63 percent motility, and greater than 12 percent normal morphologic features. Values between these ranges indicated indeterminate fertility. There was extensive overlap between the fertile and the infertile men within both the subfertile and the fertile ranges for all three measurements. Although each of the sperm measurements helped to distinguish between fertile and infertile men, none was a powerful discriminator. The percentage of sperm with normal morphologic features had the greatest discriminatory power. CONCLUSIONS: Threshold values for sperm concentration, motility, and morphology can be used to classify men as subfertile, of indeterminate fertility, or fertile. None of the measures, however, are diagnostic of infertility.

Adult↗

PubMed2001

Use of copper intrauterine devices and the risk of tubal infertility among nulligravid women.

BACKGROUND: Previous studies of intrauterine devices (IUDs), many of which are no longer in use, suggested that they might cause tubal infertility. The concern that IUDs that contain copper--currently the most commonly used type--may increase the risk of infertility in nulligravid women has limited the use of this highly effective method of birth control. METHODS: We conducted a case-control study of 1895 women recruited between 1997 and 1999. We enrolled 358 women with primary infertility who had tubal occlusion documented by hysterosalpingography, as well as 953 women with primary infertility who did not have tubal occlusion (infertile controls) and 584 primigravid women (pregnant controls). We collected information on the women's past use of contraceptives, including copper IUDs, previous sexual relationships, and history of genital tract infections. Each woman's blood was tested for antibodies to Chlamydia trachomatis. We used stratified analyses and logistic regression to assess the association between the previous use of a copper IUD and tubal occlusion. RESULTS: In analyses involving the women with tubal occlusion and the infertile controls, the odds ratio for tubal occlusion associated with the previous use of a copper IUD was 1.0 (95 percent confidence interval, 0.6 to 1.7). When the primigravid women served as the controls, the corresponding odds ratio was 0.9 (95 percent confidence interval, 0.5 to 1.6). Tubal infertility was not associated with the duration of IUD use, the reason for the removal of the IUD, or the presence or absence of gynecologic problems related to its use. The presence of antibodies to chlamydia was associated with infertility. CONCLUSIONS: The previous use of a copper IUD is not associated with an increased risk of tubal occlusion among nulligravid women whereas infection with C. trachomatis is.

Adult↗

PubMed2002

The knowledge, attitude and practice of child adoption among infertile Nigerian women.

To determine the knowledge, attitude and practice of child adoption among infertile Nigerian women we undertook a questionnaire survey of 279 consecutive infertile women seen in three tertiary care centres in South Eastern Nigeria within a 9-month period. The data were analysed by means of simple percentages and descriptive and inferential statistics, using t-tests, chi-square tests and regression equations at the 95% confidence level. Two hundred and sixty-four questionnaires were analysed. Although 228 (86.4%) of the respondents were aware of child adoption, only 72 (27.3%) knew its correct meaning. Fifty-seven (21.6%) women knew how to adopt a baby while the rest did not; 183 (69.3%) respondents expressed their unwillingness to adopt a baby while the remaining 81 (30.7%) were willing. Twelve (14.8%) of these 81 respondents (or 4.5% of all respondents) had either adopted or made an effort to adopt a child at the time of the study. The major reasons given by the 183 respondents unwilling to adopt a child were: adoption not a solution to their infertility (84 respondents); adoption psychologically unacceptable (78 respondents); fear of unknown parental background (75 respondents) and abnormal behaviour in the child (75 respondents). Univariate analysis showed six factors significantly associated with a favourable attitude to child adoption: a correct knowledge of the meaning of adoption (P=0.00007), duration of infertility >5 years (P=0.0002), previous orthodox specialist treatment (P=0.0002), tubal infertility (P=0.002), no living child (P=0.02) and maternal age >35 years (P=0.03). In a multiple logistic regression involving these six factors, with attitude to adoption as the dependent variable, two factors were associated significantly with a favourable attitude to adoption: correct knowledge of the meaning of adoption (OR=1.9, P=0.04) and previous orthodox specialist treatment (OR=2.9, P=0.05). Although the majority of infertile Nigerian women have heard of child adoption, only a minority knew its real meaning, its legality and the process it entails. Approximately one-third of them were disposed favourably to adoption as a treatment option for their infertility. The Nigerian experience was compared and contrasted with the experiences of other countries. Factors associated with a favourable attitude to adoption were presented and discussed. In the presence of such factors, especially when the probability of cure of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes.

Adoption↗

PubMedDate not supplied

Sperm surface protein profiles of fertile and infertile men: search for a diagnostic molecular marker.

