Most parents have a mental image of their ideal family, and if they find themselves unable to make that happen, it can be devastating. Infertility is heartbreaking and stressful, whether you have a child or not. Secondary infertility is more common and emotionally painful than many may think. Here is some advice for if and when conceiving Baby #2 is more difficult than expected.
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Secondary Infertility: Causes, Tests and Treatment
What is secondary infertility?
The couple’s failure to conceive a baby, in spite of being parents of a healthy child, refers to secondary infertility. Secondary infertility is the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. At such a low time, it is important to know that secondary infertility in women is common. In fact, secondary infertility is more common than being unable to conceive for the first time. About one in seven couples face this problem.
How is it caused?
There could be many causes of secondary infertility which is why conceiving the second time could be difficult. You may be having a previous complication that may have turned into a larger one. There is also a probability of developing a new infection or a surgical procedure which could have affected your capability to have kids.
A few other issues which could interfere with your fertility are:
- Damaged uterus or fallopian tubes due to endometriosis
- Blockages due to fibroids
- Ovulation disorder caused due to pcos (polycystic ovarian syndrome)
- Damaged fallopian tubes due to an earlier ectopic pregnancy
- Pid (pelvic inflammatory disorder) which happens due to a sexually transmitted infection
- Caesarean section during the previous delivery which may have resulted in uterine adhesions or scar tissues
- Poor sperm quality
- Being underweight or overweight
What sort of tests can i do if i think i have secondary infertility?
Apart from the general gynaecological examinations, you will have to undergo other tests for unexplained secondary infertility. These include:
- Ovulation testing: this is a blood test that determines your hormone levels to know if you are ovulating correctly.
- Hormone testing: these tests check the levels of pituitary hormones and ovulatory hormones which are responsible for reproductive processes.
- Ovarian reserve testing: this testing is carried out to check the quantity and quality of eggs needed for ovulation.
- Imaging tests: these tests include a pelvic ultrasound which analyses fallopian or uterine diseases and infections.
- Genetic testing: this test is conducted to know if there are any genetic defects which are responsible for infertility.
- Hysterosalpingography: this test is carried out to understand the condition of the fallopian tubes and uterus. It also checks for blockages if any. This test is done by injecting x-ray contrast into the uterus, and an x-ray is taken to know if the cavities are filled properly.
Depending on the circumstances, both you and your partner might need medical evaluations. Your doctor can help determine whether there’s an issue that requires a specialist or treatment at a fertility clinic.
how do i treat it?
This can be done in several ways:
Intrauterine insemination (iui)
During this procedure, healthy sperm is inserted directly into the uterus. This is done at the time when the ovary releases the eggs for fertilisation. The iui timing is usually matched with the regular ovulation cycle and to suit fertility medicines.
This surgery can successfully treat uterine issues like uterine septum, intrauterine scars and endometrial polyps.
Women who are infertile due to ovulation disorders are treated with fertility drugs. These drugs helping in inducing and regulating ovulation. Consult your physician to understand the benefits and risks of these medicines, and find out which one will suit you.
What are the chances of success?
More than often, it is the age of the female that is responsible for the likelihood of success. If the female is below the age of 36 then the chances are bright. However, females of age 38 and above may not have similar success. Not giving up after a couple of months of treatment is the key to improving your chances of success.
It is well-known that the older you get, the more difficult it is to conceive. You may have put on weight or lost it, had surgeries or your partner’s sperm quality and quantity has deteriorated too. If your sex life is good and yet you are unable to conceive, it is time to meet a good doctor. It is best to sit down together and create a time frame for all that will happen in the next few months. Know how much money you need and what options you will consider.
Will IVF work?
In vitro fertilisation is the preferred method of impregnation for couples with secondary infertility and would be the treatment of choice depending on the semen quality. Semen problems are treated with iui or ivf and sometimes sperm microinjection (a technique known as icsi where a single sperm is injected into an egg in an attempt to fertilize the egg).
Can endometriosis affect secondary infertility?
Endometriosis is a common condition in which small pieces of tissue that are similar in make-up to the inner lining of the womb (endometrium) grow outside of the womb; for example on the bowel or bladder, ovaries and fallopian tubes and on the lining of the abdomen.
Although endometriosis can have an effect on your chances of getting pregnant most women who have mild endometriosis are not infertile. An estimated 70% of women with mild to moderate endometriosis will get pregnant without treatment. If you know you have endometriosis and are failing to conceive, talk to your doctor who can advise you or refer you to the necessary fertility specialists.
The exact nature of the link between infertility and endometriosis is unclear but the severity of the condition and location of the tissue appears to have an effect. For example, it is not fully known how a few spots of endometriosis may affect your chances of getting pregnant, but if you have severe endometriosis your chances are likely to be affected by the changes to your anatomy. However, even with severe endometriosis natural conception is possible.