2.1 DEFINITION OF INFERTILITY : Infertility is defined as a failure to conceive within one or more year of regular unprotected coitus. 2.2 TYPES OF INFETILITY: 1. PRIMARY INFERTILITY: SECONDARY INFERTILITY 2.3 CAUSES OF INFERTILITY : • MALE FACTORS : DEFECTIVE SPERMATOGENESIS SECONDARY INFERTILITY 2.3 CAUSES OF INFERTILITY : • MALE FACTORS : DEFECTIVE SPERMATOGENESIS Infection Gonadotropin suppression Endocrine factors Immunological factors Tubal and peritoneal factors UTERINE FACTORS CERVICAL FACTORS VAGINAL FACTORS COMBINED FACTORS DIAGNOSTIC PROCEDURES FOR FEMALE HISTORY EXAMINATIONS DIAGNOSTIC EVALUATION: 1. CERVICAL MUCUS STUDY 2. HORMONAL ESTIMATION 3. ENDOMETRIAL BIOPSY 4. SONOGRAPHY 5. LAPROSCOPY 6. INSUFFLATION TEST (Rubin’s test) 2.5 RECENT ADVANCEMENT IN INFERTILITY MANAGEMENT : ASSISTED REPRODUCTIVE TECHNIQUES (ART) “ASSISTED REPRODUCTIVE TECHNIQUES INVOLVING DIRECT RETRIEVAL OF OOCYTE FROM OVARY, MANIPULATION OF GAMETS AND EMBROYOS OUTSIDE BODY FOR PURPOSE OF ESTABLISHING PREGNANCY”. TYPES OF ART : 1. IUI (Intrauterine insemination) 2. IVF-ET(In vitro fertilization & embryo transfer) 3. ZIFT(Zygote intra fallopian transfer) 4. ICSI (Intra cytoplasmic sperm injection) (TESA, PESA, MESA) 5. EMBRYO OR OOCYTE DONATION 6. GESTATIONAL CARRIER 7. SURROGACY 2.6 ROLE OF NURSE IN MANAGEMENT OF INFERTILITY : ] ASSESSMENT : - Assessment of the infertile couple is the initial stage of infertility management. The nurse is often the first contact the infertile couple make during their visit for treatment. The nurses role during this stage is to educate the couple about each test or investigation. The nurse plays a vital role in alleviating the fear and anxiety about the various diagnostic procedure. 2] TREATMENT : - The nurse plays the link between the doctor and the couple and should always be available to the couple for their assistance, guidance and support before, during and after the infertility treatment. - Numerous ethical issues are associated with infertility treatments and the couple undergoing treatment need appropriate counselling and discussion. -The goal of the nurse helping the infertile couple is to assist them through the treatment cycle as smoothly as possible. 3] EDUCATION : - The role of a nurse in educating the patients includes education about the basic male and female anatomy and physiology and how the drugs act on their body, including possible side effects. This may be offered under various setting such as • Face to face on an individual basis. • In a group situation, • Fertility nurses should also educate the couple about the self-administer medications. • Proper knowledge of administration of these medicines and storage conditions for medications, as well as the possible side affects, should be imparted to the couple undergoing treatment. 4] PSYCHOLOGICAL SUPPORT : -A couple undergoing infertility treatments are usually under stress due to variety of reasons.