Category: Infertility

Development in the human population is dependent on the ability of human beings to reproduce. Commentators on human population in the past have voiced concern about a possible population explosion due to increasing fertility levels among humans. Yet recent developments have raised concerns that are the exact reverse of these old concerns. Human population increases have been on the decline and, while female infertility has had its share contribution to this, male infertility has been identified as a major contributor to this state of affairs.

While many factors contribute to male infertility to what extent do modern lifestyles, which are marked by consumption of nutritionally deficient food, contribute to the problem?

Infertility defined

Infertility is defined as the failure of a couple to become pregnant after one year of unprotected sexual intercourse (Tarkan 2009). Infertility, according to Tarkan (2009), has been given many names including barrenness and the inability to conceive. While traditional stereotypes have tended to place the burden of inability to conceive on the woman, recent developments have shown that men, increasingly, have their fair share of contribution to problems of conception. When a couple has had unprotected sex for a period of one year and pregnancy is not achieved, this could be indicative of infertility “on one or both sexual partners” (“Male Infertility”, 2008). That men are significant contributors to the crisis of infertility is indicated by the fact that 40% of such cases are the result of problems with the male semen (“Male Infertility”, 2008).

Causes of male infertility

Male infertility is caused by several factors. At the outset, it is important to point out that the causes of this condition, many as they are, have not been conclusively studied and research on the definite causes of male infertility is ongoing. This, however, does not mean that doctors’ opinions on the causes of male infertility are mere speculation. On the contrary, much data has been collected on this condition so that doctors are able to address the problem of male infertility with a fair degree of confidence. To understand male infertility, it would be prudent to compare it with male fertility. Mason (1993) offers a guideline on male fertility that makes the understanding of infertility easier. “A broad definition of male fertility includes sperm production, sperm quality and transport mechanisms” (Mason 1993). Those three factors contribute immensely to cases of male infertility.

Sperm production

For a man to impregnate a woman there must be sexual activity and the production of sperm. Performance of the sexual act regularly is not only necessary for production of sperm but also aids in the enhancement of the movement of sperm. According to Mason (1993) therefore, regular sex improves chances of conception for the child-seeking couple than abstinence. Tied to this is the fact that regular ejaculation improves sperm production and therefore increases the chances of conception. For this reason, lack of regular sex should be considered a possible cause of male infertility. Not only should the man be able to produce sperm, he should be able to produce sperm of the right quality if conception is to be achieved. One of the primary causes of male infertility is the production of poor-quality sperm.

The factors that have been identified as contributing to the production of low-quality sperm are many and some are tied to modern lifestyles. Wheldon (2005) notes that some of the contributors to low-quality sperm, are environmental factors that are the natural consequence of increasing pollution on the planet. Sperm movement, as identified by Mason (1993) is critical to the conception process as the male semen has to fertilize the female egg for pregnancy to occur. While conception can be achieved in other ways other than sexual contact, it is much easier to achieve it through sexual intercourse (Mason, 1993).

Specific causes of male infertility

A man’s inability to impregnate a woman could be caused by a number of factors. Mason’s (1993) broad description of what constitutes male fertility not only sheds light on the reverse condition but also aids in identifying the specific causes of male infertility. Observing that the man needs to produce not just high-quality but also adequate sperm, Whiting (2001) attributes the majority of male-infertility cases to the production of deficient sperm. According to Whiting (2001) inadequate production of sperm is to blame for ninety percent of the cases of male infertility. While most men who lack the ability to impregnate a woman will be able to produce some sperm, some men actually produce no sperm at all. The latter condition is known as Azzospermia while the former is known as Olibospermia and both contribute, in varying degrees, to male infertility (Whiting, 2001). In making this observation, Whiting (2001) draws attention to the fact that most of the sperm released in an ejaculation is destroyed before reaching the egg and therefore the chances of conception are reduced drastically when the production of sperm is deficient. Agreeing with Mason (1993), Whiting (2001) observes that when a man’s sperm is healthy and able to move freely, the man cannot be considered infertile on the grounds of a low sperm count.

The contribution of environmental factors to low-quality sperm observed by Wheldon (2005) is emphasized by Whiting (2001) who attributes this increasingly common condition to the food consumed by the modern man. Consumption of food low in nutrients and high in fat contributes to production of low-quality sperm. Whiting (2001) further notes that sperm are at risk of oxidative damage and thus the need to consume food with enough antioxidants.

For sperm to be considered normal, and therefore capable of fertilizing the female egg, there are specific measures it must meet. The World Health Organization (WHO) “defines normal semen as having a concentration greater than 20 million sperm per milliliter” (Jequier, 2000). Jequier (2000) further notes that the concentration of sperm in semen varies from individual to individual and also will record different concentrations for the same individual during different times. The importance of consuming high-nutrient foods as recommended by Whiting (2001) therefore becomes critical in the production of good-quality sperm and therefore in prevention of male infertility.

One of the biggest causes of male infertility is the loss of sperm mobility. A man with perfectly healthy sperm will still be infertile if unable to deliver this to the female egg. Sperm mobility is interfered with by several factors and one of these will be infections to the male reproductive organs. While infections could prevent ejaculations, there are less severe cases that still contribute to infertility. Jequier (2000) observes that sometimes infertility is the result of reduced ejaculatory volumes. While this may not be the cause of infertility, it could aggravate an already bad situation. This reduction in volume can be caused by several factors including abnormalities with the seminal viscules. Whiting (2001) also observes that infections to the penis can lead to obstructions that will prevent the sperm from reaching the female egg. Some sexually transmitted diseases are capable of creating such obstructions and therefore contribute to male infertility. Such sexually transmitted diseases could also damage the tubes that deliver sperm in addition to blocking them. According to Whiting (2001) gonorrhea is one of the leading causes of blocked sperm ducts and therefore a major contributor to male infertility.

