The document provides information on female infertility, including its definition, causes, investigations, management, and prevention. It begins by introducing the female reproductive process and defining infertility. It then discusses the main causes of female infertility such as ovulatory, tubal, uterine, cervical, and other factors. The various investigations for diagnosing infertility including history, examination, and special tests are also enumerated. The document concludes by outlining the management approaches for different infertility causes like drugs, surgery, assisted reproductive technologies, and preventive measures.

1. s.no Specific
objective
Time Contents A/V aids Teacher/learner
activity
Evalution
1
2
To Introduce
the female
reproduction
process
TO Define the
infertility &
2 min
5 MIN
INTRODUCTION
For pregnancyto occur everypartof complex humans
reproductionprocesshastotake place justright.the
stepinthisprocesshas follow –
1 One of the twoovariesrelease amature egg.
2The egg ispickedupby the fallopiantube
3 Spermswimupthe cervix ,throughthe uterusand
intothe fallopian tube toreachthe egg forfertilization.
4 the fertilizedegg travel downthe fallopiantube to
the uterus.
5 the fertilizedegg implantsandgrow inthe uterus.
In woman,no.of factors can disruptthisprocessat any
step.female infertilityiscausedby thisone or more
factor like anatomical andphysiological .some of these
are treated.
Definition
INFERTILITY= ACCORDINGTOWHO “Infertility can be
describedas the inabilityto becomepregnant,maintain
a pregnancy orcarry a pregnancy tolive birth .”
ACCORDINGTOICMART“ Itis a diseaseof
reproductive systemdefinedby the failure toachieve
clinical pregnancy after12 monthor more of regular
unprotectedsexualintercourse
Female infertility =”female infertility refersto a female
inability to conceiveby afertile male or maintain
pregnancy orcarry a pregnancy tolivebirth . in human
it accountfor40-50%
Type
Primary = infertilitydenotesthose patient whohave
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What is
infertility

2. 2
3
5
female
infertility
To enumerate
the type of
infertility
To discussthe
causesof
female
infertility
2 min
1 min
12 min
neverconceived.
Secondary = infertilityindicate previouspregnancybut
failure toconceive subsequently.
PREVALENCE=
Female infertilityvarieswidelybygeographiclocation
aroundthe world.in2010,there wasan estimated48.5
millioninfertilecouple worldwide
CAUSES OF FEMALE INFERTILITY the responsible
causespercentage ovulatoryfactor(30– 40%), tubal
and peritoneal factor(25- 35%),andendometriosis(1-
10%)
OVULATIONFACTOR=
1 ANOVULATION OROLIGOOVULATION =the ovarian
activitytotallydepend onthe gonadotrophins andthe
normal secretiondependuponthe GnRH From
hypothalamus.
Ovariandysfunctional islikedtobe linkedwith
disturbedhypothalmo-pituitary- ovarinAXIS
2 LUTEAL PHASEDEFECT = IN this conditionthere
inadequate functionof the corpusluteum.there is
inadequate progesterone secretion.the life spanof
corpus luteumisshortenedtolessthan10 days.as a
resultthere isinadequate secretorychangesinthe
endometrium,whichhinderimplantation.
3 LUTENISED UNRUPTURED FOLLICULAR SYNDROME
(TRPPEDOVUM)
In this conditionthe ovumistrappedinside the follicle
whichgetlutinised
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Lecture cum
discussion
Lecture cum
discussion
What is
female
infertility
How many
type of
female
infertility
What are the
causesof
female
infertility

