Question 1
Infertility problems come with a significant amount of distress for the affected couple. As such, it is important that counselling should form part of the management plan. Regarding Salma and Kevin’s situation, I would use a three-pronged counselling approach to ensure that I address the most pertinent issues affecting them. The first dimension that I would counsel them is regarding acceptance of the present situation. By accepting their situation, it would be easier to find a common solution to the problem as they would be more compliant. Acceptance would also help them to support each other throughout the course of treatment instead of trading blames (Peterson et al., 2012) . The second dimension that I would counsel them on is regarding behavior change. Some behaviors such as being overweight and being physically inactive, smoking, alcoholism can lead to infertility. Therefore, there is need to counsel the patients on the need to avoid such behaviors that might be contributing to the presenting problem (Peterson et al., 2012) . The third dimension that I would counsel them on is the regarding the coping mechanism. Some people when presented with such a challenging problem might decide to use coping mechanisms that further worsen their situation. For example, use of avoidance coping mechanism is likely to worsen their problem in that it might even lead to depression (Peterson et al., 2012) . Therefore, I would counsel them on the appropriate coping mechanisms that would lead to positive outcomes.
In order to arrive at the diagnosis, there are various tests that need to be conducted. Arriving at the right diagnosis would make it possible for the most appropriate treatment modality to be applied. The tests should be performed for both the male and the female as the problem could be with either of them. For the male patient, one of the tests that need to be done is semen analysis. Semen analysis would help to identify issue with sperms for example low sperm count, issues with sperm motility among others. Imaging studies would also help to determine the cause of the problem. For example, scrotal ultrasound would help identify any abnormalities within the scrotum. Vasography would also help reveal any issues with the vas deferens. Hormone testing would also help reveal whether the male has low testosterone levels that would be contributing to the problem (Mayo Clinic, 2020) . With the female, she needs to undergo tests such as imaging which would help reveal issues with the uterus, the fallopian tubes and the cervix. Hormone testing would also be a key investigation because it would help reveal whether the patient has a deficiency of hormones such as progesterone, FSH, estrogen among others. Ovulation testing would also help to determine if the female is ovulating (Mayo Clinic, 2020) . Since the family doctor indicated that it is Kevin who has a problem, options available to them to have a baby include adopting a child and IVF.
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Question 2
IVF has revolutionized reproductive health in that couples who could not conceive using traditional methods can now conceive and raise a family just like any other couple. It involves conducting invitro fertilization of the egg and then transferring the embryo to the uterus. Regardless of the method of fertilization employed, birth defects can arise and it is therefore important to ensure that the embryo that is transferred does not contain any genetic defects by conducting a screening test (Winston, 2018) . Embryos are best transferred on the fifth day as the uterus lining is readiest for conception on the fifth day.
Even though IVF is a highly celebrated breakthrough, it is important to note that the success rate is low with the best performing fertility clinics recording a success rate of 40% (Winston, 2018) . This success rate is depending on many factors such as the woman’s age, the number of embryos that are transplanted, adherence to medications that have been prescribed and the age and quality of embryos transplanted. Therefore, I would advise the couple to be open minded as IVF is not a guarantee of success. For IVF to be successful, it is important that the woman takes the medications prescribed as advised by the doctor and hence the woman should not be afraid of medications if at all she wants to conceive.
References
Mayo Clinic. (2020). Infertility - Diagnosis and treatment - Mayo Clinic . Mayoclinic.org. Retrieved 12 May 2020, from https://www.mayoclinic.org/diseases-conditions/infertility/diagnosis-treatment/drc-20354322.
Peterson, B., Boivin, J., Norré, J., Smith, C., Thorn, P., & Wischmann, T. (2012). An introduction to infertility counseling: a guide for mental health and medical professionals. Journal Of Assisted Reproduction And Genetics , 29 (3), 243-248. https://doi.org/10.1007/s10815-011-9701-y
Winston, R. (2018). The 40th anniversary of human IVF: time to celebrate and time to reflect. Reproduction , 156 (1), E1-E3. https://doi.org/10.1530/rep-18-0293