Apart from sexually transmitted diseases, male infertility can be caused by injuries to the testes (Segal & Mastroianni 2003). Such injuries easily lead to an inflammation of the testes and could lead to the condition known as orchitis. According to Segal and Mastrianni (2003), orchitis leads to inability to produce sperm as it leads to “the loss of the germ cells that make sperm”. In addition, this primary cause of the inability to produce sperm can be caused by failure of the testicles to descend during a child’s birth. When that happens, the child’s ability to produce sperm later could be permanently impaired (Segal & Mastrianni 2003). In addition to the damages caused to the testes that can cause male infertility, Whiting (2001) also notes that infertility could be the result when the testes are improperly developed. This could be caused by several conditions including “exposure to diethylstilbestrol (DES) a synthetic estrogen used in the 1950s and 1960s that caused cysts in the male reproductive tract” (Whiting 2001).

Individual lifestyles also contribute to male infertility. Tarkan (2009) observes that male infertility could be caused by improper use of common food and drugs. In the list of consumables that could cause or aggravate male infertility are alcohol – which is dangerous when consumed heavily, and cigarette smoking. In addition, over-indulgence in drugs such as marijuana could lead to male infertility as well as the use of some prescription drugs (Tarkan, 2009). Some of the prescription drugs that can lead to male infertility include drugs for the treatment of ulcers. To be avoided too are anabolic steroids. Other drugs that could interfere with a man’s reproductive ability are drugs for the treatment of high blood pressure (Bechtel, Stains, L. & Stains L.R. 1996).

Other causes of male infertility – the “masculine” male

While many reasons have been given for the rise in male infertility in recent years, Seshardi (1995) notes that the masculinity of newborn males has been on a steady decline. Citing evidence from environmental and biological studies, Seshardi (1995) observes that there has been a general rise in male infertility due to rise in the “exposure to estrogens (sex hormones or other substances capable of developing and maintaining female characteristics of the body) during critical periods of male reproductive development” (Seshadri, 1995). This development has led to the development of men with female characteristics and who therefore lack the ability to impregnate women. This “demasculinization” of the men was arrived at by studying similar characteristics in the male wildlife. While the jury on the estrogens and much to do with male infertility is still out, Seshardi’s (1995) gets support from Bechtel (1996) who, in recommending the maintenance of a small frame as a measure to fight male infertility, observe that overweight men expose their testicles to more heat than the slimmer men. “All that fat metabolizes testosterone into estrogen, which could affect sperm count” (Bechtel, 1996).

Prevention of infertility in men

The reasons that lead to male infertility provide a useful guideline to the measures that need to be pursued to correct the condition. Harmful lifestyles contribute to the condition and Howells observes that poor diets lead to poor sperm motility and low sperm count. Moreover tests excess body weight affects fertility with studies showing overweight men as producing “24% less testosterone than men of average weight” (Howells). Bechtel (1996) identifies some basic lifestyle changes that could reverse or mitigate male infertility. One such lifestyle change is avoiding or abandoning smoking. The dangers of cigarette smoke are underlined by Bechtel’s (1996) assertion that the habit can lead to a reduction in sperm count that can be as high as fifteen percent. Improved lifestyles are also credited for improved sperm count and improvements in sperm quality by Mason (1993) who observes that, due to the sensitivity of sperm production, “men of marginal fertility can be helped by making some changes to their life” (Mason 1993).

Castigating the current obesity epidemic that afflicts most modern men, Bechtel (1996) observes that the man who maintains a “boyish figure” preserves his sperm and therefore his fertility. In addition to maintaining a trim figure, Bechtel (1996) observes some other lifestyle changes that could impact a man’s fertility. One seemingly minor but important lifestyle practice that could help in the improvement of a man’s fertility is keeping the male reproductive organs, ad especially the testes, at the right temperature. The scrotum hangs outside the body for specific reasons – it is meant to keep the testicles at 4 degrees Farenheight below the body temperature. This temperature is important and exposing the testicles to heat much higher could damage the sperm. For this reason, it is recommended that a man keeps off tight underwear and avoids hot tubs (Bechtel 1996).

Some causes of male infertility can only be addressed by medical professionals. One such case is the situation where a child is born with testicles that are not distended from the body. In such a situation, the only remedy is the performance of surgery to bring the testicles into the scrotum as quickly as possible (Mason 1993). Other remedial measures that can be undertaken by medical professionals include treatment of sexually transmitted diseases that could be blocking the flow of sperm and therefore contributing to infertility. While gonorrhea is recognized as a likely contributor to male infertility, Mason (1993) also observes that it is extremely easy to cure when proper medical attention is sought. Simple surgical procedures also come in handy in unblocking the sperm ducts (Mason 1993). Similarly, where infertility is the result of orchitis, the help of a physician should be sought. Tarkan (2009) observes that men who are vaccinated against mumps not only escape the mumps infection but are also protected against orchitis.

Conclusion

While much has been written on male infertility, evidence available on this condition would seem to suggest that there is much that is yet to be learned on the subject. Perhaps Bechtel (1996) best captures the state of affairs in the discussion on male infertility by stating that most of what is called male infertility is actually an exaggeration as most men so-classified are assumed to be unable to produce sperm yet “rarely is a man totally spermless” (Bechtel 1996 p 294). Further, Bechtel (1996) observes that reproductive medicine is a relatively new field so that the need for continued research and specialized study need not be over-emphasized. Despite the many debatable issues on male infertility, what is quite clear is that a healthy lifestyle cannot be substituted for anything. While obesity and improper nutritional habits have been blamed for a myriad of health problems, the fact that such habits are thought to contribute to male infertility should make every individual rethink the place of fatty and low-nutrient foodstuffs. Moreover, observations by medical personnel about the contribution of destructive habits such as smoking and alcohol consumption to male infertility, coupled with the fact that these habits are also blamed for many other human afflictions should cement doctors’ instructions on the importance of observing moderation in consumption habits.

