This chapter presents an overview of what is known about male factor infertility from both clinical and psychosocial perspectives and suggests critical areas for the future research. Male fertility problems are the most common cause of couple infertility. Despite the absence of strong evidence to link a lifestyle with fertility, the physician, nurse, counselor, or other health care professionals can use the consultation to discuss the general health benefits of a healthy diet and participating in exercise to treat obesity. The consultation offers support in smoking cessation, and to advise on moderating alcohol consumption and the avoidance of recreational drugs. It is known that some men with fertility problems are at an increased risk of testicular cancer. Modern medical developments can allow even men with profound sperm production problems the chance of becoming biological parents, but male fertility assessment requires a high-quality laboratory service and access to genetic testing.

Dramatic advances have been made over the past several decades in the diagnosis and treatment of infertility. Many of these advances were made possible as a result of assisted reproductive technologies (ART), particularly in vitro fertilization (IVF). The most common cause of ovulatory dysfunction is polycystic ovary syndrome (PCOS). This chapter addresses the current information about diagnosis, treatment, and medical conditions associated with PCOS. It focuses on the reproductive and psychosocial health implications of PCOS. Women with PCOS most commonly present to a health care provider with menstrual irregularity, hirsutism, and/or infertility. Menstrual irregularity, manifesting as either oligo or amenorrhea, is the most common presenting symptom of women with PCOS. The most important step in diagnosing PCOS is to exclude other medical conditions that can result in hyperandrogenism and/or anovulation. Most women with PCOS and infertility will have irregular or absent menses and polycystic ovarian morphology on ultrasound.

The process of bearing children is a significant experience for most individuals; however, many struggle to achieve a pregnancy. This chapter offers a brief discussion of the etiology of infertility and lower-level treatment, with a particular focus on assisted reproductive technology (ART) as a treatment option. It addresses a number of key causes for female-related infertility: advancing age, endometriosis, tubal blockage and hormonal imbalances. About 7” of all men are affected by infertility, and can be placed into two different categories, acquired and congenital conditions. Treatment options are grouped into two broad categories: in vivo fertilization, namely fertilization that occurs naturally within the fallopian tube, or in vitro fertilization (IVF), namely fertilization that occurs in the laboratory. The rate of multiple gestation increases with the use of in vitro fertility treatments. Ovarian hyperstimulation syndrome (OHSS) can occur in the days and weeks following the IVF process.

This chapter explains and defines family from different theoretical perspectives, examines current and future trends, and explores the implications for health care providers in the future. The universality of the concept of family was confirmed by the work of Murdock in his cross-cultural research on kinship. On a global basis, there has been an increase in life expectancy. There has been a corresponding shift in fertility rates on a global level. A certain amount of stress is intrinsic to the process of committing to a reproductive plan and taking the steps to become a parent. However, the level of stress intrinsic to the process of conception is even higher for couples who have failed to conceive without intervention and will be employing either in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment. The need for cultural competency to reduce health care disparity also applies to the area of infertility.

In 1984, the first successful treatment of an infertile woman with ovarian failure by using a donated egg from another woman was reported by scientists in Australia. Women who receive donor eggs do not typically share a genetic lineage with their donor-conceived children, although in some instances women have had their biological sisters or other close family members serve as egg donors. This chapter presents a case study of one hypothetical egg-donor-recipient woman and her dilemma with egg donation and disclosure. Informing the donor-conceived children about the origins of conception has been debated; however, there is steady support for disclosing the true nature of the conception to children including legislation to allow donor-conceived offspring access to donors’ identities. Yet, in some countries, such as the United States, where no governmental mandate exists and in countries where data were collected before current mandates, not all egg recipients opt to disclose.

In recent years, the United States and many other countries have seen radical changes in both cultural and social acceptance of same-sex couples and sexual minorities. Increases in legal recognition of same-sex relationships have also changed the expectation for parenthood among sexual minorities. Although lesbian, gay, bisexual, and transgender (LGBT) persons and heterosexuals share many fertility and reproductive care-related concerns, sexual minorities often face unique challenges in the fertility care landscape. This chapter focuses on sexual minority women’s (SMW) experiences with fertility including the decision-making process to have children, deciding which medically assisted reproduction (MAR) method to use, issues surrounding choosing sperm donors, experiences in health care settings and interacting with fertility and reproduction care providers, and fertility outcomes. Advances in MAR methods have increased the number of methods from which SMW may choose to become parents, including vaginal insemination, intrauterine insemination, and in vitro fertilization (IVF).

Reproductive health is a priority topic across the globe, yet resources and access for infertility are less consistently available for multifactor reasons. This chapter discusses the current utilization of assisted reproductive technology (ART) services, presents country-specific data about public funding for these services, and considers how different factors, including money and government regulation, are driving patients out of their own country to seek care elsewhere. One driving factor in the utilization of ART services in countries that publicly fund treatment is the eligibility for those seeking care. Another factor that must also be considered is the availability of and restrictions on certain ART procedures such as pre-implantation genetic diagnosis (PGD). Cross-border reproductive care (CBRC), formerly called “medical tourism”, is the growing phenomenon that applies to persons who are seeking infertility treatment in another country outside of their own.