The present study was conducted to examine whether there is any difference in the protein profiles of sperm membranes of fertile (n = 37) and infertile (n = 29) men. In the sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) procedure, the sperm extracts of fertile and infertile men showed 12-16 major and 8-14 minor common protein bands in various molecular regions. However, there was an additional band of approximately 78 kD present in the sperm extracts of approximately 80% of infertile men that was absent in the sperm extracts of fertile men. In the remaining approximately 20% of the infertile men, it was of relatively weaker intensity. This band was present only in the sperm extracts and not in the seminal plasma, whether of fertile or infertile men, and was designated as the infertility-associated sperm protein (IASP). Antibodies to IASP specifically immunoprecipitated the approximately 78-kD protein from the sperm extracts of only infertile and not the fertile men. In the immunofluorescence technique, the anti-IASP antibodies reacted strongly with the head and/or midpiece regions of morphologically abnormal sperm and cross-reacted with a protein in the equatorial regions of morphologically normal sperm of fertile men. The IASP molecule and its antibodies may provide molecular tools to differentiate between the normal and abnormal sperm, and, thus, may be useful markers for the diagnosis of male-factor infertility.

Biomarkers↗

PubMedDate not supplied

Walking the line between feminism and infertility: implications for nursing, medicine, and patient care.

Traditionally infertility has been viewed as a medical condition and has been managed within the medical model of diagnosis, treatment, and cure. The prevalence of infertility has been medically explained by women's sexual promiscuity, pursuit of professional career advancement, and psychological immaturity. Although authors have recently recognized an equitable proportion of infertility problems attributable to male factors, the vast majority of infertility testing and treatment procedures remain directed toward women. Reproductive technologies and their potential for perpetual treatment create a scenario of vulnerability for the infertile woman, which demands the attention of care providers who advocate feminist values of health. In this article, we present a historical overview of infertility and offer a feminist perspective for providing physical and emotional health care to infertile women. Strategies for integrating feminist perspectives of health into infertility programs are discussed.

Attitude to Health↗

PubMed2007

Dietary fatty acid intakes and the risk of ovulatory infertility.

BACKGROUND: Pharmacologic activation of the peroxisome proliferator-activated receptor gamma (PPAR-gamma) improves ovulatory function in women with polycystic ovary syndrome, and specific dietary fatty acids can affect PPAR-gamma activity. OBJECTIVE: The objective of the study was to assess whether the intakes of total fat, cholesterol, and major types of fatty acids affect the risk of ovulatory infertility. DESIGN: We conducted a prospective cohort study of 18 555 married, premenopausal women without a history of infertility who attempted a pregnancy or became pregnant between 1991 and 1999. Diet was assessed twice during follow-up by using a food-frequency questionnaire. RESULTS: During follow-up, 438 incidents of ovulatory infertility were reported. In logistic regression analyses, intakes of total fat, cholesterol, and most types of fatty acids were not related to ovulatory infertility. Each 2% increase in the intake of energy from trans unsaturated fats, as opposed to that from carbohydrates, was associated with a 73% greater risk of ovulatory infertility after adjustment for known and suspected risk factors for this condition [relative risk (RR) = 1.73; 95% CI: 1.09, 2.73]. Obtaining 2% of energy intake from trans fats rather than from n-6 polyunsaturated fats was associated with a similar increase in the risk of ovulatory infertility (RR = 1.79; 95% CI: 1.11, 2.89). In addition, obtaining 2% of energy from trans fats rather than from monounsaturated fats was associated with a more than doubled risk of ovulatory infertility (RR = 2.31; 95% CI: 1.09, 4.87). CONCLUSION: trans Unsaturated fats may increase the risk of ovulatory infertility when consumed instead of carbohydrates or unsaturated fats commonly found in nonhydrogenated vegetable oils.

Adult↗

PubMed2003

Self-reported difficulty in conceiving as a measure of infertility.

BACKGROUND: This study aimed to explore the meaning and potential use of women's self-reported difficulties in conceiving as a measure of infertility in epidemiological studies, and to compare women's stated reasons for infertility with information in their medical records. METHODS: Data were available from a population-based case-control study of ovarian cancer involving 1638 women. The sensitivity and specificity of women's self-reported infertility were calculated against their estimated fertility status based on detailed reproductive histories. Self-reported reasons for infertility were compared with diagnoses documented in women's medical records. RESULTS: The sensitivity of women's self-reported difficulty in conceiving was 66 and 69% respectively when compared with calendar-derived and self-reported times taken trying to conceive; its specificity was 95%. Forty-one (23%) of the 179 women for whom medical records were available had their self-reported fertility problem confirmed. Self-reported infertility causes could be compared with diagnoses in medical records for only 22 of these women. CONCLUSIONS: Self-reported difficulty conceiving is a useful measure of infertility for quantifying the burden of fertility problems experienced in the community. Validation of reasons for infertility is unlikely to be feasible through examination of medical records. Improved education of the public regarding the availability and success rates of infertility treatments is proposed.