References

Bechtel, S., Stains, L & Stains, L.R. (1996). Sex. New York: Rodale.

Howells, R (n.d). Lifestyle factors in male infertility. Shared journey. Your complete path to fertility. Web.

Jequier, A.M. (2000). Male infertility. Perth: Wiley-Blackwell.

“Male infertility” (2008). What is infertility. Natural eye care. Web.

Mason, M. (1993). Male infertility – Men talking. New York: Routledge.

Segal, S.J., & Mastroianni, L.D. (2003). Hormone use in menopause & male andropause: A choice for women and men. New York: OUP.

Seshadri, B. (1995). Male infertility and world population. Contemporary review, 266(1549), 77+.

Tarkan, L. (2009). Are men overlooked at fertility centers?. The new york times. Web.

Wheldon, J. (2005). Why infertility is now a male crisis; Men, not women are more likely to need treatment. The daily mail p 15.

Whiting, D. (2001). Infertility facts, prevention, and treatment strategies.Healthwithnutrition.com. Web.

Introduction

Analysis

The demographics presented provide information that is crucial to determining fertility levels of women across the United States. The fertility rates of various groups are calculated using the Crude Birth Rate (CBR) method, the General Fertility Rate (GFR) method, the Age Specific Fertility Rate (ASFR), and the Total Fertility Rate (TFR) method.

Crude Birth Rate (CBR)

The calculations show that the number of births per 1000 women reduced from fourteen to twelve between 2000 and 2010. The causes of such a reduction could be an increased interest in corporate life by contemporary women, increased awareness of birth control methods, and a constrained economy. It is worth noting that although the birth rates increased slightly in 2005 across the three groups, there was a significant reduction in birth rates in 2010.

General Fertility Rate (GFR)

The general fertility rate data shows that the general fertility of the female population between the age of 10 and 54 reduced from 28 births per 1000 potential mothers to 25 births per 1000 women who were in a position to conceive. The findings show that the number of births by women who would be considered fertile reduced as people got more accustomed to the new millennium.

Age Specific Fertility Rate (ASFR)

The Age specific Fertility Rate measures the women’s ability to give birth by measuring the number of births per 1000 women within a 5-year age-group between the age 10 and 54. Across the years, it is evident that fertility was most prominent between the ages of 20 and 34. In 2005, the ASFR of 1000 women aged 20 to 24 reduced to 101 births per year from 109 births per year. However, the ASFR value increased by 2 for women between the ages of 25 and 29, and by 5 between the ages of 30 and 34. In 2010, the ASFR reduced significantly for young women between the ages of 20 and 29. The change can be attributed to the recession that hit the United States, which may have prompted women to venture into the corporate world to increase their disposable income.

The data showed that the White (Non-Hispanic) women had a moderate birth rate across all age-groups compared to the Hispanic women. The data showed that the fertility rates of the Hispanic women started from a very young age (14 years). In 2000, the ASFR of Hispanic women between the ages of 20 to 24 years was almost double the ASFR of White (Non- Hispanic) women of the same age-group (159 births per year compared to 90 births per year). As with other parameters, the Age Specific Fertility Rate also increased across the groups in 2005. There was a considerable increase in the births per 1000 women aged between 14 and 35 across the designated groups. In 2010, the rate reduced for all groups, which could mean that the Hispanic women were more educated on birth control methods and family planning.

Total Fertility Rate (TFR)

The total fertility rate is the number of times a fertile woman gives birth within her lifetime. In 2000, the total fertility rate was 2.06. It remained stable until 2010 when it reduced to 1.9 births per 1000 women. The drop depicts a shrink in population over the years. However, this depends on the prevailing mortality rates. The total fertility rate for the White (Non-Hispanic) mothers remained stable at 1.8 births per 1000 women across the years. The TFR of the Hispanic mothers reduced from 2.7 in 2000 and 2005 to 2.3 in 2010. The data shows that Hispanic women became more literate as years passed and factors such as job availability, quest for education, the economy, and personal goals affected their rate of birth across the age-groups.

Conclusion

As evidenced in the analysis, the most effective parameter for forecasting fertility is the Age Specific Fertility Rate method. The ASFR method allows one to draw comparisons across age-groups and races in a given population. It also enables one to compute the Total Fertility Rate, which is a popular measurement tool for governments.

Introduction

Medical research findings have shown that the rate of survival for pediatric patients with cancer has risen over the years. Infertility is a major side effect that is closely associated with cancer treatment. This affects the life of the survivors to a great deal. This paper endeavors to give a critique of a quantitative research study. The research study tries to examine trends in fertility preservation attitudes displayed by pediatric oncology nurses as well as evaluating their degree of awareness on issues to do with fertility preservation. This research study uses the cross-sectional surveys which are applied in gathering information in a population at a single point in time. The study uses independent and dependent variables. The independent variable is attitude that the nurses have towards the fertility preservation while trends in clinical practice on the same serves as a dependent variable.

