An estimated three million women are affected by secondary infertility in the U.S. Secondary infertility is defined as the inability to become pregnant or to carry a baby to term after previously giving birth to a baby. Unfortunately, despite being common – and increasingly so – it’s oft overlooked because many people don’t realise that if you’ve had one child you might still have a problem conceiving in the future.
When should you seek help?
In general, doctors recommend that if you’re under the age of 35 and have frequent, unprotected sex but don’t become pregnant after a year, you should see a reproduction endocrinologist. If you’re 35 or older or you have other risk factors like diminished ovarian reserve, polycystic ovarian syndrome (PCOS) or endometriosis you should see a doctor after six months, or before. In tandem with seeing a specialist it can be helpful to implement clean living practices like cutting back on drinking and smoking, eating healthy and de-stressing.
Society might not have as much sympathy for those suffering from secondary infertility as for those dealing with primary infertility, but it’s no less emotionally challenging. Anytime someone wants to grow their family and, month after month, it’s not happening, it’s heart-crushing. To better understand this diagnosis we turned to Dr. Barry Witt, a reproductive endocrinology and OB-GYN and the medical director with WINFertility, and asked him to share with us the five things he wishes everyone understood about secondary infertility.
Aging is oftentimes responsible for secondary infertility.
“As women age, the numbers and quality of their eggs declines and this can make it more difficult to conceive or maintain a pregnancy. Depending on when their most recent child was born, a few years can make a big difference, especially in women over 35. Age is less of an issue for men, but a man’s sperm count can decline with age as well.”
Things that cause primary infertility can also cause secondary infertility.
“These include male factors, ovulation problems and blockage of the fallopian tubes. Sometimes women are able to overcome other fertility issues, like mild male factors, when they’re younger because they are very fertile, but less likely to do so when they are older, even by a few years, as they are less fertile.”
Secondary infertility may be associated with obesity.
“If there has been significant weight gain since the previous pregnancy, fertility may decline as a result of weight related ovulation disorders such as PCOS. Menstrual cycles can become much less frequent as a result of irregular ovulation or a total lack of ovulation which makes it very difficult to conceive. Obesity in men is also associated with decreases in numbers and quality of sperm.”
If subsequent to a previous pregnancy there are new health issues that developed over time, they can lead to secondary infertility.
“For instance, endometriosis is a disorder that worsens over time and can result in scarring of the fallopian tubes or decline in ovarian reserve (numbers of eggs). While it may have not been severe enough to prevent a previous conception, further progression of the disease can result in secondary infertility. Also medical problems that develop over time, such as diabetes, hypertension and thyroid disease, can have adverse effects on fertility in men and women. Medications that were started after a previous pregnancy can affect fertility as well. These can include cancer treatments, for example, or in men, the use of testosterone.”
Secondary infertility may be the result of complications of a previous pregnancy.
“These complications can include either an issue with delivery or a miscarriage. Infections or surgical procedures, such as a D & C for retained placental tissue, can result in scarring inside the uterus which can prevent subsequent conception.”
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