3. 3
4 DECREASE OVARIN RESERVE
TUBAL AND PERITONEAL FACTORS =
 Perituabal adhesion
 Endosalpingeal damage
 Previoustubal surgery
 Tubal endometriosis
 Polypsormucus debriswithinthe tubal lumen
,or tubal spasm
 Peritoneal infection
UTERINE FACTOR
 Uterine hypoplasia
 Inadequate secretory endometrium,
 fibroiduterus
 endometritis
 congenital malformationof uterus
CERVICAL FACTOR=
 ANATOMIC=anatomicdefectpreventingsperm
ascentmay be due to congenital elongationof
the cervix ,seconddegree uterine prolapse and
acute retroverteduterus.These condition
preventthe external OS tobathe inthe seminal
pool , or polyps
 PHYSIOLOGIC=the faultliesinthe composition
of the cervical mucus, somuch that the
spermatozoafail topenetrate the mucus.the
abnormal constituentsinclude excessive ,
viscouspurulentdischarge asinchronic
cervicitis,presence of antispermAb
VAGINALFACTORS =
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4. 4
 Atresia vagina
 Transverse vaginal septum,
 septate vaginaornarrow introituscausing
dysparenia
 vaginitisandpurulentdischarge
OTHER FACTOR =
1. ADVANCEAGE- more than 35 years the
reproductive yearprogress,the no.and quality
of the eggdiminish.the chance of havinga
babydecrease by3 -5 % .
2. CHRONICILL HEALTH
3. HORMONAL FACTOR- pituitarygland
dysfunction
Hyperprolactinaemiaandhypothalamic
disorder
4. COMBINED FACTOR= Anxiety,apprehension,
inadequate orinfrequentintercourse ,sexual
intercourse ,immunological factor
.&psychological andsubstance abuse ,
education,STI,
INVESTIGATIONOF INFERTILITY
OBJECTIVEOF INVESTIGATION
 TO Detectthe etiological factorfactor
 To rectifythe abnormalityinanattempt
to improve the fertility.
 To give assurance withexplanationtothe
couple if noabnormalitydetect.
Whento investigate ?
As perdefinitioninfertilecouple shouldbe investigate

5. 5
6
TO enlistthe
various
investigation
5 min.
afterone year of regularunprotectedsex. The interval
isshortenedto6 monthafterthe age of 35 years of the
woman.And40 yearsof man.
What to investigate ?
1 semenanalyasis
2 confirmationof ovulation
3 confirmationof tubalpatency
FEMALE INVESTIGATION
HISTORY TAKING-
1 A genral medical history
2 Surgical history
3 Menstrual history
4 Previousobstetrichistory
5 Contraceptive practice
6 Sexual problem
EXAMINATION –
1 General examination
2 Systemicexamination
3 Gynaecological examination
4 Speculumexamination
SPECIAL INVESTIGATION-
Noninvesible orminimal invasive methodare tobe
employedpriortomajor invasive one .
OVARIAN FACTORS- Diagnosisof ovulation are as
follow
Indirect,direct, conclusive
Indirect–menstrual history
Evalutionof peripheral orendogens changes
A) BASALBODY TEMPERATURE
B) CERVICALMUCUS STUDY
C) VAGINALCYTOLOGY
D) HORMONE ESTIMATION
Serumprogesterone
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Enlistthe
variousin
investigation

6. 6
.
.
LH
Oestradiol
Urine LH
Endometrial biopsy
E)Sonography
Direct
Laproscopy
Conclusive
Pregnancy
MANAGEMENTOF FEMALE INFETILITY
THE treatmentof female infertilityare grouedasfollow
accordingto disorderidentified
Ovulatory
Tubal
Associateddisorderlike endometriosis
Cervical
Immunological
Unexplainedinfertility
Utero vaginal canal
Assistedreproductivetechnology
General drugs surgery
General
 Psychoterapy
 Reductionof weightinobesity orimprove the
weightif lowweight.
Drugs
STIMULATION OFOVULATION
 Clomiphene citrate
 Letrozloe
 h MG(PERGNOL)