Strengths

One of the strengths of the research study is the systematic way in which the study is presented. This makes the study to be comprehensive since it becomes easy for one to link ideas. In displaying the steps that were involved in the process, the study exposes the samples, instruments used and the results obtained from the study (Clayton, Quinn, Ji-Hyun, King, Miree, Nieder & Vadaparampil, 2008). This shows that the study was conducted in a chronological manner hence it is easy to understand the content. The aspect of carrying out the study ion an orderly manner is further evidenced by the way the data is presented, the data is presented in a way that observes clarity, the tables are made in such a way that one can easily make inferences. Generally, the study covers all the relevant points in a sound manner and the research is presented in a reader friendly manner.

The study allows for verification. This can be exemplified by the careful use of sources in citations. This is one of the most important elements in any piece of work that may borrow ideas from another source. This shows that the researchers made reference to other sources and most importantly giving the reader a chance to prove the arguments that the author makes in trying to persuade that reader to see his or her point of view or informing the reader. Bryane (2002) notes that readers should be given a chance to prove the ideas that are presented by the author particularly if they have been borrowed from other sources. This is also seen when the authors refers to other research findings to present ideas.

The research methods are practical. The same research can be conducted elsewhere at any given time. The mode in which the study has been conducted is easy hence it enhances the understanding of the readers, this way one is able to make deductions from the findings. Practicability is an important element in any quantitative research work (Bryane, 2002). This is further enhanced by the fact that the findings do not make many assumptions, this increases the likelihood of having accurate results since a big portion of the information is derived from sources.

Weaknesses

The technical terms used in the research study are not explained. Words that are only applied in specific fields need to be explained so that the reader can understand the content well. The use of words without explanation forces the reader to make references to the dictionary hence wasting a lot of time. Some of the technical terms that have been used in the research study and should be explained include oncology, fertility preservations, gonadal and prognosis (Clayton et al., 2008). These terms are not common to other fields of study hence they should be explained. This aspect enhances the understanding of the reader and at the same time serves an important function of saving time.

The issue of carrying out research study for two successive years is not good. It would be ideal to conduct such a research after a time interval of about one year. This will give precise data since the time interval allows for any changes. It would also be appropriate to conduct more than one study so that the inferences can give a close estimate of the exact outcomes. The authors refer to research conducted between 2005 and 2006. The idea of carrying out research more than once ensures that the outcomes have been explored to come up with the final results.

The study would have presented more information if more data collection methods were applied in the research. This is important since it allows comparison of data from the many sources. Although this is time consuming, it allows for the attainment of desired results that observe accuracy. As Bryane (2002) notes, the use of many data collection methods is appropriate since it gives a chance to compare data before compiling final outcomes.

Importance of the research

The research problem under discussion is of great importance to the nursing profession since it acts to enlighten both nurses and trainee nurses on issues surrounding the problem. Although the study does not present points of views of the authors in an effort to see a point of view, it digs deep on the issue of fertility preservation trends in patients with cancer. The study endeavors to show the role of nurses in discussing the fertility preservation options with the patients. The study exposes barriers that come in the way hence interfering with nurse’s discussion with patients on the issue. The identification of this is the very initial step towards coming up with strategies that can help enhance the discussions.

The study establishes the attitude of nurses towards fertility preservation discussions with their patients. This serves as an important aspect in determining what nurses think about the issue in terms of establishing the most effective agents for the discussions; the attitude of the nurses towards the problem exposes their dedication towards making discussions with the patients. Their attitude acts as a basis for decision making in the profession since decisions are made on if the nurses are in a good position to discuss the issue with the patients or if third parties will be needed to carry out the discussions in place of the nurses.

The strengths of the study outweigh the weakness. This is due to the fact that the most important aspects of any research are observed. The main elements of carrying out a quantitative study namely practicability, the issue of presenting it in a chronological manner and the aspect of giving the reader a chance to verify information through citations far outweigh the weaknesses discussed above. This means that the findings of the study are agreeable. The outcomes expose evidence that rotates about the nursing since weaknesses discussed above can be easily overcome. As Bryane (2002) notes, issues like not having explained technical terms can be solved by referring to a dictionary while poor arrangement of data cannot be solved by the reader since the data may be presented in such a way that the readers cannot make inferences.

Critiquing the Study

The title of the study is appropriate since it gives a rough idea of what is to be expected in the study. Bryane (2002) states that the title of any written piece of work needs to have a good title in terms of giving the readers a clue of what to expect in the discussions, he further says that titles whose meaning is not straight forward are not likely to attract the attention of the readers as compared to those that have straight forward meaning. This is because readers read for different purposes. Those who read for academic purposes would not bother much about the title since their main aim is to gain knowledge. On the other hand, readers who read to gain general knowledge would be attracted by the title of the book they read to gain an insight and to be updated with information.

The introductory bit (abstract) summarizes the main ideas in the report. This serves an important role of exposing the main points in the study. This further acts as an attracting force as it attracts the attention of the readers especially those that are interested in the topic. A good introduction is important since it summarizes the main points; moreover, it introduces the topic under discussion. The purpose of the study and the importance are well brought out in the introduction. The authors clearly state the importance of the problem to the nursing profession is well brought out. The research question covers the issue well and it is consistent with the study objectives.

The aspect of using sources that are up to date is evidenced in the study. This ensures that the findings that are presented are current. The primary sources applied give a detailed coverage of the topic by presenting research studies that have been conducted in the recent years concerning the problem at hand as well as the research findings (Clayton et al., 2008). The authors make many references in addressing the issue implying that most of the data that was presented was clearly looked into. Sources that are outdated may provide faulty results especially in cases where the trends of the question under discussion have been changing over the years (Bryane 2002).

