1. Al-ghad international collages - Kingdom of Saudi Arabia - Tabuk* * Girls

2. Fatima Alkhebari Ra’edah Alshahrany Ms. Fatimah Dr. mary Infertility

3. Outlines:  Objective  Introduction of infertitily.  Definition of infertitily.  Types of infertility.  Causes of male and female.  Risk factors  Complications  Management.  Summary.  References.

4. Objective: At the End of this lecture the students nurse will be learn to : Define the infertitily. Define the types of infertility. Explain the causes of infertitily. To Know of risk factors. To know the Complication and management.

5. :introduction  Significant social and medical problem affecting couples worldwide:  Average incidence of infertility is about 15% globally. - varies in different populations.  Some causes can be detected and treated, whereas others cannot. - unexplained infertility constitutes about 10% of all cases.

6. Definition:  Infertitily: Is defined as a couple’s inability to achieve pregnancy after 1year of unprotected intercourse ( Hatcher et al 2011)

7. Types of infertility:  Primary infertility: - refers to a couple who has never had a child.  Secondary infertility: - means that at least one conception has occurred, but currently the couple cannot achieve a pregnancy.

8. Causes: Female: Male: Age Tobacco Stress Poor diet Overweight Underweight Medications. Infection cervix Age Tobacco Drugs Radiation Chemotherapy Alcohol Enviromental factors: - pesticides - lead

10. Risk factors: Age Tobacco use Alcohol use Being overweight Being underweight Exercise issues. Lack of or not enough exercise contributes to obesity, which increases the risk of infertility.

11. Complications:  Multiple pregnancy  Ovarian hyperstimulation syndrome (OHSS) - ovaries may enlarge and cause pain and bloating - higher risk in polycystic ovarian syndrome (PCOS) women  Bleeding or infection  Low birth weight  Birth defects

12. Management:  Treatment of the cause -Avoid alcohol, tobacco and drugs. -Avoid over weight and under weight. -Limit medications. -Eat a balanced diet. -Avoid excessive heat to the testes.  Artificial insemination (intrauterine insemination / intra cytoplasmic injection) (IUI/ICSI)

13.  Ovulation induction The WHo classifies ovulation disorders into 3 groups:‏ 1. Group I: hypothalamic pituitary failure (hypothalamic amenorrhoea or hypogonadotrophic hypogonadism ).‏ 2. Group II: hypothalamic-pituitary-ovarian dysfunction (predominately polycystic ovary syndrome).‏ 3. Group III: ovarian failure  IVF/ICSI (in vitro fertilization / intra cytoplasmic injection) is a process by which the oocyte is fertilized by a sperm outside the body: in vitro, and then a gamete retransferred intrauterine

14. Nursing management Encourage client to express feelings and thoughts about self fertility and infertility. Review and reinforce with client positive attributes about self. Clarify any misconceptions client may have about fertility and infertility. Assist with measures to increase independent role functioning and encourage active participation in decision making

16. IVF

17. Infertility is a significant social and medical problem affecting couples wordwide. Female and male factors are equally responsible. Treatment depends on the cause of infertility. Summary:

18. :References