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Infertility and its Treatments - course1.winona.edu

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Infertility and Its Treatments
By: JaimieStudenski, Jessi Ackerman and Melanie Dettmer
Infertility-what is it?
When a woman fails to get pregnant after a year of unprotected sexual intercourse, or after 6 months if the woman is over 35. This also includes being unable to carry a pregnancy to live birth.There are two types of infertility:Primary Infertility-difficulty conceiving when the couple has no previous childrenSecondary Infertility-difficulty conceiving when at least one partner has previous children10.2% of women and 12.9% of married women have fertility issues40% has been traced back to problems on the male’s part, 40% has been traced back to problems on the female’s part, 10% is linked to both partners, and 10% remains unknown
Infertility-Female Causes
Failure to OvulateHormonal ProblemsScarred OvariesPremature MenopauseFollicle ProblemsPoorly Functioning Fallopian TubesInfectionAbdominal DiseasesPrevious SurgeriesEctopic PregnancyCongenitalDefectsEndometriosis
Additional FactorsOther VariablesAbnormal uterusCongenital abnormalities, such as septateuterusAbnormal cervical mucousBehavioral FactorsDietand ExerciseSmokingAlcoholDrugsEnvironmental FactorsLeadMedicalTreatments andMaterials such as radiationEthylene OxideDibromochloropropane(DBCP)
Infertility-Male Causes
Hormonal ProblemsHyperprolactinemiaHypothyroidismCongenital AdrenalHyperplasiaHypogonadotropic HypopituitarismPanhypopituitafismPsychological/Physical/ Behavioral ProblemsErectileDysfunction(ED)PrematureEjaculationEjaculatoryIncompetence
Physical ProblemsVaricoceleDamaged SpermDuctsTorsionInfection andDiseaseKlinefelter’sSyndromeRetrogradeEjaculationEnvironmental FactorsSmoking/Alcohol/Drug UseSteroid useOverly intensive exerciseTight underwearExposure to environmental hazardsMalnutrition and anemiaInadequate Vitamin C and ZincExcessive stress
Infertility Treatment for Women and Men
WomenWomen who have problem with ovulation can try medicine such as clomiphene and metformin.If a woman has unexplained infertility they can take Clomiphene, receive hormone injections, or insemination.If fallopian tubes are blocked, treatment may include tubal surgery.If a woman has mild endometriosis, they could have laparoscopic surgery. It might not be an option for severe endometriosisMenSuggested to try insemination
Assisted Reproductive Technology
In vitro fertilization (IVF)- fertilized eggs or eggs inserted in woman’s uterus through cervixIntracytoplasmic sperm injection(ICSI)-Injects one sperm into one egg in the lab.If fertilization occurs-it is implanted into the women’s uterus
Natural Treatments
NutritionRemove carbohydrates from grains, processed foods, sugars and starches and instead get them from vegetables, fruits, sweet potatoes and squash.Increase healthy fatsGet enough proteinEat a lot of vegetablesAvoid processed dairy and instead have organic dairy such as butter, ghee, and heavy creamDrink lots of waterControl insulin levelsLifestyle Factors•Lack ofsleep, exposuretotoxins, lackof exercise or too muchexercise,highstresslevels, and certainmedications orsupplementsSupplementsVitamin D, Vitamin C, Folic Acid, Zinc, Selenium, B-vitaminsRed Raspberry Leaf, Nettle Leaf, Dandelion, Alfalfa, Red Clover,Maca,Vitex/Chaste Tree Berry, Natural Progesterone Cream
Social Issues
Negative impact on self-esteem and increased risk of depressionFeel as if having a child is important art of life plan, infertility is a major life problemPeople who have children from past relationships feel desperate to conceive with current partnerLife has been put on hold, body is failingInfertility in Western WorldStudies show involuntary childlessness has multiple psychological and psychosomatic effects-especially womenDistress, depression, anxiety, reduced self esteem, somatic issues, reduced sex drive, sense of blame and guiltStudies show elderly people with no children have less social support and framework for independent livingImpact communication with family and friends that have childrenCoping strategy is participating in care of others children, 10% of couple adopt this strategy
Social Issues
Infertility in Developing CountriesNot as many psychological effect as in the Western World, main issues are social and cultural effectsWomen view lives as hopeless if childlessFace discrimination in many culturesOstracism and stigma if childlessViewed as “non-human” or cursedLittle to no availability for infertility services and IVF is often unaffordableLack of support emotionally and financiallySub-Saharan Africa women are not encourage by male partners to get modern fertility treatments, so women seeking fertility help often have unavailability of these services and no support from their significantother
Ethical Issues
Multiple PregnancyIVF increases the chance of two or more fetuses developing, thus increasing the risk of premature babies, infant health problems and low birth weightEmbryosClinics freeze additional fertilized eggs that are not implanted for future attempts. People need to consider what do with eggs in case of death, divorce, or if the clinic isn’t able to contact them.Donor Egg/Sperm of surrogacyRights and responsibilities defined for both the surrogate and the couple for the future child
Ethical Issues