The research study used a good sample size. This is because the sample was neither too big nor too small. This makes it easier for the researchers to conduct the study since the sample is easy to handle. The likelihood of having accurate data is high since the size gives the researcher a chance to collect information from the sources. According to Bryane (2002), the sample size is an important element in any research work as it determines how accurate the end results will be, the smaller the sample the higher the chances of attaining accurate outcomes. It is however, important to note that the sample size should neither be too small since this will not provide much information; the nature of the study will determine the sample size to be used. For this particular study, the sample size used was suitable since the nature of the study could allow such a sample to be used.

The data collection method applied was appropriate. The instruments that were used in collecting the data were suitable for evaluating the data hence they could be considered reliable. The issue of having reliable instruments in any research work is important since the outcomes attained are reliable. One can therefore make inferences from the findings without having to carry out more research. The survey instruments used in the study served the important role of measuring three key variables namely practice characteristics, attitude towards the problem by nurses and patient factors. The instruments were appropriate since they measured the three variables appropriately.

The data analyses method conducted in a simplified manner hence it is easier to link the idea with others. The mode in which the data is presented is also good since readers can easily derive conclusions; this is because the data has been presented in an orderly manner hence one can easily tell the implications of certain results. The simplified mode of data presentation enhances the reader’s interest further since complex data makes the readers to lose interest in data because of the complexities involved; this is also because one may waste a lot of time in trying to understand the data. The analyses method used is appropriate since it is economical in as far as time management is concerned. Simplified data is important in any research work as it enables readers to make logical conclusions (Bryane 2002).

Conclusion

The survival rate for patients diagnosed with pediatric cancer has been on the rise over the years. One of the effects of cancer treatment is infertility. Fertility preservation is therefore an important factor in pediatric oncology. The research study addresses the topic under discussion well since it is evident that the authors were well informed on the issue under discussion. Although the study presents some weaknesses, it is evident that the research findings presented are valid. The most important aspects of a study design have been incorporated hence making the study findings coherent.

References

Bryane D. (2002). Interpreting quantitative data. AZ: SAGE. Clayton, H., Quinn, G. P., Ji-Hyun, L., King, L.M., Miree, C. A., Nieder, M., & Vadaparampil, S. T. (2008). Trends in clinical practice and nurse’s attitudes about fertility preservation for pediatric patients with cancer. Oncology Nursing Forum, 35(2), 249-255.

Introduction

Infertility is a common problem in women, but it also affects several men. Normally, infertility is associated with stress and depression among women. Generally, infertility is the inability to conceive or contribute to conception within one year (fertility neighborhood, 2005). According to Lykeridou, et al. (2009 p224), “infertility is described as the fourth most traumatic experience in a woman’s life, compared to death and unfaithfulness of a partner.” In the contemporary world, the rate of infertility continues to increase, forcing many couples to wait for longer periods before conceiving. It is a devastating state, keeping in mind that the chances of infertility increase with age; therefore, most couples result to adopting babies. Statistics indicate that 25% of women between the age of 15- 45 have difficulties conceiving at some point; however, 57% of women experiencing difficulties in conceiving are treated (Fertility Neighborhood, 2005, p.6).

Infertility in Reference of Professionals

The rate of infertility increases due to the change of an individual’s lifestyle; therefore, there is an increase in depression and anxiety among the affected parties. Given that infertility is a shared experience between men and women, there is a tendency for each spouse to assist the other to cope with the situation (Torrez, 2010 p3). According to Omoaregba (2011, p.20), infertility can be a stressful experience, as it is stigmatized in some cultures; in women, it affects their faith, self-esteem, and relationship with spouse, friends, and family.

The common symptoms associated with infertility are psychological, which include depression, anxiety, and even suicide attempts. Stigmatization is common among African cultures who relate infertility with the wrath of gods, therefore a cause of distress for such women (Omoaregba, et al., 2011, p.22). A study conducted in South West Nigeria revealed that there was a high trend of delaying childbearing among the employed women until late reproductive years. Abortion cases were common in this group of women, which contributed to high infertility rates compared to the unemployed women (Omoaregba, et al., 2011, p.23). However, there is an increase in the number of couples seeking treatments globally, with Assisted Reproduction Technology (ART) becoming increasingly popular.

Failure of treatments to provide positive results can be rather stressful. Marriages are also affected by infertility, especially the couple’s sex life. A study conducted on the infertile individuals undergoing fertility treatments proved that most women who experienced infertility were highly educated, and most of them had undergone various therapies in an attempt to conceive. Only 14% of women had one child, the rest were childless. These women experienced higher rates of anxiety even while undergoing the infertility treatments; however, personal, social, marital and trait stress were common in both male and female patients (Lykeridou, et al., 2009, p.231).

To cope with infertility, attachment stability is necessary, which is determined by the relationship between the individual and his/her family and friends (Torrez, 2010, p.24). The author further adds that positive caregiving behavior is important to the patient since it contributes to the development of acceptance and confidence, which are adaptive coping strategies. Omarabad, et al. (2011, p.23) insist that gynecologists should undergo a training program that assists them in dealing with psychological stress in a patient, therefore providing holistic care for infertile patients.

Objectives

1. This two-hour program aims at educating the primary caregivers on the causes and impacts of infertility on the affected.
2. It provides ways of dealing with the affected individual, both medically and emotionally.
3. The primary caregivers should be able to recognize infertility as a medical problem and not a taboo.
4. At the end of this program, the caregivers should be in a position to recognize psychological issues associated with infertility.
5. This professional should involve both spouses while trying to treat the affected spouse.
6. This program aims at educating the caregivers to encourage the patients not to lose hope.

Measurements

1. The above objectives have been measured using both the present and previous questionnaires, evident in the academic journals.
2. The use of surveys is also evident in this study, in finding how frequently patients seek medical assistance without success.

