Infertility

Infertility is the inability to achieve a clinical pregnancy after 12 months of regular unprotected sexual intercourse. It describes an outcome, not one single disease. The cause may involve ovulatory dysfunction, tubal or pelvic disease, uterine factors, sperm factors, a combination of factors, or no clearly identified cause. The menstrual pattern provides an important clue. Irregular or absent menses makes ovulatory dysfunction more likely because follicular development and ovulation may not be occurring predictably. Regular bleeding, however, does not prove that ovulation is occurring and does not exclude tubal, uterine, or sperm-related factors. A fertility assessment therefore considers both partners rather than assuming that the person who may carry the pregnancy is the source of the problem. The practical nurse’s assessment is directed toward the patient’s timeline, treatment safety, emotional wellbeing, and changes that require escalation. Fertility treatment can be emotionally demanding, but distress does not explain away a new physical warning sign.