Introduction
Infertility is a serious health problem affecting millions of individuals of reproductive age. According to the 2021 World Health Organization Report on Fertility, approximately 180 million individuals and 48 million couples suffer from infertility worldwide (Carson & Kallen, 2021). W.H.O. defines infertility as a condition in which a female or a male reproductive system fails to achieve pregnancy after a series of unprotected sex (WHO, 2020). Infertility has severe social and health impacts on infertile individuals, particularly women. Infertile women often experience depression, low self-esteem, emotional stress, violence, social stigma, violence, divorce, and emotional stress that adversely affect their well-being. There is a need to improve the standard of care to help people living with infertility become fertile. The increasing number of individuals and couples with infertility calls for evidence-based care to implement an effective intervention plan to prevent and treat infertility.
Pathophysiology
Various factors can lead to infertility. The causes can be categorized into environmental or personal factors. The common known risk factors for infertility in all genders include age (40 for men and 35 for women), health conditions (diabetes, bulimia, anorexia disorder, stress, S.T.D.s, and obesity), exposure to toxins like pesticides and lead, smoking and substance abuse (Rooney & Domar, 2018). Moreover, there are risk factors that are common among females. These include damaged fallopian tubes, abnormal menstruation, kidney disease, celiac disease, pelvic inflammatory disease, sickle cell anemia, thyroid disease, and pituitary gland disorder. When it comes to males, the main risk factors include varicocele, cystic fibrosis, exposing testicles to high heat, injury to the testicles or scrotum, hypogonadism, misuse of steroids, and premature ejaculation.
Treatment Options
For female infertility, the healthcare provider will ask various questions and perform multiple tests. The common tests include a pelvic exam to assess the structural issues and a blood test. Other tests include a transvaginal ultrasound and a hysteroscopy to examine problems with the uterus. In men, tests such as semen analysis, blood tests, and scrotal ultrasounds are done to avoid problems with sperm, testosterone, and other testicular issues.
After diagnosis, infertility is treated either through surgery or medication. Medication involves prescribing fertility drugs that stimulate ovulation in women and raise testosterone in men. Surgery can include opening blocked fallopian tubes and removing uterine polyps and fibroids in women. According to a study by the Centers for Disease Control and Prevention (C.D.C.)., surgical treatment of endometriosis in women doubles their chance of conception (Shreffler et al., 2018). When it comes to men, surgery involves opening blocked tubes that carry and store sperm.
There are also fertility treatment options for all genders; these include intrauterine insemination (IUI), In vitro fertilization (IVF), Intracytoplasmic sperm injection (ICSI), and Third-party A.R.T. Intrauterine insemination (IUI) involves using a long tube to insert sperm directly into the uterus. In vitro fertilization (IVF) involves harvesting the eggs after stimulation and putting the egg together with the sperm in a lab container to allow for fertilization after the fertilized egg is transferred into the uterus (Kuroda et al., 2018). ICSI involves transferring an embryo into the uterus and third-party A.R.T. where couples decide to use donor embryos, donor sperm, or donor eggs.
Best Practices and Standards Related to the Disease Management
The Center for Disease control and Prevention (C.D.C.) has published various guidelines to help individuals, especially women, maintain or regain their lost fertility. These practices include maintaining a healthy weight, quitting smoking, avoiding alcohol, and reducing stress. Being underweight and overweight in men and women increases the risk of infertility (Kuroda et al., 2018). There is a need for individuals to exercise moderately to maintain their fertility. Moreover, tobacco smoking has various negative impacts on fertility, and it is advisable for individuals who smoke to quit if they want to remain sexually active and fertile (Kuroda et al., 2018). Individuals must also avoid alcohol, as heavy alcohol use is associated with decreased fertility.
Infertility management requires that an individual sets management objectives. These objectives include diagnosing any root cause of infertility, offering an accurate prognosis, and providing psychotherapy, care, and information. Nurse practitioners can counsel the patient concerning S.T.I. prevention and encourage them to seek medication as soon as possible when they suspect they have S.T.I. Moreover, informing the patient about the associated complications significantly improves the patient’s treatment adherence (Carson & Kallen, 2021). Furthermore, the nurse must notify the patient of the association between overweight and infertile. Excess weight, especially in men, is associated with problems in sperm production. Therefore, individuals must maintain a healthy weight and overcome smoking and alcohol addiction.
Conclusion
Infertility is a global health issue affecting millions of men people around the world. It is a medical condition associated with physical, emotional, and psychological problems. An evidence-based approach to infertility care can significantly help prevent, treat, and manage infertility. By implementing evidence-based practice, healthcare organizations can identify the root causes and the best healthcare interventions that can be used to diagnose and treat infertility, such as surgical procedures, medicines, and assisted conception.
References
Carson, S. A., & Kallen, A. N. (2021). Diagnosis and management of infertility: A review. Jama, 326(1), 65-76.
Kuroda, K., Brosens, J. J., Quenby, S., & Takeda, S. (Eds.). (2018). Treatment strategy for unexplained infertility and recurrent miscarriage (pp. 79-84). Singapore: Springer.
Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in clinical neuroscience, 20(1), 41–47. Web.
Shreffler, K. M., Gallus, K. L., Peterson, B., & Greil, A. L. (2020). Couples and infertility. The handbook of systemic family therapy, 3, 385-406. Web.