Case-Control Studies↗

PubMed2005

Is the CAG repeat of mitochondrial DNA polymerase gamma (POLG) associated with male infertility? A multi-centre French study.

BACKGROUND: Recent data emphasized the implication of polymerase gamma (POLG) CAG repeats in infertility, making it a very attractive gene for study. A comparison of POLG CAG repeats in infertile and fertile men showed a clear association between the absence of the usual 10-CAG allele and male infertility, excluding azoospermia. It has also been suggested that the POLG gene polymorphism should be considered as a possible contributing factor in unexplained couple infertility where semen parameters are normal. In this study, we investigated the POLG CAG repeats, in a well-defined population of patients with severe male factor infertility. METHODS: We conducted a large study of POLG CAG repeats in 433 infertile and 91 fertile, normozoospermic and healthy males. In all subjects, phenotypic data, including semen parameters, hormonal status and clinical profiles, were available. RESULTS: Thirteen 'homozygous mutants' (3%) were found among the 433 idiopathic infertile patients. The follow-up of the 13 'homozygous mutant' resulted in pregnancy for more than half of the couples, through assisted reproductive techniques or even spontaneously. In addition, one 'homozygous mutant' was identified in 91 fertile men (1.1%) CONCLUSION: Under our conditions, our study does not confirm any relationship between the polymorphic CAG repeat in the POLG gene and male infertility.

Adult↗

PubMed2005

Is chromosome analysis mandatory in the initial investigation of normovulatory women seeking infertility treatment?

BACKGROUND: There is no agreement about the frequency of chromosomal abnormalities (CAs) in the female partner of an infertile couple and therefore there is no evidence base for determining whether karyotype analysis is mandatory before the initiation of infertility treatment. The aim of this prospective study was to estimate the prevalence of karyotype abnormalities in normovulatory women attending an infertility clinic and compare it to that known to be present in the newborn female population. METHODS: Cytogenetic testing was performed in 1206 women with normal ovulatory cycle seeking infertility treatment. At least 15 GTG-banded metaphases were analysed in each case. In the case of a structural abnormality, fluorescent in situ hybridization (FISH) analysis and high resolution banding (HRB) were performed on a new blood sample to elucidate the aberration. When mosaicism was suspected, the number of analysed metaphases was increased to a total of 115 and an additional analysis of 200 metaphases was done on a second blood sample. RESULTS: A chromosomal abnormality was demonstrated in 0.58% (95% CI: 0.28-1.19) of cases which did not differ significantly from that reported in female newborns (0.79%; 95% CI: 0.68-0.94). Balanced reciprocal translocation was observed in 0.4% of patients (n = 5), paracentric inversion of chromosome X in 0.08% (n = 1) and gonosomal mosaicism in 0.08% (n = 1). However, chromosomal aberrations were less common among females with primary infertility compared to those with secondary infertility (0.25 versus 1.25%, P = 0.04). CONCLUSIONS: The present study suggests that routine cytogenetic analysis cannot be advocated in normovulatory infertile women. Nevertheless, the relatively higher frequency of abnormal karyotypes in women with secondary infertility indicates that this subgroup of patients might benefit from a routine karyotype analysis.

Adult↗

PubMed2005

Comparative birth weights of singletons born after assisted reproduction and natural conception in previously infertile women.

