SCHOOL OF HEALTH AND ALLIED HEALTH SCIENCES

Nursing Department

SELF-DIRECTED LEARNING (NUR 146 - CLINICAL AREA)

Name: Cumayas, Divine Grace N. Group: _____ Date: 03/18/2021

I. Identify the terms described below.

Subfertility 1. It is the inability to conceive after at least 1 year of engaging in unprotected
coitus.
Infertility 2. The couple cannot conceive a child at present but has had previous viable
pregnancy.
Seminogram 3. It evaluates certain characteristics of a male's semen and the sperm
contained therein.
Anovulation 4. Absence of ovulation and it is the most common cause of subfertility in
women.
Polycystic ovarian syndrome (PCOS) 5. It is the most frequent cause of anovulation.

II. Briefly describe the following subfertility assessments:

1. Semen Analysis

A complete semen analysis measures the quantity and quality of the fluid released
during ejaculation. It evaluates both the liquid portion, called semen or seminal fluid, and
the microscopic, moving cells called sperm. It is often used in the evaluation of male
infertility.

2. Ovulation Monitoring

Detection and monitoring of ovulation has long been practiced by women pursuing or
avoiding pregnancy. The fertility window begins approximately 3–5 days (sperm lifespan)
before ovulation and continues to a point approximately 1–2 days (oocyte lifespan) after
ovulation. Identifying this window, rather than simply identifying or detecting ovulation, is
vital for encouraging or discouraging contraception. For physicians or women who wish to
know if a menstrual cycle is normal or to evaluate ovarian function, a test that
retrospectively confirms ovulation should suffice, but for artificial reproductive techniques,
the time of ovulation and the fertility window must be defined clearly.

3. Tubal Patency

Tubal patency is when a woman's fallopian tubes are not blocked. Tubal patency is
determined by an x-ray test called a hystero-(uterus)salpingo-(fallopian tube)graphy (HSG).
HSG is a standard radiological imaging study that is used to determine if the fallopian tubes
are open and free of disease. It is commonly done in women with an infertility diagnosis.
The investigators usually do this test in the first 10 days of the menstrual cycle. Sometimes
the tubes will appear to be blocked on the HSG when they are actually open. The timing of
the HSG study during the menstrual cycle, or the use of hormonal contraception may make
a difference in whether the tubes appear blocked on the HSG when they are actually patent.

III. What measures (at least 5) may be appropriate for a man to take to increase
his sperm count?
 Exercise regularly
 Get enough vitamin C
 Relax and minimize stress
 Avoid substance abuse
 Check your environment

IV. Discuss how the following measures affect ovulation among women.

1. Nutrition

Poor intake of proteins, micro and macro-minerals and vitamins is associated with
reduction in reproductive performance since the altered energy balance is directly correlated
to the reduced ovulatory maturation in women. Thus, inadequate nutrition is closely linked
to female reproductive pathophysiology.

2. Body Weight
 Being underweight (BMI under 18.5) can reduce a woman's fertility by causing
hormone imbalances that affect ovulation and the chance of getting pregnant. Compared to
women in the healthy weight range, women who are underweight are more likely to take
more than a year to get pregnant.

2. Exercise

For overweight and obese women with PCOS regular exercise can increase the
frequency of ovulation which leads to more regular menstrual cycles. As ovulation becomes
more frequent, the chance of conceiving increases.

V. Explore the facilities in your city/place to which you might refer clients with
subfertility/infertility problems (e.g., sperm or egg banks, infertility clinics, and
adoption agencies)

In our city, there’s no clinic related to reproductive health. But the nearest
reproductive health clinic is Repro Optima in Cebu City which offers IN-VITRO Fertilization
(IVF), Intrauterine Insemination (IUI), Assisted Fertilization (ICSI),and Surgical Sperm
Retrieval (MESA, TESE).