7. 7
7
Explainthe
management
of female
infertility
12 MIN
 FSH(METRODIN)
 h CG(PROFSI)
 GnRH
 GnRH Agonist
CORRECTION OF BIOCHEMICAL ABNORMALITY
Hyperinsulinaemia- metformin
Androgenexcess- dexamethasone
Prolactinraised –bromocriptine
SUBSTITUTION THERPY
Hypothyrodism-tyroxin
DM-antidibeticdrugs
Surgery
ovarian
 LaproscopicovariandrillingORlaser
vaporisation
 Surgeryfor pituitaryprolactinomas
 Surgical removal of ovarianor adrenal tumour
Tubal and peritoneal factors
 by laproscopy orlaprotomy
 cannulationand ballon tuboplasty .
 fimbrioplasty –release of fimbrial adhesionor
dilationof fimbrial phimosis.
 Neosalpingostomy- tocreate anewtubal
openinginanocculdedtube .
 Tubotubal anastomosis
 Adjuvanttherapy –include antibiotics,
hyrotubation
Endometriosis
Treatedby surgeryor medication
Cervical factor
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8. 8
Oestrogen1.25 mg orally dailystartingonday 8-5 days
Antibioticsif infectionoccurdoxycycline 10mg twice
daily
Immunological factor Dexamethasone 0.5mg at bed
timeinthe follicularphase
Gilliantype operationtocorrectthirddegree
retroversioninunexplainedinfertility
UTEROVAGINALSURGERY
MYOMECTOMY
METROPLASTY
ADHESIOLYSISwithinsertionof IUCD
FENTON OPERATION –enlargementof the vaginal-oitus
Unexplainedinfertility
the recommendedtreatmentforunexplainedinfertility
are- INDUCTIONOFOVULATION
INTARUTERINE INSEMINATION / ARTIFICAL
INSEMINATION
FALLOPIAN TUBE SPERMPERFUSION
ASSISTEDREPRODUCTIVETECHNOLOGY
IVF–ET=IN VITROFERTLIZATION ANDEMBRYO
TRANSFER
GIFT = GAMETE INTRA – FALLOPIAN TRANFER
ZIFT= ZYGOTE INTRA FALLOPIAN TRANSFER
ICSI= INTRA CYTOPLASMICSPERM INJECTION
EMBRYO OR OCCYTE TRANSFER
GESTATIONALSUROGACY

9. 9
To discussthe
preventive
measure of
female
infertility
2 min
2
Prevention
Some strategies suggested or proposed for avoiding
female infertility include the following:-
 Avoiding stress as it changes hormonal
function.
 Avoiding substance abuse& alcohol use.
 Make a proper sexual relationship with her
partner .
 IF the female don’t conceive ,take adequate
treatment
 Avoid false contraceptive and any mediaction
practice.
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What is
preventive
meaure

10. 10
Summary
So for we have discussed about the various key terms, definition of female infertility, its causes, the various investigations used for
diagnosis and the management & prevention of female infertility.
Conclusion
At last I conclude my topic by saying that infertility may have profound psychological effects. In many cultures, inability to conceive
bears a stigma. But today science has made it possible to treat almost all causes of infertility. Being a nurse, we can play a vital role in
it by counseling the couple. We can tell them about the various preventive measures and management of infertility.
Reference
 VG Padubidri & SN Daftary , ‘’Howkins & Bourne Shaw’s Textbook of Gynecology’’, Fifteenth Edition, Elsevier India
Private Limited, 2011, Pp 200-209
 D.C.Dutta, ‘’Textbook of Gynecology’’, Fifth Edition, New central book agency (P) Ltd, Kolkata, 2006, Pp 220-226
 www.google.com
Assignment
Define female infertility. Discuss the management of female infertility in details.

11. 11
LESSON PLAN
BASELINE INFORMATION
NAME OF STUDENT TEACHER : MRS. SNEHLATA PARASHAR
NAME OF THE SUPERVISOR :
GROUP : PEER GROUP
SUBJECT : OBSTETRIC AND GYNAECOLOGICAL NURSING
TOPIC : FEMALEINFERTILITY
PLACE : CLASSROOM, GOVT. COLLEGEOF NURSING,JAIPUR
DATE& TIME : 17/06/2014 & 11:00AM
DURATION : 45 MIN.
METHOD OF TEACHING : LECTURE CUM DISCUSSION
TEACHING AIDS : CHALK BOARD AND CHART
PREVIOUS KNOWLEDGE : STUDENTS HAVE SOMEKNOWLEDGEREGARDING INFERTILTY

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General Objective:-
At the end of the teaching, studentwill be able to enhance their knowledge about female infertility and apply
this knowledgein their clinical practice
Specific objectives:-
At the end of the teaching Students will be able To:-
 Introducethe reproductiveprocess and infertility .
 Define infertility and female infertility .
 Discuss thecause of female infertility.
 Enlist the various investigation.
 Explain the management of female infertility.
 Discuss theprevention of female infertility.

13. 13
GOVERNMENT COLLEGE OF NURSING
JAIPUR
A
LESSON PLAN
ON
FEMALE INFERTILITY
(SUB: OBSTETRIC AND GYNAECOLOGICAL NURSING)
SUBMITTED TO: SUBMITTED BY:
MRS. SNEHLATA PARASHAR
M.Sc. NURSING (PRE)
GOVT. COLLEGE OF NURSING,
JAIPUR
SUBMITTED ON: 04/01/2015

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