Embryo Creation, Selection, and DispositionInfertility treatments are expensive and often not covered by insurance-this could deter lower income families from access to these resourcesSince payment is so high, encourages implanting many embryos at one time and creating more than what the couple will need to reduce cost and extra chance of carrying one to termUse of preimplantation genetic diagnosis(PGD) for selecting characteristics of the embryo to implantCost, Coverage, and AccessInfertility clinics don’t have any regulations for cost, access, or quality of treatmentsCost of IVF Cycle is $12,400Debate on whether insurance should cover infertility treatment-if so does this suggest conceiving a biological child is preferable to adoptionTheorists argue that procreation and parenting are important to one’s identity and life goals rather than a luxuryResource AllocationLaw, policies, and practices of ARTs developed separately from state and the national child welfare systemsUnregulated infertility treatments result in difficult pregnancies with multiple babies that may have been avoided if there was more conservative implantation practices to help conditions that cause infertility in the first place
Ethical Issues-Sperm Donation
Sperm Donor RightsDonor anonymityClientRightsCan be informed about limitations and complications involved with sperm donation, sperm bank can’t guarantee disease free or no genetic abnormalities in sperm. The client(s) must also be fully responsible for any offspring conceived with the donated spermSperm donor and client rights established through a consent form. The form indicates that the client understand their rights and rights of sperm donor.Choosing SpermAll sperm banks are highly selective, but some more than others. CaliforniaCyrobankonly accepts graduates from major 4-year university who are also tall, trim, heterosexual, and between 19 and 34 years old. Repository of Germinal Choice only accepted sperm from Nobel prize winners.This raises ethical concerns abut eugenicsHow Much Sperm Can Be Donated?Sperm banks have a limitation on how many children a donor can produce-a maximum of ten children
Ethical Issues-Egg Donation
AutonomyQuality of consent-payment and high financial payoutsStudies show that women who donate eggs for financial reasons suffer more emotional harm and more likely to regret the decisionWith the technical terminology, donors may not fully understand potential risks and treatment options without a background in biology and medicineJusticeShortage of egg donors, upper class women can afford more advertising, compensation, and agency fees then lower class womenInfertility doctors have to do all they can to ensure a successful pregnancy, but with the shortage of eggs, donor recruitment is necessary. This causes a conflict of interest because they need to encourage donation for their patients but also have to protect the health of donors who would otherwise not be involved in the risks of the procedure.Beneficenceand Non-maleficenceThese principles require that egg donation is performed for purpose of improving the health of the patient and preventing harm. However, there is already maleficence because the donors do not get any clinical benefit. This brings to light on whether to place a donor at risk for harm is justifiable for the benefit of an infertile patient.Side effects for ovulation enhancing drugs is not completely known-may be risk of ovarian cancer, ovarianhyperstimulationsyndrome, lacerations, and ovarian cancer
Ethical Issues In Other Countries
Anonymity for donors in Greece but not in the UKMany countries allow embryo to develop for a certain number of days to pick the healthiest one for implantation, but some countries only use early embryosPaying a surrogate is not allowed in many countries but is legal in IndiaSpain and Canada can store embryos for an unlimited time, but in Brazil they can only be stored for 3 yearsGenetic screening before implantation is completely banned in some countries but have strict regulations(but still can be used) in othersMany countries there is a limit to only one embryo being implanted, however in other countries it is up to the doctorIceland has the frozen sperm destroyed if the male dies, but in Belgium sperm can be used for future treatment if written permission is givenCatholic Church believes life begins at conception and allows fertilization if all viable embryos are implanted, others wait a few weeks later and only pick the healthiest embryos and destroy the rest
Infertility Myths
It'seasy for most women to getpregnantMendon't have infertilityproblemsInfertilityis a psychological -- not physical --problemCoupleswho "work" hard enough at having a baby will eventually getpregnantOncea couple adopts a child, the woman will becomepregnantHusbandsoften leave their wives if they'reinfertileYouneed to orgasm in order toconceiveLifting your legs in the air for 20 minutes after having sex will help you getpregnantDoing it missionary style is the only way toconceiveEating yams while trying to conceive will causetwinsChugging cough syrup will help youconceiveBeing on the Pill for too long will delaypregnancy
Works Cited:
"7 Myths About Infertility."Parents Magazine. Parents Magazine, 2015. Web. 7 Nov. 2015."10 Crazy Fertility Myths -- Debunked - Getting Pregnant - Myths & Superstitions."10 Crazy Fertility Myths --Debunked- Getting Pregnant - Myths & Superstitions. The Bump, 2015. Web. 7 Nov. 2015.Asch, Adrienne, and RebeccaMarmor. "Assisted Reproduction."The Hastings Center. The Hastings Center,2015. Web. 7 Nov. 2015."How to Naturally Reverse Infertility & Get Pregnant Naturally."Wellness Mama. Wellness Mama, 2015.Web. 15 Nov. 2015."Infertility: Ethical and Legal Concerns-Topic Overview."WebMD. WebMD, 30 Sept. 2014. Web. 7 Nov. 2015."Infertility Treatment: An Overview."Infertility Treatment: An Overview. Stanford University, 2015. Web. 7Nov. 2015.Robertson, Sally. "Infertility Ethics."News-Medical. News-Medical, 18 May 2010. Web. 7 Nov. 2015.Robertson, Sally. "Infertility Social Impact."News-Medical. News-Medical, 18 May 2010. Web. 7 Nov. 2015."What Are Infertility Treatments? Types, Benefits, Risks, and More."WebMD. WebMD, Jan. 2014. Web. 7Nov. 2015.

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Infertility and its Treatments - course1.winona.edu