Uterine Transplant vs Pharmacological Agents

Pharmacological Agents

There are many methods to managing infertility and depending on the cause of infertility, certain pharmacological treatments are chosen. One of the specific causes of infertility is referred to as polycystic ovary syndrome (PCOS) where it is known about 80% of women who have this syndrome are deemed anovulatory (Davidson et al., 2020). This term refers to the lack or absence of releasing the egg (ovulation). This syndrome is known to cause insulin resistance and hyperinsulinemia. This is where the pharmacologic agents, the insulin-sensitizing agents come into play and function to normalize the blood sugars. The main insulin-sensitizing agent included for women with PCOS is Metformin, which works to lower the blood sugars by increasing the muscle, fat, and liver’s sensitivity to insulin. The agent helps to induce ovulation in women specifically with PCOS and increases the number of successful pregnancies.

The cost of the insulin-sensitizing agent Metformin can range from as low as $4 a month up to $500 a month. For patients with health insurance, diabetes medication can cost from $4 to $100 per month. For patients without health insurance, diabetes medication can cost from $8 to $200 per month or more, and $200-$500 for multi-drug regimens (Romauldi et al., 2020). The success rates for the agent Metformin have led to improvements in the women’s menstrual pattern, ovulation rate, and clinical pregnancy (Romauldi et al., 2020). Metformin is recommended to be added alongside other drugs that aid in the facilitation of ovulation for PCOS-specific women.

The insulin-sensitizing agents are a less invasive pharmacologic approach for women with infertility issues. These are preferred oral agents that aid in the induction of ovulation. The specific agent, Metformin, has mild to moderate side effects, a sustainable dosage orally per day, is safe to use in the long term, and is easily accessible on the market. The agent Metformin I feel is a top contender for women who are trying to conceive based on the aforementioned reasons.

The intensity of the effects of Metformin can vary from mild to moderate intensity. Common metformin-related disturbances are gastrointestinal (GI) symptoms including abdominal pain, nausea, vomiting, diarrhea, taste disturbances, and appetite loss reported in 10%–60% of patients (Romauldi et al., 2020). Some possible psychological/mental side effects are anxiety, depression, and nightmares. These effects can play a factor in the disruption of the ovulation process leading to the woman’s hormone levels changing and expressing various emotions. The inability to conceive, carried from these psychological effects will change the woman’s plan and lead to a downward spiral of deep and negative emotions. The approach to these effects warrants the nurse to observe the woman carefully while taking Metformin and be able to assess any inconsistencies that may arise.

To continue, one nursing diagnosis is anxiety related to infertility. The first nursing intervention is to not leave the patient alone and speak softly using short, simple commands. This way the patient can receive and comprehend the information in a calm manner. The second intervention is to describe to the patient what will happen and compare it with her expectations. This is a good and effective way to set realistic goals with the patient and not give any false hope. The third intervention is to practice relaxation techniques when stress begins to build. These exercises will come in handy when the woman is having anxiety. The fourth intervention is to refer the woman to a support group, this can give the woman reassurance that there are others that deal with anxiety.

All in all, the specific pharmacologic agents I chose were the insulin-sensitizing agents (Metformin) specifically for women dealing with PCOS (polycystic ovary syndrome), along with the benefits, costs, and specifics of their purpose. The emotional effects can alter the woman’s behavior and lead her to reconsider her plan of conceiving related to the psychological/mental side effects including anxiety, depression, and nightmares. It is the duty of the nurse and information that reassures the woman of other options to consider when dealing with infertility issues.

Find any scholarly article(s) fewer than ten (10) years old, to respond to your classmate. The response must include a comparison of the associated costs, the physical, mental, and emotional pain that may be experienced, and why I believe that my assigned ART (Uterine Transplant) may be more worthwhile than your classmate’s assigned ART (Pharmacologic Agents).

References

Davidson, M. R., London, M. L., & Ladewig, P. W. (2020). Olds’ maternal-newborn nursing & women’s health across the lifespan (11th ed.). Pearson.

Romualdi, D., Versace, V., & Lanzone, A. (2022, January 14). What is new in the landscape of insulin-sensitizing agents for polycystic ovary syndrome treatment. SAGE Publications Inc. Retrieved September 24, 2022, from https://us.sagepub.com/en-us/nam/journals