NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE

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Donnez, J., Dolmans, M. M., Pellicer, A., Diaz-Garcia, C., Ernst, E., Macklon, K. T., & Andersen, C. Y. (2015). Fertility preservation for age-related fertility decline. The Lancet, 385(9967), 506-507. DOI:10.1016/S0140-6736(15)60198-2

Evans, A., de Lacey, S., & Tremellen, K. (2018). Australians’ understanding of the decline in fertility with increasing age and attitudes towards ovarian reserve screening. Australian journal of primary health, 24(5), 428-433. Doi: 10.1071/PY18040_CO

Hammer, K. C., Kahan, A. N., Fogg, L. F., Walker, M. A., & Hirshfeld-Cytron, J. E. (2018). Knowledge about age-related decline in fertility and oocyte cryopreservation: A national survey. Journal of human reproductive sciences, 11(4), 359. Doi: 10.4103/jhrs.JHRS_158_17

Senturk, L. M. (2017). Fertility problems in late reproductive years. Maturitas, 100, 113. DOI: 10.1016/j.maturitas.2017.03.072

Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)

This article relates to the clinical issue of age-related fertility decline in that Donnez et al. discusses how fertility preservation can be used to tackle the problem. The research highlighted that fertility preservation is gaining momentum across the world and would most likely expand significantly in the next ten years. The findings of the study suggested that fertility preservation, especially ovarian tissue cryopreservation increases the rate of pregnancy. The ethical consideration of this research is beneficence. Addressing age-related fertility decline is an act of kindness to the unborn babies which lose their lives due to pregnancy-related complications.  

The problem of age-related fertility decline is increasing, and there is a need for women to be vigilant to be screened of any issues concerning their ovarian reserve. Most pregnancy complications result from the ovary, such as the decline in oocysts which prevents pregnancy from occurring. The ethical considerations of the research are that it aims at saving women from age-related fertility decline by increasing their knowledge about the issue. Knowledge about the age-related fertility decline would enable people to make sound reproductive life decisions.

Hammer et al. had realized that women across the world delay bearing children without the knowledge of the age-related fertility decline. As women advance in age, they unintentionally remain childless. The researchers hypothesized that the respondents would have little information about age-related fertility decline and the use of cryopreservation. Cryopreservation is a method used to transplant an embryo into a woman’s uterus after failing to conceive. Issues relating to research ethics in the research included confidentiality of participant personal information as well as beneficence.

Senturk discusses the problem of fertility decline in women above 32 years of age. The research identifies 20s as the best reproductive time in a woman’s life. However, the researcher pointed out that fertility declines when women attain the age of 32 years, with more rapid decline recorded in women above 37 years of age. The study added that when a woman attains the age of 40, her chances of conception are below 5 percent in every cycle. The ethical consideration of the research was that the research maintained confidentiality and did not expose the names of the persons who were interviewed.

Brief description of the aims of the research of each peer-reviewed article

The research aimed to establish the effectiveness of fertility preservation techniques in increasing the rate of pregnancy. The results of the study suggested that 20 out of the 80 women who received transplants conceived. The pregnancy rate was 25 percent, with some women delivering twice or thrice. The research showed that fertility preservation could be used as an alternative when a natural pregnancy fails due to age-related issues. However, the research did not state the number of normal births that occur in women above the age of 35 years.

The aim of the research was to determine whether Australian women have sufficient knowledge about the problem of age-related fertility decline. They also sought to find out what socially influences them to make decisions about starting families. They also intended to establish what Australians feel about getting screened to learn about their ovarian reserves. The study established that Australians lack knowledge about age-related fertility decline despite most of the population attaining higher levels of education. The researchers suggested that most of the Australian population delay starting their families.

The aim of the research was to determine the number of women that are aware of age-related fertility decline and the cryopreservation technology. The findings of the study established that women in a partnership had knowledge about age-related fertility decline while those without partners stated that they had no knowledge about it. However, the majority of the study population had little knowledge about cryopreservation despite hearing it. The research targeted younger women who are of the reproductive age. The research recommended that there is a need for women, especially single women within the childbearing age to be educated about age-related fertility decline and cryopreservation.

The aim of the research was to establish the reasons for fertility problems in women. The research established that women struggle to bear children long before reaching menopause. The premenopausal period was, however, found to be characterized by various health issues such as obesity, type 2 diabetes, and insulin resistance. In addition, the use of cosmetics was identified to have a potential influence on the hormonal balance in women which may significantly affect the time of pregnancy. However, it was noted that there is a lack of empirical evidence on the effect of cosmetics on human life. Pelvic infection, severe endometriosis, radiation therapy, chemotherapy, smoking, as well as ovarian surgery, were the reasons highlighted behind fertility decline before menopause.

