fertility

By: Janice P. Casumpang R.N.

Nihma S. Ilimin R. N.
Realiza T. Dia R. N.
Pamela Santos R.N.
Fertility
The ability to conceive and have
children, the ability to
become pregnant through normal
sexual activity. Infertility is defined as
the failure to conceive after a year of
regular intercourse without
contraception.
Understanding Your Monthly Cycle
The first phase starts with the first day of your period.
Your body releases hormones that stimulate eggs to
grow within follicles inside your ovaries. Between day
7 and 11, those hormones also help thicken the lining
of your uterus to get ready for the implantation of a
fertilized egg.
At the moment of ovulation, the
egg emerges from a ripe follicle.
What Happens During Ovulation
Most women have a cycle of between 26
and 30 days long. On average, if
ovulation happens it does so between 11
and 21 days after your last period,
although it can be different for every
woman. A brain hormone called
luteinizing hormone (LH) surges,
triggering the release of the egg that's
most ripe. At the same time, your
cervical mucus changes to a slippery,
egg-white consistency, to help sperm to
make their way to the egg.
It's All in the Timing
Women are born with about 1 million eggs, but only
300 to 400 will be released through ovulation. Usually
just one egg is released each month. The egg travels
down the fallopian tube toward the uterus, where it's
ready to be fertilized. The egg only lives about 12 to 24
hours. Sperm can live for about 3 to 5 days, so knowing
you're due to ovulate soon can help you and your
partner plan sex for when you're most likely to
conceive.
Tracking Your Most Fertile Days
Generally, most women are fertile during the days just
before and during ovulation. If you have a regular 28-
day cycle, count back 14 days from when you expect
your next period to start. Plan on having sex every
other day around that day -- say days 12, 14, and 16
(having sex every day may decrease a man's sperm
count). Your cycle may be longer or shorter, so using
an online ovulation calculator may help identify the
likely day
Tracking Ovulation By Temperature
After an egg is released, what's left of the follicle -- the
corpus luteum -- releases the hormone progesterone
to help thicken the lining of the uterus and maintain a
pregnancy. Progesterone causes your body
temperature to go up slightly. Taking your temperature
every morning with a basal thermometer (about $10 at
drugstores) before getting out of bed is one way to
track ovulation. It's inexpensive, but not as accurate as
other methods
Tracking Ovulation by Hormone
A surge in LH is what triggers the egg to be released
from your ovaries. If you know about when you should
be ovulating, using ovulation kits (from $20 to $50) to
check LH levels in your urine can help you pinpoint
the day of ovulation. These kits are more expensive
than basal thermometers but provide more accurate
timing and may be more convenient.
The Last Phase Of Your Monthly Cycle
The lining of your uterus thickens to get ready for a
fertilized egg to implant. If the egg isn't fertilized, it
disintegrates and about 12 to 16 days later, it -- along
with blood and tissues from the lining of the uterus --
is expelled. That process, which usually lasts 3 to 7
days, is menstruation. Then the cycle begins again.
Foods That Boost Ovulation
Choose monounsaturated fats (like olive oil) over trans fats
(those in fast food and baked goods); vegetable protein (soy)
over red meat; and high-fiber, low-glycemic foods -- whole
grains, veggies, and some fruits -- over refined carbs and
sugars. Ice cream lovers take note: A moderate amount of
high-fat dairy products (ice cream, whole milk, and cheese)
may help increase female fertility
If you have problems ovulating, is your diet responsible?
If either of you are overweight, it can be harder
to get pregnant.
Weight Affects Fertility
Being overweight or underweight can make it harder
to get pregnant. A study of women found that those
whose body mass index (BMI) was above normal took
twice as long to get pregnant as those with a normal
BMI. In men, those who are obese are more likely to
have low testosterone. According to a researcher at
the National Institutes of Health, a 20-pound weight
gain can boost infertility chances by 10%
How long should you try before
talking to a doctor?

