Pediatric Diagnoses Contributingto Infertility
An understanding of pediatric diagnoses contributing to infertility can facilitate management plans, and the impact of these diagnoses should be discussed with patients and their parents in preparation for postpubertal years. When a child or adolescent is diagnosed with a condition that may affect future fertility, it is often met with great anxiety by the parents and patient. At the time of diagnosis, about 30% of adolescents experience anxiety and depressed mood related to the diagnosis (Steeno, Knops, Declerck, Adimoelja, & van de Voorde, 1976). Likewise, potential fertility issues related to these diagnoses. Urology nurses and midlevel providers are helpful in recognizing such concerns, serving as a health information resource to facilitate patient and family understanding of the diagnosis and relieving some anxiety. The prevalence rates, pathophysiology, current evaluation, and management options of the most commonly encountered pediatric causes of male infertility are discussed.
The pediatric history focuses on prenatal history, including prenatal ultrasound-detected genital anomalies, in utero exposures, and the mother's prenatal course. The postnatal history includes developmental, medical, and surgical history, as well as the presence or absence of physical abnormalities on initial examination.
Social history and identification of substance abuse is especially important in adolescent patients. Anabolic steroid abuse and chronic opioid use are more common in this population and may cause hypogonadism through dysregulation of normal gonadotrophic pathways (Jarow & Lipshultz, 1990; Vuong, Van Uum, O'Dell, Lufty, & Friedman, 2010). Providers need to be perceptive at identifying risk factors for use of these substances and educate about potential longterm effects on fertility.
Urol Nurs. 2012;32(5):237-248. © 2012 Society of Urologic Nurses and Associates