Conclusion

Infertility is a very difficult experience faced by both genders; however, with adaptive coping strategies, an individual can survive this ordeal until she can conceive via the aid of treatments. Assisted Reproductive Technology can result in either a positive outcome or a negative one. In case of a negative outcome, the quality of attachment is necessary to avoid stress. Nevertheless, medical practitioners should provide moral support to such couples, giving them hope for positive results in the future.

References

Fertility Neighborhood. (2005). Infertility defined. Freedom fertility pharmacy. Web.

Lykeridou, K. et al. (2009). The impact of infertility diagnosis on psychological status of women undergoing fertility treatment. Journal of Reproductive and Infant Psychology, 27(3); 223–237. Web.

Omoaregba, J. et al. (2011). Psychosocial characteristics of female infertility in a Tertiary health institution in Nigeria. Annals of African Medicine, 10(1); 19-24. Web.

Torrez, B. (2010). Psychological stress of infertility. UMI Dissertation Publishing. Web.

This paper delves into the areas, patient types, and specialties that comprise my infertility and pain treatment practice. This practice focuses on recognizing, diagnosing, and treating female infertility and pain treatment. The practice involves a fertility doctor who is also a reproductive endocrinologist—a doctor that specializes in reproductive endocrinology and infertility and obstetrics and gynecology. REI is an area of biology that deals with hormonal abnormalities in these women’s fertility and sterility. Furthermore, pain treatment comprises pain relief provided by an osteopathic professional. Although they practice therapeutic pain medicine, many of these doctors are anesthetists or physiatrists. Anesthesiology, neurosurgery, and internal medicine are some of the various clinical specialties engaged in pain management. In addition, the managing care provider at my clinic may refer patients to occupational therapy specialists, caseworkers, or complementary therapy providers for treatment.

This practice is centered on female patients. The first steps in the testing process include a health history and physical examination, including a pelvic exam. The professional will then examine their follicles to discover if they are ovulating frequently and generating ova. Blood tests are used to determine hormone concentrations. Ultrasonography is performed to examine the ovaries and womb, and X-ray scans are utilized to examine the uterine and fallopian lines. Other areas include ovulatory assays, hysterosalpingography, ovarian reserve screening, imaging assays, and hormone diagnostics.

The choices for this practice are critical since long-term administration of certain medicines for pain and distress may disturb female hormone stability and make conceiving difficult. Nonsteroidal anti-inflammatory drugs (NSAIDs) have been associated with ovulation irregularities. NSAIDs function through the enzyme cyclo-oxygenase (COX), which is involved in ovulation. The ovulation route can be disrupted by interfering with COX synthesis and activity. Furthermore, females who have a long history of severe menstrual cramps termed “dysmenorrhea” may take NSAIDs regularly for comfort. Hence, this infertility treatment aims to stimulate the ovaries to produce more eggs than they would ordinarily. Pain management aims to minimize pain rather than eliminate it and improve patients’ functionality and living standards.

Abstract

• Assisted reproductive technology (IVF-ET) can help couples to overcome problems of infertility.
• IVF-ET is complex and risky.
• Success is not always guaranteed.
• Theoretical concepts and outcomes may differ.
• There are ethical and legal issues to consider.

Introduction

• In vitro fertilization and embryo transfer (IVF-ET)has existed for over 30 years.
• Many million babies have been conceived through IVF-ET.
• IVF-ET technology procedure is developed to aid conception in couples for whom other fertility therapies have been unsuccessful or are not possible (Georgia Reproductive Specialists, 2007).
• IVF-ET is complex with multiple steps.
• Every procedure is risky.
• Procedures result in the insemination and fertilization of oocytes (eggs) in laboratory.
• Embryos are placed in uterus for implantation.

Benefit of IVF-ET

• IVF is an elective medical therapy.
• Couples unable conceive may use IVF-ET to develop pregnancy.
• IVF-ET is a costly therapy.
• IVF-ET needs specialists and elaborate laboratory.
• The risk of congenital baby malformation is yet to be determined.

IVF-EF Procedure

• Several hours after insemination, oocytes are examined for pronuclei or potential fertilization.
• Oocytes are further cultured for additional 24 hours.
• Embryo transfer (ET) into the uterine cavity is conducted.
• The women may go home 2 to 3 hours after the procedure (Georgia Reproductive Specialists, 2007).

Procedures & Risks of IVF-EF

• Superovulation:
  • Stimulates egg development to produce several eggs;
  • Multiple eggs enhance chances of embryos (fertilized eggs);
  • Medications are required for superovulation;
  • Medication is administered via injection.
• Risks include:
  • Allergic reactions;
  • Hyperstimulation of the ovaries;
  • failure of the ovaries to respond;
  • Cancellation of the treatment cycle due to some adverse outcomes.
• Ovarian Hyperstimulation Syndrome (OHSS):
  • High-level of estrogen;
  • Excessive fluid retention in the abdomen or chest cavity;
  • Thrombosis of arteries or veins may occur and cause stroke;
  • Excessive enlargement of ovaries.
• Constant monitoring is required and blood samples needed:
  • Pain;
  • Skin infection;
  • Scarring at the point of extracting blood.
• Use intravaginal ultrasound to monitor follicular development.
• Retrieving the Oocytes (egg retrieval):
  • Procedure conducted under transvaginal ultrasound guidance.
• Risks:
  • Negative reactions during drug administration and anesthesia;
  • Risks from the inserted needle.
• Collecting and Preparing the Sperm:
  • Collected through masturbation;
  • It is recommended to abstain for two to five days before specimen collection;
  • Men may experience stress and failure to produce specimen sperm.
• Insemination of Eggs and Embryo Culture:
  • All eggs should be inseminated to enhance the quantity of embryos for transfer;
  • Eggs may not be fertilized;
  • Progesterone is administered to the woman after transfer, but has side effects, including:
    • Vaginal dryness;
    • Bloating, breast tenderness;
    • Depression, mood swings;
    • Delay of menses;
    • Some may cause birth defects (Synthetic progesterone-like medications).
• Transferring Embryos to the Uterus:
  • Transfer may take place after three days;
  • Healthy embryos should be identified;
  • Transfer is done through catheter;
  • Transfer procedure should aim for the uterus;
  • Use medications to increase success rate (DeCherney, 1986; Farquhar, Rishworth, Brown, Nelen, & Marjoribanks, 2013).
• Embryo transfer risks:
  • Mild cramping;
  • Loss through displacement to the cervix;
  • Tubal / ectopic pregnancy due to displacement;
  • Minimal risks of bleeding or infection;
  • Miscarriage.