BACKGROUND: The possible interference of assisted reproduction techniques (ART) with epigenetic reprogramming during early embryo development has recently sparked renewed interest about the reported lower birth weight among infants born as a consequence of infertility treatments. However, the latter finding so far has relied on the comparison of the birth weight of infants conceived with ART to general population data. A more appropriate comparison group should involve pregnancies in infertile women after natural conception. Therefore, we compared neonatal birth weight data of infants born after various ART treatments, including intrauterine insemination (IUI), with those of previously infertile women achieving pregnancy after sexual intercourse. METHODS: Between August 1996 and March 2004 the data of all infertile women presenting in the infertility unit of the University Women's Hospital of Basel, Switzerland, were collected prospectively, adding up to 995 intact pregnancies and deliveries. The birth weight of all infants resulting from 741 singleton pregnancies were analysed with regard to the patients' characteristics, the occurrence of complications during pregnancy and the type of infertility treatment with which the pregnancies were achieved. RESULTS: Comparison of duration of pregnancy and birth weight of infants born after infertility treatment confirms a shorter pregnancy span and a lower mean birth weight in infants born after IVF and ICSI. If women with pregnancies after ART deliver before term, neonatal birth weight is significantly lower. CONCLUSIONS: There is a specific effect of ART, mainly IVF and ICSI, on both shortening the duration of pregnancy and lowering neonatal birth weight. Both these parameters seem to be interrelated consequences of some modification in the gestational process induced by the infertility treatment. Freezing and thawing of oocytes in the pronucleate stage had a lesser impact on pregnancy span and on neonatal birth weight.

Adult↗

PubMed1993

Association between antibody to the chlamydial heat-shock protein and tubal infertility.

To determine the prevalence of antibody to Chlamydia heat-shock protein 60 (C-hsp60) in women with tubal infertility, an ELISA using purified recombinant C-hsp60 was developed. Antibody to C. trachomatis was present in 32 (72.7%) of 44 women with tubal infertility compared with 9 (32.1%) of 28 with other causes of infertility and 55 (28.9%) of 190 pregnant women (P < .001). Among the seropositive women, antibody to C-hsp60 was present in 26 (81.3%) of 32 women with tubal infertility compared with 0 of 9 with other causes of infertility and 9 (16.4%) of 55 pregnant women (P < .001). The C-hsp60 ELISA detected Chlamydia-associated tubal infertility in infertile women with a sensitivity of 81.3% and a specificity of 97.5%. There is a strong association between antibody response to the C-hsp60 and the development of Chlamydia-associated tubal infertility. Thus, a C-hsp60 ELISA may be useful as a predictor for poor fertility outcome.

Antibodies, Bacterial↗

PubMed1996

The incidence and possible relevance of Y-linked microdeletions in babies born after intracytoplasmic sperm injection and their infertile fathers.

Microdeletions linked to deletion intervals 5 and 6 of the Y chromosome have been associated with male factor infertility. Members from at least two gene families lie in the region containing azoospermia factor (AZF), namely YRRM and DAZ. With the advent of intracytoplasmic sperm injection (ICSI), it is possible for men with severe male factor infertility to produce a child. The genetic consequences of such a procedure have been questioned. This report describes the first study of a population (32 couples) of infertile fathers and their sons born after ICSI. The objectives were firstly to determine the incidence and map location of Y chromosome microdeletions and to compare the frequencies with other population studies involving severe male factor infertility, and secondly to formulate a working hypothesis concerning developmental aetiology of Y chromosome microdeletions. The incidence of microdeletions in the ICSI population was shown to be 9.4% (within the range 9-18% reported for populations of severe male factor infertility patients). Microdeletions in two out of three affected father/son pairs mapped in the region between AZFb and AZFc and the third involved a large microdeletion in AZFb and AZFc. Of three affected father/son pairs, microdeletions were detected in the blood of one infertile propositus father and three babies. Assuming that the gonomes of the ICSI-derived babies are direct reflections of those of their fathers germ lines, it is possible that two of three infertile fathers were mosaic for intact Y and microdeleted Y chromosomes. In such cases, the developmental aetiology of the microdeletion may be due to a de-novo microdeletion arising as a post-zygotic mitotic error in the infertile propositus father, thus producing a mosaic individual who may or may not transmit the deletion to his ICSI-derived sons depending on the extent of primordial germ cell mosaicism. In one of three affected fathers, the microdeletion detected in his blood was also detected in his ICSI-derived son. In this case the de-novo event giving rise to the microdeletion may have occurred due to a post- (or pre-) meiotic error in the germ line of this father's normally fertile father (i.e. the ICSI-derived baby's grandfather).

Adult↗

PubMed1996

A comparison of baseline and induced DNA damage in human spermatozoa from fertile and infertile men, using a modified comet assay.