Age Affects Your Conception Chances

A woman's decline in fertility starts around age 30. Experts
say a woman should talk to her doctor if she's under 35 and
has been trying to conceive for more than 12 months, or is
over 35 and has been trying to conceive for more than 6
months. An FSH hormone test can evaluate your ovarian
reserve, or egg supply, which is one indicator of your
potential to get pregnant. The test is available over-the-
counter or from your doctor.
Men's decline in fertility is more
gradual compared to women's.
Fertility Declines in Older Men, Too
Studies show that sperm count and motility
(movement) usually decrease as men age. One study
found that it took men age 45 or above longer to
achieve a pregnancy once the couple started trying to
conceive. If your partner is older, you may want to talk
to your doctor about ways to boost your chances of
conception
Don't forget to consider the man's
health
How Men Can Boost Fertility
Managing stress, avoiding alcohol and tobacco,
maintaining a proper weight, and eating a diet high in
zinc (found in meat, whole grains, seafood, and eggs),
selenium (meat, seafood, mushroom, cereals, and
Brazil nuts) and vitamin E can improve male fertility.
So can keeping the testicles cool -- no long hot baths,
hot tubs, or saunas, which can decrease the number of
sperm
Many couples who struggle with infertility
can conceive with treatment
Treatments for Infertility
A number of factors can cause infertility, so the first
step is for your doctor to evaluate you and your
partner. Infertility treatments can include taking
fertility drugs to stimulate ovulation and in vitro
fertilization, which involves removing eggs from the
ovaries, fertilizing them (shown at left), and then
implanting them back into the uterus
An egg usually implants in the uterus 6
to 10 days after fertilization
How Home Pregnancy Tests Work
Home pregnancy tests check your urine for the
"pregnancy hormone," called hCG, that your body
produces once a fertilized egg implants in your uterus.
Usually a home pregnancy test can tell if you're
pregnant as early as 5 days before your first missed
period. You can get a false negative if you test too early,
so repeat the test a few days or a week later. Your
doctor can provide more accurate results with a blood
test
What changes might indicate I'm
pregnant?
5 Early Signs
You miss a period.
You need to urinate frequently.
You tire easily.
You're nauseous in the morning – or all day.
Your breasts become tender and enlarged.
EXHIBITION
“UNDERSTANDING
INFERTILITY”
What is
infertility?
“Infertility is failure to
conceive within one or more
years of regular unprotected
coitus”
TYPES OF INFERTILITY

Primary Infertility
Secondary Infertility
INCIDENCE OF INFERTILITY
Worldwide 8-15% of
couples suffer some
form of infertility
problems
Male factor(30%)
Female factor(30%)
Both factors (30%)
Unexplained
factors(10%)
PRIMARY INFERTILITY
It denotes
those
patients who
have never
conceived.
SECONDARY INFERTILITY
It indicates previous
pregnancy ,but
failure to conceive
subsequently.
CAUSES OF
INFERTILITY?
 CAUSES IN MALES
Defective
spermatogenesis
Obstruction of the
efferent duct
system
Failure to deposit
sperms high in the
vagina
Errors in the seminal
fluid
It is caused due to
Congenital causes ,namely,
Undescended testes
Hypospadias
Thermal factors
Infection
Genetic factors
Endocrine factors
Iatrogenic
Immunological factors
 CAUSES IN FEMALES
OVARIAN FACTORS:-
Anovulation or oligo –
ovulation
Luteal phase defect
Lutetinised unruptured
follicle
TUBAL FACTORS
PERITONEAL FACTORS
UTERINE FACTORS
CERVICAL FACTORS
VAGINAL FACTORS
COMBINED FACTORS
obesity
COITAL PROBLEMS
INVESTIGATIONS
OF INFERTILITY
WHEN TO INVESTIGATE
?
Infertile couple should be
investigated after 1 year
of regular unprotected
exposure with adequate
frequency.

After the age of 35 years

in women & 40 years in
man ,interval is
shortened to 6 months.
INVESTIGATIONS IN MALES
History
Examination
Routine investigation
Semen analysis
Hormonal assay
Testicular biopsy
Transrectal USG
Karyotype analysis
Immunological tests
Diagnostic
laparoscopy
 DEFECTIVE SPERMATOGENESIS
It is caused due to
Congenital causes ,namely,
Undescended testes
Hypospadias
Thermal factors
Infection
Genetic factors
Endocrine factors
Iatrogenic
Immunological factor