K.G.M.

U COLLEGE OF NURSING

KING GEORGE’S MEDICAL UNIVERSITY, LUCKNOW

SUBJECT: MEDICAL SURGICAL NURSING

PRACTICE TEACHING

ON

INFERTILITY

SUBMITTED TO SUBMITTED BY

MRS. MATHIVATHANI M. MS. VICTORIA ANGELA FERNANDEZ

NURSING TUTOR M.Sc. NURSING I YEAR

K.G.M.U COLLEGE OF NURSING K.G.M.U COLLEGE OF NURSING

DATE OF SUBMISSION: 19/07/2022

LESSON PLAN

Name of the student teacher : Victoria Angela Fernandez

Topic : Infertility

Subject : Medical Surgical Nursing

Group : B.Sc IInd year

Place : Lecture hall

Date : 19 /07/2022

Duration : 45 minutes

Language : English

Method : Lecture-cum- Discussion

Audio-visual Aids : Slides, Flip chart, handouts, white board and video

Teaching Supervisor : Mrs. Mathivathani M.

K.G.M.U CON, INFERTILITY Page 2

 Previous Knowledge The students are expected to have some previous knowledge regarding Infertility

After the end of the class student will be able to gain knowledge regarding infertility and will be able to
General Objective
implement the knowledge in clinical settings.

At the end of the teaching student will be able to:

 To introduce the topic.
 To define infertility
 To illustrate incidence of infertility
Specific Objectives  To enumerate the types of infertility
 To enlist the factors affecting fertility
 To discuss the diagnostic evaluation
 To explain the management of infertility in males.

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 SPECIFIC A.V ACTIVITY
TIME CONTENT EVALUATION
OBJECTIVES AIDS
TEACHER STUDENT
1 min To introduce the INTRODUCTION: LCD Introduce Student guess
projector the topic the topic
topic. • Most people will have the strong desire to conceive a
child at some point during their lifetime.
• Most couples (approximately 85%) will achieve
pregnancy within one year of trying, with the greatest
likelihood of conception occurring during the earlier
months.
LCD Student Students listen
To Define infertility DEFINITION: Define
2 min projector Teacher carefully and
• Acc. To WHO “Infertility is a disease of the male or will define write the infertitlity?
the definition
female reproductive system defined by the failure to
infertility
achieve a pregnancy after 12 months or more of
regular unprotected sexual intercourse”
• Acc. To CDC “infertility is defined as not being able
to get pregnant (conceive) after one year (or longer) of
unprotected sex”
1 min LCD Student Student will
To Illustrate the INCIDENCE: What is the
Projector Teacher pay attention
incidence of
incidence of infertility • Infertility is a global health issue affecting millions of will
infertility in
illustrate
people of reproductive age worldwide India?
the
• Available data suggests that between 48 million incidence of
infertitlity
couples and 186 million individuals have infertility
globally

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
• The WHO estimates the overall prevalence of primary
infertility in India to be between 3.9 and 16.8 per cent.
• Estimates of infertility vary widely among Indian
states from 3.7 per cent in Uttar Pradesh, Himachal
Pradesh and Maharashtra, to 5 per cent in Andhra
Pradesh and 15 per cent in Kashmir
INFERTILTIY STATISTICS
• Male infertility : 30%
• Female: 30%
• Combined: 10%
• Unexplained: 25%
• Others: 5%
2 min To enumerqate TYPES: Flip Student Student will What are the
cards teacher will learn the types
the types of Primary infertility types of
enumerate the
infertility • It refers to the couples who have not become pregnant types of infertility?
infertility
after at least 1 year having sexual intercourse without
using contraceptives
Secondary infertility
It refers to couples who have been able to get pregnant
regardless of the outcome, but is unable to conceive.

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
4 min To enlist the FACTORS AFFECTING FERTILITY: LCD Student Student will What are the
Projector teacher will write it down
factors affecting • frequency of intercourse factors
enlist the
fertility • timing of intercourse factors affecting male
affecting the
Male factors: fertility?
fertility
• Defective spermatozoa (decreased number of mature
sperm count)
• Obstruction of efferent duct
• Failure to deposit sperm high in the vagina
• Errors in seminal fluid
• Exposure to heat for prolong
• Cancer treatment
Female factors:
• Ovulatory dysfunction(decrease ovulation)
• Tubal disease(decrease ovum motility due defect in
cilia)
• Uterine factors (congenital disorders or fibroifdor
polyps; PCOS)
• Cervical factors
• Pelvic endometriosis

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT STUDENT EVALUATION
OBJECTIVES AIDS STUDENT
TEACHER
• Under or over weight (10-15% below norml or obese
may lead to less frequent ovulation)
• Prolactenemia
Combined factors:
• Age beyond 35 years in female and male both.
• Anxiety and depression
• Dyspareunia and apareunia
• Spermicidal lubricants
• Immunological factors
video
• Hormonal factors
• Other disease conditions
• Smoking & Alcohol (reduce conception and sex
drive and sperm count)
• Surgery
• Thyroid disease
• Drugs
• Nutrition
• Congenital defects

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
3 min To discuss the DIAGNOSTIC EVALUATION: LCD Student Students will What are the
Diagnostic Projector Teacher will discuss the diagnostic
History collection
evaluations discuss the topic evaluations of
• Past medical / surgical history diagnostic infertility?
evaluation of
• Family history
infertility with
• Sexual history the students
• Reproductive history
• Previous testing and treatment of infertility
• Habits
• Lifestyle
Physical examination
• Weight
• Other disease examinations
Psychological examination
• To rule out anxiety, stress or depression
Blood investigations
Semen analysis:
• Azoospermia: infertility can be related to inability to
produce sperm cells.
• Oligospermia: The production of low or poor quality
sperm.