Baseline DNA damage in spermatozoa from fertile and infertile men was compared using a modified alkali single cell gel electrophoresis (comet) assay. Semen from normozoospermic fertile, normozoospermic infertile and asthenozoospermic infertile (World Health Organization criteria, 1992) samples were studied. No significant difference was observed in levels of baseline damage between the three groups. A median value for baseline damage of approximately 20% (80% head DNA) was obtained in all samples. Irradiation with X-rays (5-30 Gy) produced no additional damage in fertile samples when median values were examined. However, irradiation with 30 Gy X-rays produced significant damage in both infertile groups. Hydrogen peroxide (40 microM) treatment induced significant damage in the asthenozoospermic group, whereas 100 microM H2O2 was required to cause significant damage in the normozoospermic fertile and infertile samples. Within the fertile population a subgroup in which percentage head DNA was greater than 80% was observed in both treated and untreated specimens. This subgroup significantly decreased with treatment in both infertile groups. We conclude that the asthenozoospermic infertile group is more susceptible to damage than the normozoospermic infertile group, which in turn is more susceptible than the fertile group. The fertile group contains a resistant subpopulation of spermatozoa with relatively intact DNA.

DNA↗

PubMed1996

Characterization of human sperm antigens reacting with sperm antibodies from autologous serum and seminal plasma in an infertile population.

Immunoblotting techniques were used to characterize the reactivity of human sperm antigens with sperm antibodies from an infertile population. Sperm antigens of each individual were tested with autologous sperm antibodies present in serum and seminal plasma in order to construct a preliminary map of the antigens of the infertile spermatozoon and to compare the qualitative differences in the antigenic profile between fertile and infertile subjects. A total of 61 infertile males, comprising 51 subjects having poor semen quality and 10 subjects with no abnormalities in semen analysis, entered the study; 55 subjects with proven fertility served as controls. Infertile subjects often showed specific immunoreactivity to 50-, 55-, 57-, 62-, and 72-kDa proteins in serum and to 57- and 62-kDa proteins in seminal plasma. As to comparison of immunoreactivities between fertile and infertile individuals, the sperm antigens may be divided into three groups. Group 1 antigens (50-, 69-, and 72-kDa proteins) were recognized by sperm antibodies present in both populations; group 2 antigens (57- and 62-kDa proteins), by sperm antibodies typical of the infertile population; group 3 antigens (45-, 55-, and 85-kDa proteins), by sperm antibodies typical of the fertile population. This classification shows that the infertile spermatozoon differs substantially at the immunogenic level from the fertile spermatozoon. The group 2 antigens seem to be involved in a relevant step in the reproductive process and hence have been termed "fertility-related antigens."

Autoantibodies↗

PubMed1993

The role of the female doctorally prepared nurse in caring for infertile women.

Today, in medical and nursing literature, infertility is described as a couple problem, with interventions aimed at treating the couple. While not dismissing the fact that the conception does involve both genders, the reality of infertility treatment is that the woman, not the couple, undergoes the majority of infertility testing and treatment. The numerous physical demands made of women during infertility investigation and therapy are associated with significant emotional and informational needs. As such, all infertility practices should offer supportive counseling to their clients. Incorporation of such services into general infertility treatment will ensure that the greatest number of female infertility clients receive the information and emotional support they need. The health care professional best qualified to provide these services is the female doctorally prepared nurse. By virtue of both her gender and training, she is more likely to be capable of intervening therapeutically, woman to woman, in a sensitive and empathic manner. Furthermore, she can anticipate extending her role to include the following services: (a) provision of basic gynecological care, (b) follow-up of patients on hormone therapy, (c) coordination of patient care, (d) provision of supportive counseling, and (e) participation in research. To secure a position, the female doctorally prepared nurse needs to recognize the importance of promoting herself in the infertility marketplace. Ultimately, both the establishment and survival of her role will depend on her professional uniqueness.

Education, Nursing, Graduate↗

PubMedDate not supplied

Caring for the infertile woman.

Increasing numbers of women are seeking infertility services. In light of this, it is important that professional nurses learn about infertility treatments and options, for the public looks to nurses for guidance in all aspects of healthcare. This article describes the systematic assessment, planning, implementation, and evaluation phases of the nursing process for women who are involved in infertility evaluation and interventions. Much of the basic work-up for infertility can be accomplished by a generalist (OB/GYN, CNM, or nurse practitioner), but if the patient does not conceive in a few months, referral to an infertility specialist is essential. Women need help to understand the possibilities as well as the limitations of current therapies for infertility. The toll that the emotional roller coaster of infertility takes on women and their partners can be devastating so those caring for them must be prepared to address that aspect of the experience. The nurse must be prepared to help the infertile woman deal with crushing disappointment and grief when cycles fail or pregnancies end in the early stages. The caring aspect of professional nursing is an essential component of meeting the special needs of these patients.

Female↗