NURS 2866 Ch. 5 - Infertility, Contraception, and Abortion

Infertility affects how many couples?

1 in 4 couples.

What defines infertility in women <35 years old?

Inability to conceive after 1 year of regular, unprotected intercourse.

What defines infertility in women ≥35 years old?

Inability to conceive after 6 months of regular, unprotected intercourse.

Name some female factors affecting infertility.

Developmental anomalies, lack of ovulation, medications, endometriosis, nutritional deficiencies,

obesity, thyroid disorders.

Name some male factors affecting infertility.

Drug/substance abuse, obesity, endocrine disorders, congenital disorders, trauma, environmental toxins, STIs.

What hormone function is needed in both partners for fertility?

Intact hypothalamic-pituitary-gonadal hormone function.

How long can sperm survive in the reproductive tract?

3–5 days.

How long is the ovum viable after ovulation?

12–24 hours.

When is the best time for intercourse for conception?

Day before and day of ovulation.

How often should couples trying to conceive have intercourse?

2–3 times a week.

What assessments are involved in infertility evaluation?

Height, weight, appearance, STI/reproductive history, labs.

What is a semen analysis?

A test measuring sperm motility, survival, and ovum penetration ability.

How often is semen analysis done?

Minimum of 2 analyses, several weeks apart.

What psychosocial effects can infertility have?

Affects self-esteem, relationships, and career; emotional support is crucial.

What are examples of non-medical infertility treatments?

Healthy lifestyle changes, exercise, reduce alcohol/nicotine/drug use.

What is the focus of medical infertility treatments?

Correcting ovulation dysfunction and stimulating ovulation.

What do surgical infertility treatments depend on?

The underlying cause of infertility.

What are ARTs?

Assisted reproductive therapies involving egg and sperm handling.

Name types of ARTs.

Egg retrieval, IVF, embryo transfer, surrogacy.

When might adoption be considered?

If ARTs fail or couple chooses not to pursue them.

What is contraception?

Intentional prevention of pregnancy.

What is birth control?

Devices/practices used to prevent conception.

What is included in contraceptive care management?

Assess history, physical exam, labs; discuss preferences and barriers.

What is coitus interruptus?

Withdrawal before ejaculation; no STI/HIV protection.

What are fertility awareness methods (FAMs)?

Tracking fertile window with charts, records, and observations.

Pros and cons of FAMs?

Pros - no cost/hormones. Cons - strict adherence needed, no STI protection.

Failure rate of FAMs?

Around 24% in the first year.

What are spermicides?

Chemicals that reduce sperm mobility; inserted ≤1 hour before sex.

Failure rate of spermicides?

15–29%.

How often must spermicide be reapplied?

For each act of intercourse.

What do condoms do?

Prevent sperm from entering cervix; some protect against STIs.

What is a diaphragm?

Latex/silicone device fitted over cervix; inserted ≤6 hours before sex.

How often must a diaphragm be refitted?

Annually or with weight change/childbirth.

What is a cervical cap?

Silicone cap that fits around cervix; stays in for 6–48 hours.

Risks of cervical cap?

Higher risk of toxic shock syndrome.

What is the contraceptive sponge?

Polyurethane sponge with spermicide; wet before use.

How long can the sponge stay in?

6+ hours up to 24–30 hours.

Hormonal contraception includes what?

Combined estrogen-progestin and progestin-only methods.

What can reduce effectiveness of oral contraceptives?

Anticonvulsants, antifungals, anti-TB, anti-HIV meds.

What does ACHES stand for?

Abdominal pain, Chest pain/SOB, Headaches, Eye problems, Severe leg pain.

Where is a transdermal patch applied?

Abdomen, buttocks, upper torso (not breasts); weekly change.

How is a vaginal ring used?

Inserted for 3 weeks, removed for 1 week.

What is the minipill best for?

Lactating women and women >40 years.

How often are injectable contraceptives given?

Every 11–13 weeks IM or SubQ.

How long do implant contraceptives last?

3+ years.

When is emergency contraception used?

After condom break, sexual assault, missed birth control.

When is emergency contraception most effective?

Within 72 hours (some up to 120 hours).

Is emergency contraception OTC?

Yes, for those ≥17 years old; some require prescriptions.

What is an IUD?

T-shaped device inserted in uterus with strings for self-check.

IUD risks?

Increased risk of pelvic inflammatory disease within first 20 days.

What is sterilization?

Permanent contraception; occlusion of fallopian tubes or vas deferens.

What guarantees absolute sterility in females?

Removal of ovaries or uterus.

What is abortion?

Termination of pregnancy before 20 weeks.

Types of abortion?

Elective (by choice), Therapeutic (for health reasons).

What care is involved in abortion management?

Labs, gestational age, Rh status.

Why is RhoGAM given post-abortion?

To Rh-negative women within 72 hours to prevent isoimmunization.

What is a first-trimester surgical abortion?

Aspiration with local anesthesia.

Post-op warning signs of aspiration abortion?

Fever, chills, foul discharge, heavy bleeding, increased pain.

What meds are used in medical abortion?

Misoprostol (induces contractions) and Mifepristone (blocks progesterone).

Side effects of misoprostol?

Nausea, vomiting, diarrhea, fever, dizziness.

What is a second-trimester abortion method?

Dilation and evacuation (D&E).

Risks of second-trimester abortion?

Long-term cervical damage, future pregnancy complications.

What are nursing considerations for abortion?

Educate about options, procedure, aftercare; offer emotional support.