Fertility nursing is a relatively new speciality which offers a diverse and challenging environment in which a specialist nurse otherwise called the Fertility Nurse provides care for individuals and couples before, during and after fertility treatment.
By definition, a Fertility Nurse Practitioner is a registered trained nurse with additional training to provide optimum care for individuals, couples and families seeking counselling and/or treatment options related to reproductive health the most common of which involves couples having difficulty with conception.
The roles of Fertility Nurse Practitioners could be summarised thus:
- Providing general information, advice and counselling with respect to General health and wellbeing
- Preconception counselling and psychological support
- Lifestyle modification of couples seeking fertility treatment
- Education on sexual intercourse and its optimum timing for conception
- Managing and coordinating menstrual cycles
- Performing ultrasound scans for follicle tracking
- Performing intrauterine insemination (IUI)
General information
- Infertility is best explained as difficulty in conceiving.
- A couple is considered infertile or subfertile if, after a year of unprotected intercourse does not result in conception.
- 15-20% of couples may not get pregnant a year of trying.
- 40% of cases of infertility are found to stem from female factors, and another 40% from male factors.
- 10% of couple’s infertility factors are found in both man and woman. The remaining 10% remains unexplained.
- Secondary infertility is when a couple who have been able to achieve conception finds it difficult to do so again.
- To achieve conception;
- A woman’s ovaries must be regularly producing and releasing good-quality eggs at ovulation..
- Normal sperm count and quality must be delivered during sexual intercourse high inside the vagina.
- The reproductive passageways must be clear enough for:
- Sperm to enter the uterus (through the cervix) and swim into the tubes to unite with the egg.
- The egg or early embryo to travel to the uterus (through the fallopian tubes).
- The lining of the uterus must be capable of having the embryo implant, and thereafter sustain the pregnancy.
General health and wellbeing
Baseline general medical check up should include:
- Measuring vital signs such as Blood Pressure, Pulse, Temperature, Weight and Height
- Excluding common reproductive-age diseases such as Iron deficiencies anemia, thyroid diseases, Diabetes, etc.
- Undergoing screening for sexual infections that can be transmitted during pregnancy or through tissue transplants, such as hepatitis or human immunodeficiency virus (HIV) infection.
- Undergoing screening for other common diseases and infections especially relevant during pregnancy such as Rubella, CMV infections, etc
Counselling and psychological support
Emotional support is vital when you are coping with infertility and its treatment. Infertility per se is a crisis that many women and men describe as the most upsetting of their lives. But then, its treatment is also compounded with a lot of stress. All these can place a lot of stress/strain on couples! Furthermore, some medications used can sometimes have negative impact on the woman’s mood and ability to concentrate.
Lifestyle modification
Couples seeking conception are advised to some life styles changes including;
• Dietary changes including adequate intake of vitamins especially folic acid, iodine, fibre, etc.
• Maintenance of optimum weight
• Limitation of alcohol and caffeine consumption
• Reduction of Stress
• Avoidance of substance and medication abuse
• Inappropriate herbal concoction consumption
• Avoidance of Environmental pollutants
• Use of routine vaccinations
Timing of sexual intercourse
Maximizing the chances of conception by having sexual intercourse regularly during the fertile part of the cycle should be the goal. An ovulation predictor (available without a prescription) may help you determine when you ovulate so you can better time intercourse. It is advisable to have sexual intercourse a day before ovulation, the ovulation day and a day after ovulation.
Managing and coordinating menstrual cycle
The Fertility Nurse helps in educating the women on the physiology of the menstrual cycle thereby helping them to be able to understand and identify the length of their menstrual cycle, their ovulation period (fertile period). The Fertility Nurse also helps to synchronize the donor menstrual cycle with the recipient during ART procedures
Performing ultrasound scan for follicular tracking
Transvaginal ultrasonograpgy is used in ART for viewing the follicles in the ovaries, the endometrial lining and later the gestational sac or fetus in the uterus. Fertility nurses carry out ultrasound scans to monitor follicle development and to determine their maturity and the appropriate time of oocyte (ovum) retrieval.
Performing intrauterine insemination
Intrauterine insemination (IUI) is a medical procedure that involves placing sperm into a woman’s uterus to facilitate fertilization. IUI is a low-tech ART procedure, because it does not involve the manipulation of eggs.