1. Causes of Infertility in Men and Women By: Tammy, Merissa, and Heather For Nursing 519 Unit 6

2. Infertility…an overview Infertility is defined as the inability to conceive after 1 year of unprotected sex. Infertility is defined as the inability to conceive after 1 year of unprotected sex. Infertility affects approximately 15% of couples (McCance &Huether, 2006). Infertility affects approximately 15% of couples (McCance &Huether, 2006).

3. Infertility in Men Male factors influencing infertility include decreased production and quality of sperm as well as impaired delivery of sperm (McCance & Huether, 2006). Male factors influencing infertility include decreased production and quality of sperm as well as impaired delivery of sperm (McCance & Huether, 2006). Decreased production and quality of sperm include the following factors: Impaired shape and movement of sperm, low sperm counts, varicocele, or infection (Mayoclinic.com, 2007). Decreased production and quality of sperm include the following factors: Impaired shape and movement of sperm, low sperm counts, varicocele, or infection (Mayoclinic.com, 2007).

4. In men, hyperthyroidism can decrease production and motility of sperm, in comparison to women, where hypothyroidism can decrease fertility (McCance & Huether, 2006). In men, hyperthyroidism can decrease production and motility of sperm, in comparison to women, where hypothyroidism can decrease fertility (McCance & Huether, 2006). Impaired delivery of sperm may include the following factors: Blockage of the epididymis or ejaculatory ducts, hydrospadias, or anti-sperm antibodies (Mayoclinic.com, 2007). Impaired delivery of sperm may include the following factors: Blockage of the epididymis or ejaculatory ducts, hydrospadias, or anti-sperm antibodies (Mayoclinic.com, 2007).

5. Health and lifestyle factors such as stress, drug or alcohol abuse, and a history of radiation to the testicles impact male fertility (Mayoclinic.com, 2007). Health and lifestyle factors such as stress, drug or alcohol abuse, and a history of radiation to the testicles impact male fertility (Mayoclinic.com, 2007). In addition, a history of STDs, smoking, and chemical exposure are other factors that may impact male fertility (McCance & Huether, 2006). In addition, a history of STDs, smoking, and chemical exposure are other factors that may impact male fertility (McCance & Huether, 2006).

6. Infertility in Women Common Causes of Infertility in Women Common Causes of Infertility in Women Retrieved from Fertility.com Retrieved from Fertility.com Retrieved from Fertility.com

7. Polycystic Ovarian Disease (PCOD) In POD, ovaries become enlarged. They have a smoother and thicker layer than nondiseased ovaries. They are covered with small cysts, which may cause amenorrhea or infrequent menstrual cycles (Cooper, 2007). In POD, ovaries become enlarged. They have a smoother and thicker layer than nondiseased ovaries. They are covered with small cysts, which may cause amenorrhea or infrequent menstrual cycles (Cooper, 2007).

8. POD can be classified into three categories: POD can be classified into three categories: Mild – women with mild POD may take longer to conceive, but can conceive nevertheless. They have normal ovulation. There is an increased incidence of spontaneous miscarriage associated with Mild POD. Mild – women with mild POD may take longer to conceive, but can conceive nevertheless. They have normal ovulation. There is an increased incidence of spontaneous miscarriage associated with Mild POD.

9. Moderate – These women do not ovulate or have infrequent cycles. They will have amenorrhea. Moderate – These women do not ovulate or have infrequent cycles. They will have amenorrhea. Severe – No menses present. Women are infertile. These women are usually obese and display hirsutism (facial hair) (Cooper, 2007). Severe – No menses present. Women are infertile. These women are usually obese and display hirsutism (facial hair) (Cooper, 2007).

10. An over production of luteinizing hormone by the pituitary gland causes abnormally high levels of androgens in the body, specifically testosterone. An over production of luteinizing hormone by the pituitary gland causes abnormally high levels of androgens in the body, specifically testosterone. According to Wikipedia.com, “a majority of patients with PCOS have insulin resistance and/or are obese. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS” (2009). According to Wikipedia.com, “a majority of patients with PCOS have insulin resistance and/or are obese. Their elevated insulin levels contribute to or cause the abnormalities seen in the hypothalamic-pituitary-ovarian axis that lead to PCOS” (2009).