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
• Malformed sperm: Sperm that cannot live long
enough to fertilize the egg.
• Urinalysis (to rule out infection)
• Endocrine tests( to measure concentration of
hormone testosterone, FSH and LH)
• Sperm DNA assessment.
• Sperm penetration assay ( to establish ability of
sperm to penetrate the egg)
• Postcoital test ( to establish ability of sperm to
enetrate cervical mucus)
• Transrectal USG
• Vasogram
6 min To explain the MANAGEMENT: LCD Student teacher Students will What are the
management of Projector will explain the learn it and surgical
MEDICAL:
infertility in male management of make notes management of
• Hormone therapy (Human Gonadotrophin for infertility male infertility?
Hypogonadism)
• Dopamine agonist for altered testosterone level and
to improve libido potency fertility.
• Antibiotics for genital tract infections
• Clomiphen citrate to increase serum levels of
FSH,LH and Testosterone

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
SURGICAL:
• Vasectomy reversal: This common procedure is an
outpatient surgery. The surgeon reconnects vas
deferens which is the tube in the scrotum through
which sperm passes. Viewing the vas deferens
through a high-power surgical microscope, the
surgeon carefully sews the ends back together.
• Vasopididymostomy: vas deferens is surgically
split, the blockage is removed and the ends of the
tube are reconnected. When the original vasectomy
was performed many years previously, an additional
blockage may have formed in the epididymis, the
coiled tube that lies against your testicle where sperm
cells mature.
• Sperm Retrieval: In some severe cases, a biopsy of
the testicle is required to find sperm.
OTHER MANAMGENT:
• In vitro fertilization: For some couples dealing with
male infertility, in vitro fertilization (IVF) is the
treatment of choice.

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 SPECIFIC A.V ACTIVITY
TIME CONTENT EVALUATION
OBJECTIVES AIDS
TEACHER STUDENT
During the IVF process, the ovaries are stimulated
with injectable fertility medications to cause multiple
eggs to mature. When the eggs are ready, they are
collected in a minor procedure. Fertilization is
accomplished by exposing the eggs to sperm in a
culture dish, or by directly injecting a single sperm
into each mature egg, a process called
intracytoplasmic sperm injection. After fertilization,
embryo development is monitored over the next three
to five days, and two to three embryos are then placed
into the uterus by way of a small catheter inserted
through the cervix
NURSING MANAGEMENT:
• Body weight maintenance
• Avoid smoking and alcohol
• Decrease level of anxiety and stress
• Maintain a healthy lifestyle
• Provide proper nutrition
• Avoid tight or warm garments
• Avoid medicationthat interfere such as
anticonvulsants, antidepressants and beta-blockers

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 SPECIFIC A.V ACTIVITY
TIME CONTENT EVALUATION
OBJECTIVES AIDS
TEACHER STUDENT
1. Impaired self esteem mechanism related to Video
perception of disorder
Goal : to maintain the self esteem of patient.
• Assess patient psychological status.
• Encourage patient to verbalize his feelings.
• Provide psychological support to the patient.
• Recommened group therapy to the patient.
• Advice different methods of conception.

2. Disturbed sleeping pattern related to stress

Goal: to maintain sleeping pattern of the patient.
• Assess the sleeping pattern of the patient .
• Assess the factors that causing sleep disturbance.
• Maintain a routine sleeping pattern.
• Advice patient for meditation.
Clear all doubts of the patient.
• Provide calm and quite environment at night.

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 ACTIVITY
SPECIFIC A.V
TIME CONTENT EVALUATION
OBJECTIVES AIDS STUDENT
STUDENT
TEACHER
3. Risk for infection related to obstruction
Goal: to decrease risk for infection
• Assess the the signs of infection.
• Advice patient to maintain his hygiene
• Advice patient to inform if any pain or discomfort
occurs.
• Provide antibiotics as prescribed by physician.

4. Anxiety and Fear related to treatment of disorder

Goal: To decrease the anxiety level.
• Assess the psychological status of the patient.
• Assess the emotional status of the patient.
• Explain the treatement modalities to the patient.
• Motivate the patient to verbalize his feeling.
• Reassess the patient.

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 SUMMARY In today’s class we have studied about Infertility. infertility is the disorder of not
being able to conceive after unprotected intercourse for 1 year. it is of 2 types
primary and secondary.There are different factors that affect the fertility of women
and men. semen analysis ids the main diagnostic tests. medical management only
hormone therapy can be most effective. we studied about surgical and nursing
meengement.

Conclusion After today’s Class student will be able to know about infertility , its causes and
factors; they can be able to provide support and guidance to people who are in need
of it. they will be able to work in management of different types of infertility.

Assignment Write the small note on nurses role in infrtitlity.

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References:-

◦ Brar Navdeep Kaur.Textbook of Advance Nursing Practice. 3 rd edition; Health Science Publishers; New Delhi; Page no:846- 863

◦ Lynn Taylor Lemone. Fundamentals of Nursing the art and Science of Nursing care. 7th edition; Wolters Klowers publication; Canada: page no:1602-
1634

◦ Bucher Heitkemper Dirksen Lewis” Medical Surgical Nursing Assessment and management of clinical Problems, ninth edition, Elsevier publisher, page
no: 1226-1228

Webliography

• https://www.who.int/news-room/fact-sheets/detail/infertility
• https://my.clevelandclinic.org/health/diseases/17201-male-infertility
• https://www.cdc.gov/reproductivehealth/infertility/index.htm

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