Clinical update
Infertility SPL
Essential facts Infertility means a couple cannot conceive, despite having regular unprotected sex. It is estimated that infertility affects one in seven heterosexual couples in the UK. The charity Infertility Network UK supports people who have been affected emotionally.
NICE fertility problems quality standard consultation (consultation ends June 12, 2014) tinyurl.com/nb5hs5p
What’s new The National Institute for Health and Care Excellence (NICE) is preparing a new clinical standard, with the aim of ending the postcode lottery of treatment and support for people with fertility problems. A set of draft statements, published last month, highlight areas of care where improvements are needed. Recommendations include offering three full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after two years of trying, and one full cycle of IVF to women aged between 40 and 42 if certain criteria are met. The consultation follows claims that people in some parts of the country are not being offered treatment.
Signs/symptoms NICE says that a woman of reproductive age who has not conceived after one year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment, along with her partner. An earlier referral should be offered when the woman is aged 36 or over, if there is a known cause of infertility or a history of predisposing factors.
Causes/risk factors Conception problems are caused by ovulatory disorders in about 20 per cent of cases,
Expert comment Trudi Campbell is nurse manager at CRM CARE London, a private fertility clinic 18 june 4 :: vol 28 no 40 :: 2014
Find out more
NICE clinical guidelines on fertility (February 2013) www.nice.org.uk/CG156 Infertility Network UK www.infertilitynetwork uk.com tubal damage in 15 per cent, and uterine or peritoneal problems in 10 per cent. About 30 per cent of cases are attributable to the male partner, and the cause is unexplained in about 25 per cent of couples. In more than a third of cases, disorders are found in both the man and the woman. NICE says uterine or endometrial factors, embryo defects and pelvic conditions such as endometriosis may also play a role.
How you can help your patient According to the draft NICE standard, people who are concerned that it is taking longer than expected to conceive should be given written and verbal advice on the impact that lifestyle can have on their chances of getting pregnant. This includes factors such as smoking, alcohol, obesity and recreational drug use. NICE also calls for people to be offered counselling before, during and after investigations and treatment for fertility problems, irrespective of the outcome.
‘For many people, having a child is a very important part of their life plan, so any problems conceiving puts a massive strain on a relationship. Sadly, we do see couples who break up during or after fertility treatment. ‘Nurses who encounter couples struggling to conceive should be sympathetic and understanding.
Fertility treatment in 2012 – trends and figures (March 2014) www.hfea.gov.uk/docs/ FertilityTreatment2012 TrendsFigures.PDF Articles from RCN Publishing: Male and female reproductive systems and associated conditions McLafferty E et al (2014) Nursing Standard. tinyurl. com/M-Freproductive Gynaecological assessment and history taking Summers A (2013) Emergency Nurse. tinyurl.com/ngfstw3
Those who have been trying for a year – or less for women aged over 36 – should be encouraged to see their GP so they can be referred to a specialist. ‘Also, healthcare staff need to be aware that for women over 37 there is a massive drop-off in the success of fertility treatment, so the window for assisting reproduction is rapidly closing.’
NURSING STANDARD
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Infertility SPL
Essential facts Infertility means a couple cannot conceive, despite having regular unprotected sex. It is estimated that infertility affects one in seven heterosexual couples in the UK. The charity Infertility Network UK supports people who have been affected emotionally.
NICE fertility problems quality standard consultation (consultation ends June 12, 2014) tinyurl.com/nb5hs5p
What’s new The National Institute for Health and Care Excellence (NICE) is preparing a new clinical standard, with the aim of ending the postcode lottery of treatment and support for people with fertility problems. A set of draft statements, published last month, highlight areas of care where improvements are needed. Recommendations include offering three full cycles of IVF treatment to women aged under 40 who have failed to get pregnant after two years of trying, and one full cycle of IVF to women aged between 40 and 42 if certain criteria are met. The consultation follows claims that people in some parts of the country are not being offered treatment.
Signs/symptoms NICE says that a woman of reproductive age who has not conceived after one year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment, along with her partner. An earlier referral should be offered when the woman is aged 36 or over, if there is a known cause of infertility or a history of predisposing factors.
Causes/risk factors Conception problems are caused by ovulatory disorders in about 20 per cent of cases,
Expert comment Trudi Campbell is nurse manager at CRM CARE London, a private fertility clinic 18 june 4 :: vol 28 no 40 :: 2014
Find out more
NICE clinical guidelines on fertility (February 2013) www.nice.org.uk/CG156 Infertility Network UK www.infertilitynetwork uk.com tubal damage in 15 per cent, and uterine or peritoneal problems in 10 per cent. About 30 per cent of cases are attributable to the male partner, and the cause is unexplained in about 25 per cent of couples. In more than a third of cases, disorders are found in both the man and the woman. NICE says uterine or endometrial factors, embryo defects and pelvic conditions such as endometriosis may also play a role.
How you can help your patient According to the draft NICE standard, people who are concerned that it is taking longer than expected to conceive should be given written and verbal advice on the impact that lifestyle can have on their chances of getting pregnant. This includes factors such as smoking, alcohol, obesity and recreational drug use. NICE also calls for people to be offered counselling before, during and after investigations and treatment for fertility problems, irrespective of the outcome.
‘For many people, having a child is a very important part of their life plan, so any problems conceiving puts a massive strain on a relationship. Sadly, we do see couples who break up during or after fertility treatment. ‘Nurses who encounter couples struggling to conceive should be sympathetic and understanding.
Fertility treatment in 2012 – trends and figures (March 2014) www.hfea.gov.uk/docs/ FertilityTreatment2012 TrendsFigures.PDF Articles from RCN Publishing: Male and female reproductive systems and associated conditions McLafferty E et al (2014) Nursing Standard. tinyurl. com/M-Freproductive Gynaecological assessment and history taking Summers A (2013) Emergency Nurse. tinyurl.com/ngfstw3
Those who have been trying for a year – or less for women aged over 36 – should be encouraged to see their GP so they can be referred to a specialist. ‘Also, healthcare staff need to be aware that for women over 37 there is a massive drop-off in the success of fertility treatment, so the window for assisting reproduction is rapidly closing.’
NURSING STANDARD
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