NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE

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Home>Applied Sciences homework help>NURS 6052: ESSENTIALS OF EVIDENCE-BASED PRACTICE

Part 1: An Introduction to
Clinical Inquiry

Ashraf Khouchen

NURS 6052

Walden University

Dr. Debra Sullivan

September 15, 2019

Age-Related Decline in Fertility in Women

  • Fertility begins to decline at the age of 35 years.
  • This is about 15 years before they reach menopause.
  • Decreased pregnancy rates and use of in vitro fertilization confirm the decline in natural fertility (Donnez et al., 2015).
  • Women above 35 years of age experience spontaneous miscarriages.
  • In vitro fertilization (IVF) is used when natural pregnancies fail (Hammer et al., 2018).

Age-fertility As women attain the age of 35 years, their fertility begins to decline long before that reach menopause. The decrease in the rate of pregnancy in younger women and increased usage of oocyte cryopreservation as well as in vitro fertilization have confirmed the existence of age-related fertility decline in women. Women above the age of 35 years experience spontaneous miscarriages, fetal chromosomal abnormalities, cesarean deliveries, fetal mortality, and premature labor which makes childbearing difficult. According to Donnez et al. (2015), 50 percent of women above 45 years of age experience miscarriages and have a 5 percent chance of conceiving naturally.

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Age-Related Decline in Fertility in Women

  • The decline in the ovarian reserve decreases the ability of a women to conceive.
  • Both the quantity and the quality of oocytes influence women’s fertility level.
  • Previous conditions, medical procedures and daily practices influences age-related fertility decline.
  • Conditions such as pelvic infection, fibroids and endometriosis increase the likelihood of fertility to decline (Senturk, 2017).
  • Medical procedures such as radiation therapy, chemotherapy, and ovarian surgery are contributing factors to decline in fertility (Senturk, 2017).
  • Older women are less likely to benefit from IVF as compared to younger women (Evans et al., 2018).

The decrease in the quality and the quantity of oocytes in the body lead to a decline in the ovarian reserve. When the ovarian reserve is diminished, the chances of a woman to conceive decline. Fertility may decline in case a woman has previously had pelvic infection, fibroids, and severe endometriosis; undergoes radiation therapy, chemotherapy, and ovarian surgery; and if she practices smoking (Senturk, 2017). Treatment of infertility in women is dependent on the age of the woman. Younger women are likely to respond better to medication than older women due to the quantity and quality of oocytes in the ovary (Evans et al., 2018).

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Age-Related Decline in Fertility in Women

  • Women have no sufficient information about age-related fertility decline.
  • Knowledge about this clinical issue would prompt women to avoid delaying bearing children.
  • Age-related fertility decline is a major reason why some women unintentionally remain childless (Hammer et al., 2018).
  • Knowledge about age-related fertility decline would give women a chance to avoid fetal mortality and other pregnancy complications.
  • Information about treatment methods is essential but it doesn’t always work (Donnez et al., 2015).

Young women delay bearing children without the knowledge of the danger of age-related fertility decline in women. Some of these women end up childless because they fail to conceive or have pregnancy complications which prevent proper fetal development and safe delivery. In addition, the knowledge of oocyst cryopreservation as well as IVF can be used to help women unable to conceive. However, these treatment practices do not work for all women, especially older women above the age of 45 years. Therefore, prior knowledge of age-related fertility decline would save many women by encouraging them to bear children on their 20s.

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Key Words in Age-Related Decline in Fertility

  • Age, fertility decline, and women were the key words used to search for information about the clinical issue.
  • Age was essential because the research focused on young women.
  • Fertility decline was the key concept of the research.
  • Since fertility issues affects both men and women, specifying that the information required was only about women’s fertility was necessary in the search.

The search process for the research involved usage of the various key words in which included were age, fertility decline, and women. Age was a key word because naturally fertility declines after menopause but for this cause, the point of concern was fertility declines many years before menopause, notably from 35 years of age. “Fertility decline” was the key phrase in the research search process in major databases of nursing. The word “women” was also essential in the search process because fertility issues affect both men and women but this research focused on young women’s fertility issues

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Research Databases

  • Cochrane Database of Systematic Reviews
  • Cumulative Index to Nursing & Allied Health Literature (CINAHL).
  • MEDLINE
  • ProQuest Nursing & Allied Health Source

The four databases used to search for information for the research included Cochrane Database of Systematic Reviews, Cumulative Index to Nursing & Allied Health Literature (CINAHL), MEDLINE, and ProQuest Nursing & Allied Health Source. The sources were obtained from the Walden University Library.

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References

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