Theoretical Concerns & Possible Outcomes

• IVF-ET procedure does not guarantee conception or a successful outcome of pregnancy.
• The known reasons for pregnancy failure:
  • Failure of egg development during treatment cycle, premature ovulation, lost egg, pre-existing pelvic condition or technical difficulties;
  • Abnormal eggs;
  • Insufficient semen;
  • Failed fertilization;
  • Failed development of embryos;
  • Difficulties with embryo transfer;
  • External factors, including lab environments (Kovacs, 1999).

Alternatives to IVF-ET

• Couples are unique and thus causes of infertility.
• Consider the following alternatives, which may work or not:
  • Intrauterine insemination (IUI);
  • Medicinal therapy.
• Consult with physician before opting for IVF-ET.

Other Issues with Assisted Reproduction

• Psychological stress.
• Anxiety.
• Disappointment.
• Time and money commitment are required and thus there is need to reduce costs and ensure success (Nargund, 2009).
• Changes in schedule to meet therapy requirements.

Ethical and Legal Issues

• Written consent form is required from patients.
• Couples must choose how to handle any remaining embryos.
• Potential harm to the embryo (Goldworth, 1999).
• Embryos should be destroyed if the couples are dead.
• Nurses and physicians must observe all legal and ethical concerns (Giddens, 2013).

References

DeCherney, A. H. (1986). In vitro fertilization and embryo transfer: a brief overview. Yale Journal of Biology and Medicine, 59(4), 409–414.

Farquhar, C., Rishworth, J. R., Brown, J., Nelen, W. L., & Marjoribanks, J. (2013). Assisted reproductive technology: an overview of Cochrane Reviews. Cochrane Database Syst Review, 8. Web.

Georgia Reproductive Specialists. (2007). IN VITRO Fertilization and Embryo Transfer. Web.

Giddens, J. (2013). Concepts for nursing practice. St. Louis, MO: Mosby.

Goldworth, A. (1999). The Ethics of In Vitro Fertilization. Pediatrics in Review, 20(8), e28 -e31. Web.

Kovacs, G. (1999). What factors are important for successful embryo transfer after in-vitro fertilization? Human Reproduction, 14(3), 590-592. Web.

Nargund, G. (2009). Natural/mild assisted reproductive technologies: Reducing cost and increasing safety. Women’s Health, 5(4), 359–360. Web.

People are now much more concerned about their health than before because of new coronavirus infection. As a consequence of the spread of the disease, rumors, and gossip lead to a great deal of false information. The result can be an increase in distrust of the health care system, an increase in mortality due to not seeking medical care, a decrease in demographics and other indicators (Tsirintani, 2021). Among such news stories are false rumors linking Covid-19 vaccination and infertility: there is a perception that vaccination leads to the formation of immunity, causing a woman’s body to reject the placenta.

Rumors about the link between vaccinations and infertility have lasted for more than six months. Still, a recent gossip was Nicki Minaj’s tweet in which she claims to have caused infertility in one of her acquaintances. According to data from snopes.com, vaccinations do not affect the formation of infertility (Lee, 2021). This opinion was based on incorrect claims that immune cells could mistake the placental protein for a coronavirus protein. It is not possible because of their different nature and the mechanism of action of the vaccines themselves (Fathi et al., 2020). Nevertheless, despite many studies, distrust of vaccination among women of childbearing age and young men remains high.

Dissemination of misinformation under epidemiological stress can lead to unfortunate consequences. A high percentage of false information can increase new cases of coronavirus infection, increasing the number of individuals with severe forms of the disease. Vaccination is designed to build social immunity, so people interested in science and public health can create various informational posters in the workplace or school setting (Tsirintani, 2021). These actions would disseminate reliable information about the vaccine: for example, demonstrating the differences in vaccines, explaining the principle of action, and providing links to studies. Such actions will give insight into vaccinations and avoid spreading new rumors.

References

Fathi, M., Vakili, K., Deravi, N., Yaghoobpoor, S., Ahsan, E., Mokhtari, M., Moshfeghi, M., & Vaezjalali, M. (2020). Coronavirus diseases and pregnancy: COVID-19, SARS, and MERS.Przeglad epidemiologiczny, 74(2), 276–289.

Lee, J. (2021). Do COVID-19 Vaccines Make You Infertile?

Tsirintani, M. (2021). Fake News and Disinformation in Health Care-Challenges and Technology Tools. Studies in health technology and informatics, 281, 318–321.