11. Endometriosis Endometriosis occurs when the endometrium proliferates, spreading into the pelvis. Infertility occurs when it implants onto the pelvic floor causing obstruction with adhesions. It may cause damage to the fallopian tubes and ovaries. Women with this disorder may have very painful, heavy and long menses. Interestingly, the amount of symptoms present is not reflective of the degree of disease present (Cooper, 2007). Endometriosis occurs when the endometrium proliferates, spreading into the pelvis. Infertility occurs when it implants onto the pelvic floor causing obstruction with adhesions. It may cause damage to the fallopian tubes and ovaries. Women with this disorder may have very painful, heavy and long menses. Interestingly, the amount of symptoms present is not reflective of the degree of disease present (Cooper, 2007).

12. The exact cause of endometriosis is unknown. It is hypothesized that several etiologies could lead to the disease including increased estrogen levels, retrograde menstruation, lymphatic or vascular distribution, immune system dysfunctions and genetic factors (endometriosis.org, 2007). The exact cause of endometriosis is unknown. It is hypothesized that several etiologies could lead to the disease including increased estrogen levels, retrograde menstruation, lymphatic or vascular distribution, immune system dysfunctions and genetic factors (endometriosis.org, 2007).

13. Pelvic Inflammatory Disease (PID) PID is usually caused by sexually transmitted diseases like Chlamydia and Gonorrhea. PID is the main cause of tubal infertility because mucus is altered in the tubes and adhesions and obstructions are formed (Cooper, 2007). PID is usually caused by sexually transmitted diseases like Chlamydia and Gonorrhea. PID is the main cause of tubal infertility because mucus is altered in the tubes and adhesions and obstructions are formed (Cooper, 2007).

14. A question to ponder… What role can NPs play in assisting couples experiencing infertility? What role can NPs play in assisting couples experiencing infertility?

15. References Cooper, M. (2007). Female infertility: pathophysiology. Practice Nursing, (18)12. 611-614. Cooper, M. (2007). Female infertility: pathophysiology. Practice Nursing, (18)12. 611-614. Denson, V. (2006). Diagnosis and management of infertility. American College of Nurse Practitioners, (2)6. 380- 386 Denson, V. (2006). Diagnosis and management of infertility. American College of Nurse Practitioners, (2)6. 380- 386 Endometriosis.com (2007). What causes endometriosis? Retrieved February 10, 2009, from http://www.endometriosis.org/causes.html Endometriosis.com (2007). What causes endometriosis? Retrieved February 10, 2009, from http://www.endometriosis.org/causes.html http://www.endometriosis.org/causes.html Fertility.com (2008). PCOD: Polycystic ovary disease. Retrieved February 10, 2009, from http://www.fertility.com/international/concern/Inferti lity_in_Females/Ovulatory/Polycystic_Ovary_Disease.j sp Fertility.com (2008). PCOD: Polycystic ovary disease. Retrieved February 10, 2009, from http://www.fertility.com/international/concern/Inferti lity_in_Females/Ovulatory/Polycystic_Ovary_Disease.j sp http://www.fertility.com/international/concern/Inferti lity_in_Females/Ovulatory/Polycystic_Ovary_Disease.j sp http://www.fertility.com/international/concern/Inferti lity_in_Females/Ovulatory/Polycystic_Ovary_Disease.j sp

16. References continued Mayoclinic.com (2007). Infertility. Retrieved February 9, 2009 from http://www.mayoclinic.com/health/infertility/DS0031 0/DSECTION=causes Mayoclinic.com (2007). Infertility. Retrieved February 9, 2009 from http://www.mayoclinic.com/health/infertility/DS0031 0/DSECTION=causes http://www.mayoclinic.com/health/infertility/DS0031 0/DSECTION=causes http://www.mayoclinic.com/health/infertility/DS0031 0/DSECTION=causes McCance, K., & Huether, S. (2006). Pathophysiology: The biologic basis for disease in adults and children. (5th ed.). St. Louis, MI: Elsevier Mosby. McCance, K., & Huether, S. (2006). Pathophysiology: The biologic basis for disease in adults and children. (5th ed.). St. Louis, MI: Elsevier Mosby. Wikipedia. (2009, February). Polycystic ovary syndrome. Retrieved February 10, 2009, from http://en.wikipedia.org/wiki/Polycystic_ovary_syndro me#Pathogenesis Wikipedia. (2009, February). Polycystic ovary syndrome. Retrieved February 10, 2009, from http://en.wikipedia.org/wiki/Polycystic_ovary_syndro me#Pathogenesis http://en.wikipedia.org/wiki/Polycystic_ovary_syndro me#Pathogenesis http://en.wikipedia.org/wiki/Polycystic_ovary_syndro me#Pathogenesis