Infertility Treatments

Nursing Knowledge

Infertility Treatments

Infertility treatments are interventions with the goal of helping individuals and couples conceive. Options include medications to stimulate ovulation, surgical procedures, and assisted reproductive technologies like IVF and IUI. Infertility treatment is always a complex, sensitive process in which nurses play a central role in supporting clients through interdisciplinary treatments.
Last updated: May 27, 2024

Table of contents

What is infertility? 

Infertility is defined as pregnancy not being achieved after 12 months of unprotected sex. In couples over 35, infertility treatments may be initiated after 6 months. 

How common is infertility? 

Infertility statistics by the WHO suggest that roughly 1 in 6 people worldwide experience infertility, specifying the lifetime prevalence at 17.8% in high-income countries and 16.5% in low- and middle-income countries.

What causes infertility? 

In heterosexual couples, infertility may be due to female and/or male factors, or idiopathic. 

Causes of female infertility  

  • Ovulatory disorders
  • Endometriosis
  • Pelvic adhesions
  • Tubal blockage
  • Other tubal or uterine abnormalities
  • Hyperprolactinemia
  • Increased age

Causes of male infertility  

  • Endocrine imbalances
  • Genetic factors
  • Urogenital abnormalities
  • Urogenital infections
  • Malignancies
  • Effects of medications
  • Environmental toxins

How does endometriosis cause infertility? 

Endometriosis is a condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus. This can cause infertility through:

  • Scar tissue formation
  • Tubal blockage through adhesions
  • Effects on ovarian function (reduced quality and quantity of eggs)
  • Chronic inflammatory environment

Options for infertility treatments

Fertility treatment is always a complex process involving physical, psychological, emotional, and spiritual dimensions. It requires a thoughtful, interdisciplinary team approach. 

Fertility treatments may be sought by couples unable to conceive after 6–12 months depending on the age, same-sex and gender diverse couples, as well as unpartnered individuals who desire pregnancy. 

Fertility treatments may include genetic material from one, both, or neither intended parent. They may also include contributions from one or more donors, and/or a gestational surrogate via:

  • Egg donation 
  • Sperm donation
  • Embryo donation
  • Gestational surrogacy

Male factor infertility treatments 

Evaluation includes semen analysis, other lab studies, and scrotal and/or transrectal ultrasound. Depending on the pathology identified, treatment may include:

  • Gonadotropin therapy
  • Ejaculatory duct cyst resection
  • Varicocelectomy
  • Transurethral resection of the ejaculatory ducts

Female factor infertility treatments 

Monitor follicle production via ultrasound while using medication to stimulate the ovaries. LH injections can trigger ovulation. Counsel clients on timing of intercourse to promote conception. 

  • Ovulation stimulation: Clomid, Letrozole
  • Endometrial stabilization: Progesterone

Potential complications

  • Multiple gestation: Treatments that stimulate the ovaries and procedures involving multiple embryo transfer may result in implantation of multiple ova.
  • Ectopic pregnancy: Often related to structural abnormalities underlying initial infertility.

Assisted reproductive technologies 

Assisted reproductive technologies may be used when male and female factor treatments are not successful, or when these treatments are not an option given client characteristics (e.g., in same sex couples). 

Options include: 

  • Artificial insemination: procedure in which sperm is directly inserted into a female’s uterus, cervix, or fallopian tubes to facilitate fertilization
  • In vitro fertilization: series of procedures where an egg is combined with sperm outside the body in a laboratory, and the resulting embryo is then implanted into the uterus
  • Intracytoplasmic sperm injection: specialized form of IVF where a single sperm is injected directly into an egg
  • Gamete intrafallopian transfer: eggs are extracted from the ovaries, mixed with sperm, and then immediately placed into the fallopian tubes

Common client questions and client education 

Can birth control cause infertility? 

Most forms of birth control, including oral contraceptives, IUDs, and implants, temporarily prevent pregnancy while in use, but normal fertility typically returns soon after stopping their use. Some clients may experience a brief delay in the return of regular menstrual cycles after discontinuing hormonal birth control, but this delay is usually temporary and does not result in long-term infertility.

Resources for patients struggling with infertility

How can infertility be tested?

Tests for males aim to check for if enough healthy sperm is produced, tests for females evaluate if healthy eggs are released by the ovaries. 

Tests for males: 

  • Semen analysis
  • Hormone and genetic testing
  • Testicular biopsy

Tests for females: 

  • Ovulation testing and ovarian reserve testing
  • Thyroid function tests
  •  Hysterosalpingography
  • Hormone testing or imaging 


Infertility Treatments

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Nursing Cheat Sheet

Concise overview of the female-factor and male-factor causes of infertility, tests, and treatment options including reproductive-assisted technology.

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