Nursing 209

N209: Reproductive Health Study Guide because it results in abnormal functioning of the male or female reproductive system. After an infertility diagnosis is made, the patient should be referred to a reproductive endocrinologist. The patient should also be referred if they have had one miscarriage. Unexplained infertility means there is no known cause. One in five couples have unexplained infertility after undergoing a full workup. Secondary infertility is the inability to conceive or carry a pregnancy to term after having a child. Impact of Infertility • Loss of self-worth • Loss of stability in the relationship • Loss of pregnancy and birth experience • Loss of work productivity • Loss of hope for the future • Repeated disappointment month after month of not becoming pregnant can lead to depression Diagnostic Testing for Women • Thorough health and reproductive history, including lifestyle and work environment • Physical exam including palpation of thyroid, abnormal hair patterns (may indicate male hormones), breast exam (to check for discharge, which may indicate prolactin presence, which could suppress ovulation) • Pelvic exam to evaluate for growths, infections, or abnormal pap smear • Cervical mucous evaluation (post-coital test): Done shortly after intercourse to check mucous and presence of viable sperm • Hysterosalpingogram: Evaluates uterus and fallopian tubes for blockage and other problems • Luteal phase testing: o Plasma progesterone level; increase indicates ovulation has occurred o Prolactin, Androgen, and TSH o Endometrial biopsy: Done after day 21 to determine if the lining is thick enough for implantation of a fertilized embryo • Ovarian function tests: o Basal body temperature charts to indicate ovulation o Ovulation predictor kits o Day 3 FSH: Increased FSH on day three of the menstrual cycle may indicate a decrease in production of good quality eggs and embryos o Day 3 estradiol tests: An increase may indicate poor egg quality o Inhibin B levels: Check if level is too low o Ultrasound (Transvaginal) done several days after LH surge to see if ovulation has occurred

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