Infertility is defined as a failed attempt by a couple to try and get pregnant within a year. It can occur in females or males due to different reasons. In men, infertility is mainly caused by sperm problems, including low sperm count, abnormally shaped sperms, and low semen volume. Though only one sperm is required in fertilizing the egg, most sperms are unsuccessful as a result of the hostile acidity of the Vagina. Therefore, for an individual with sperm problems, it may be difficult for the sperm to reach the egg for fertilization hence infertility. For females, infertility is caused by reproductive system problems, such as fibroids and polyps that attack the uterus. These attacks may cause trouble to the production of an egg, making it impossible for it to be made available for fertilization, therefore, making one infertile.

Medical support can intervene to increase the chances of a couple getting a successive pregnancy. First, they should start a program to teach the importance of the overall health of an individual’s infertility. Such practices as maintaining an average body weight can reduce the chances of being infertile (Woo et al., 2019). Too much weight higher the levels of Leptin hormone produced in the fatty tissue leading to disruption of a woman’s fertility. Underweight women also have a significant risk of infertility which may be caused by a hormonal imbalance that affects the process of ovulation. Another precaution the medical support should inform couples is to avoid smoking habits since they also have adverse effects on fertility. Smoking lowers one’s chances of pregnancy and increases the risk of miscarriage for expectant mothers.

Consequently, the medical support staff can give precaution ally measures to the couples when they seek guidance on contraceptives. In some cases, contraceptives contribute to infertility issues, even though it is in very few cases. If not well explained to the couple, the side effects can make the couple make poor decisions on the use of family planning. One of the factors to consider before deciding whether to use it is family history. A couple should be well informed about how the planning has worked before in the family lineage. If it has had other side effects, including infertility, there is a high likelihood that the same will repeat; hence, there is a need to abstain from it.

In my opinion, the technique that I find good to assist in preventing infertility is starting an educational program. The program will help couples to stop practices that may expose them to the risk of infertility. Some teams engage in risky behaviors due lacking guidance against the habit. Some people can ignore such conditions as being overweight and underweight, or they might not be aware of the consequences only to realize them later. It is, therefore, a good idea for all health centers to create awareness among people, especially couples, on the health behaviors that can reduce the causes of infertility. When people cannot conceive despite months of trying, it can be disheartening and frustrating. Infertility is complex and nausea (Woo et al., 2019). She further explained that medical support should intervene and provide the necessary support to the couple who had problems with infertility. Several measures should be taken at the early stages of a couple reporting the incident since, in some cases, it might not be natural and can be managed.

Reference

Woo, I., Zhang, Y., Hui, H., & Mor, E. (2019). Resistant ovary syndrome masquerading as premature ovarian insufficiency. Journal of Clinical Gynecology and Obstetrics, 8(4), 111-113. Web.

Infertility or impaired fertility can be defined as the inability to become pregnant or conceive within the timeframe of one year as a result of unprotected sex. Due to the fact that fertility may become impaired with age, health care providers usually treat women according to this decline after the age of thirty-five and within six months of unprotected sex. Impaired fertility may manifest at a number of stages of a typical pregnancy. Because a pregnancy requires the release of an ovum, fertilization by a sperm, and attachment of an embryo to the inside of the uterus, a number of factors may be responsible for infertility or impaired fertility. Impaired fecundity refers to a condition that relates to infertility but is specific to women who have challenges becoming pregnant or carrying pregnancies to term. Currently, infertility and the inability to conceive affect approximately 15% of all couples (Huether & McCance 807). Additionally, factors that influence infertility may be due to issues in the female pregnancy process, the reproductive system of the male partner, or even in both partners. Within women, around 6% between the ages of fifteen and forty-four can be affected by infertility, while impaired fecundity affects about 12% of the same population.

Because infertility is an issue that may also be a result of conditions in the male partner’s body, cases of impaired fertility are not only a problem faced by the female partner. Some of the ways in which pregnancies may be impeded by male conditions include the disruption of testicular or ejaculatory function, hormonal disorders, or genetic disorders. Many of these conditions cause either the lack or under-production of sperm. Some conditions may even alter the shape of the sperm, which may result in impaired fertility.

Within women, female infertility may occur as the effect of dysfunctions within regular reproductive processes. These can include menses, ovulation, fallopian tube operations, ovarian dysfunctions, or incorrect implantation of a fertilized egg within the receptive endometrium. Disruptions to the ovarian system can include polycystic ovary syndrome, limited ovarian reserves, menopause, premature ovarian insufficiency, or even functional hypothalamic amenorrhea. The aforementioned conditions often affect the ways in which hormones and ovarian reserves can become ineffective or insufficient, thereby limiting the chances of a successful pregnancy. Fallopian tube obstructions may manifest through conditions such as pelvic infections, ruptured appendicitis, a history of gonorrhea or chlamydia, or previous abdominal surgeries. The physical features of the uterus are also likely to play a role in impaired fertility, as any abnormal uterine contours obstacles to fertilization.

In the case that a couple decides to treat infertility or impaired fertility, health care providers recommend the simultaneous use of medication and intrauterine insemination. Additionally, the specific treatments are decided by a number of factors which include the factors contributing to the condition, the duration of infertility, the age of the female partner, and the preference of the couple after counseling and discussion concerning rates, benefits, and risks. Male-specific treatments usually include medical, surgical, or assisted reproductive therapies. Female-oriented infertility medication usually involves ovulation stimulants, follicle stimulation, or even ovulation-preventing hormones in the case that a woman is being treated by in-vitro fertilization. Some medication also addresses the high rates of testosterone and lowers them in women, such as those that have polycystic ovary syndrome, which can cause impaired fertility. Further, the couple may use assisted reproductive technology for a potentially successful pregnancy.

Reference

Huether, S. E., & McCance, K. L. (2019). Understanding Pathophysiology. Elsevier Health Sciences.