How Common is Secondary Infertility?
Getting pregnant the first time was no problem, but now that you’re ready for baby number two, it’s just not happening. What gives? It could be secondary infertility, the technical term for the inability to have a child after successfully conceiving your first one. But don’t let the term scare you: a couple who has previously had a baby together almost always faces better odds than a couple who’s never been able to conceive. Time is of the essence
What Causes Secondary Infertility?
Sometimes, couples just get lucky with baby number one. Testing might reveal that you or your partner was only marginally fertile all along. More likely, though, something happened after your first pregnancy. Undiagnosed STDs can cause scarring within the reproductive system, leading to infertility. An accident, illness or health issue, such as a ruptured appendix, may damage the fallopian tubes. More often than not, though, age is the major factor in secondary infertility.
How Can I Cope with Secondary Infertility?
“One of the most important things you can do is to become part of a positive community,” Kintner says. That can be hard when you’re dealing with secondary infertility. Women who are struggling with primary infertility may give you “hey, just be grateful you have a baby” vibes, while your parent friends are wrapped up in their own families. Some women find support online. Others find comfort in books.
I`ve Been Pregnant Before, But Never Carried a Child to Term. Does That Still Count as Secondary Infertility?
For all practical purposes, yes. Experts still debate the exact definition of secondary infertility — is it the inability to conceive after giving birth? The inability to conceive after previously conceiving? — but the exact definition really doesn’t matter. If you’re struggling to have a baby, seek help.
Is Secondary Infertility a Male or Female Problem?
A full 40% of all infertility (primary or secondary) is related to sperm (usually, not enough healthy, active sperm), while 30% is due to ovulatory dysfunction. Another 20% is related to female “plumbing problems,” such as blocked tubes, uterine fibroids or endometriosis. The remaining 10% is unexplained — but that can actually be a good thing! “The data shows that the more normal your testing is, the more likely you are to be successful with infertility treatment,” .
When Should I See a Doctor?
The old advice was to wait a year. But increasingly, the experts recommend seeking help after six months — especially if you’re over 35, as your odds of having a healthy baby decrease each month. “Eighty-five percent of couples who have unprotected intercourse will conceive within a year of trying,” says Jani Jensen, MD, an obstetrician/gynecologist and reproductive endocrinologist at Mayo Clinic. “But research shows that most pregnancies really occur within the first six months of patients trying to conceive.” So get help sooner rather than later!
Do I Need to See an Infertility Specialist?
Yes. Your OB/GYN is probably a great doc, but most OB/GYNs aren’t up-to-date on the latest infertility treatments, and every month you spend in generalized care is a month you could be working on a solution to the problem. A board-certified infertility specialist is an OB/GYN who has received an additional two to three years of training in the diagnosis and treatment of infertility.
What Tests Are Used to Diagnose Secondary Infertility?
Your infertility specialist will probably perform several tests, likely including:
– A general physical exam to assess your overall health
– A blood test to check hormone levels
– A semen analysis to check your partner’s sperm count and quality
– An ultrasound to look for any blockages in the male or female reproductive system
– A hysterosalpingography (HSG) to check for blockage of the fallopian tubes. (Fluid is injected in the uterus and tubes; technicians monitor fluid flow.)
– A laparoscopy to look for issues such as endometriosis or uterine fibroids.
Physicians use a tiny camera to look in the abdomen under general anesthesia.
How Can I Increase My Chances of Having Another Baby?
If you smoke, quit. “Smoking negatively affects both the quality of sperm and the quality of eggs,” Dr. Jensen says. Also try to maintain a normal weight. Excess weight is related to problems with ovulation; even losing a few pounds can make a difference. Ovulation predictor kits can help you time intercourse for maximum advantage. They detect the presence of a hormone that indicates that ovulation is about to occur — and that’s important info because having sex right before an egg is released gives you the best chance of pregnancy. “I tell couples to start checking with ovulation predictor kits on cycle day 10,” Dr. Jensen says. “When the kit is positive, have intercourse that night, then again within about 24 to 36 hours.
Charting your basal body temperature isn’t nearly as effective, because by the time your temp spikes, you’ve already ovulated.
Do Any Natural Remedies Help?
Acupuncture may help, especially if you’re undergoing IVF. A review of seven research studies found that doing acupuncture immediately before or immediately after embryo transfer during IVF improves the rates of pregnancy and live birth. Acupuncture may also help with ovulatory problems.
Stay away from supplements designed to enhance fertility. Unlike acupuncture, ingested substances can have unwanted side effects. “We don’t want people taking weird, over-the-counter herbs or remedies that might interfere with treatment,” Dr. Garrisi says. Bottom line: check with your doctor before taking any medication, herb or supplement.
What Medical Treatments Are Most Effective?
Infertility treatments are all about maximizing opportunity. So if there’s an ovulatory problem, medications that stimulate the ovaries to release more eggs each cycle can be a good option. If a sperm issue is affecting fertility, concentrating the sperm (in a lab) and injecting them directly into your uterus – a process called intrauterine insemination (IUI) – may be successful. Sometimes fertility doctors combine techniques. “Usually, if a woman takes fertility drugs, IUI works the first, second, or third time,”. “If it doesn’t, it may be time to move on to in vitro fertilization (IVF).”
IVF is the process of combining the egg and sperm in a laboratory setting to create an embryo, which is then implanted directly into the uterus. If a physical problem prevents a woman from carrying a pregnancy to term, couples may op to implant the embryos into another woman, known as a gestational carrier. Egg donors are sometimes used when a woman’s age (and the age of her eggs) affects fertility.
How Will I Known When It`s Time to Move on?
Infertility is an intensely personal experience. You and your partner are the only ones who can decide when to step up your efforts and when to back off. “most studies suggest that if a treatment is going to work, it’s probably going to work in the first three to four months,” Dr. Jensen says. “I usually tell patients that we’ll try something for up to four cycles; after that, we should review if we want to move on to a more aggressive step.” Some couples ultimately choose to adopt. Others decide to end their pursuit of another child. Whatever choice you make, you can rest assured that it’s the best choice for you. In the end, that’s all that matters.