Brief description of the research methodology used Be sure to identify if the methodology used was qualitative , quantitative , or a mixed-methods approach. Be specific.

The researchers adopted a quantitative research methodology. The research involved numerical analysis of data. The researchers collected data from four facilities, where fertility preservation is conducted. The data were statistically analyzed to give the percentage of pregnancies that occurred from transplantation. The researchers presented the data about the number of women transplanted, the number of conceptions, and the number of live births in a table which is a characteristic of a quantitative research method.

The research adopted a mixed research methodology. The researchers used quantitative methods collected and analyzed numerical data from the 383 participants of the study, which included childless men and women. The age of the participants was between 18 and 45 years. The researchers established that the number of men and women that would start bearing children early if they realize their ovarian reserve is low was higher than those who wouldn’t. Besides, qualitative research was used to establish the reasons why the participants delayed starting their families. Qualitative research seeks to establish the underlying motivations, opinions, and reasons behind a certain relationship.

The research adopted a quantitative research methodology in the collection and analysis of data. A cross-sectional survey was used to analyze the information collected from the sample, which included women between the age of 25 and 45 years. The survey was conducted electronically. The research used ANOVA tests and a linear regression model to analyze the data collected. The research methodology was useful in the statistical analysis of numerical data.

The researcher adopted a mixed methodology to get the reasons behind fertility decline in women long before they reach menopause and the number of Turkish women of different age groups who have struggled to bear children. The research applied a quantitative methodology to determine the number of women who have experienced pregnancy losses in the various age groups. After statistically analyzing collected data, the research established that 9.9 percent of women below the age of 33 had experienced miscarriages, and the rate increased to 13,7 percent for those aged 35 years. For those at the age of 38 years, the rate of miscarriages was 19.8 percent. The researcher added that treatment is recommended in up to 6 months after a failed pregnancy but recommended immediate action for women above 40 years of age.

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

The strength of the quantitative research methodology used in the research is that it presents data in a clear way which makes analysis easy. The data is presented in numbers to represent the various variables and totals provided. Besides, it makes it easy to generalize the findings of the research to the whole population. The quantitative research methodology was valid and reliable because the research involved collection and analysis of numerical data on the number of pregnancies and live births recorded as a result of transplantation. Numerical data can only be collected and analyzed quantitatively.

The strengths of mixed research methodology in this study are that it enables the researchers to understand both the percentage of Australians with knowledge about age-related fertility decline. It also allows them to establish the reasons why they start families later in life despite the increasing cases of age-related pregnancy problems. The research methodology is reliable because it allows the researchers to understand the amount of knowledge about age-related fertility decline in the Australian population as well as their opinions towards ovarian screening. The research offers valid information because it relied on first-hand data collected from participants in the population.

The strength of the quantitative methodology in this research is that it enabled the researchers to statistically measure the data collected. The instruments used to analyze the research data are reliable and provided valid information. Statistical tools can be validly used as a measurement tool in a quantitative study. Numerical data requires quantitative analysis to allow the research to make sound conclusions. Quantitative methods are essential when the research involves the collection and analysis of numerical data.

A qualitative approach allowed the researcher to establish both the reasons behind fertility decline in women. The researcher was able to qualitatively get the opinions of women and experts and use quantitative methods to analyze data on the number of women who have experienced pregnancy losses. The methodology was reliable because the researcher was able to get the valid reasons behind the increase in fertility decline cases in early menopause. The research findings are valid and can be replicated in other studies.

General Notes/Comments

Technology can be used to address the problem of declining fertility in young women. Techniques such as cryopreservation and in vitro fertilization can be useful. However, the success rate seems to be still low with only 25% of the 80 people who received transplants conceiving.

Screening can be used to help women determine the likelihood of them conceiving by establishing the quantity and quality of their ovarian reserve.

With the common trend of women delaying bearing children, it is most likely that the number of childless women would increase as the issue of age-related fertility decline persists. Knowledge about the clinical issue would possibly help women to bear children earlier before their fertility declines. The knowledge of oocysts cryopreservation would help some women to bear children.

20s were identified to be the years when women are most productive. With this knowledge, women would most likely ensure that they get children before the most reproductive years are over. This would help them avoid the problem of pregnant losses that are experienced by women as they try to get children in their late 30s.