Secondary Infertility

There is a general impression that in a case where you have had a baby once, you won't have any fertility issues again. The concept of primary and secondary infertility is thus very less known. If you have one child or more, it is very much possible that you can face difficulty in getting pregnant again. It is a shocking thing to hear and can be similarly as irritating and hard to manage as it would be in the case when you were trying to have a baby for the first time. Fertility is associated with age and several other factors. Both women and men can have these issues while planning a pregnancy for the second or third time, or about couples facing secondary infertility when to stop trying?
secondary-infertility
Secondary Infertility

What is Secondary Infertility?

Secondary infertility is the failure to produce a child after a past successful birth even after several attempts. As mentioned by the World Health Organization (WHO), infertility means the inability of a person to produce a child following at least a year of unprotected intercourse. Secondary infertility means the same, but only after a person has at least one child or have had at least one conception (successful or unsuccessful in the past) and is facing difficulty in getting another, opposed to primary infertility, which is the condition when a person is having issues in having the first child.

Fertility decreases as we age, and numerous couples today have kids very late in their lives due to changing lifestyle. If you think that a couple has had their first child in their 30s and then try for another kid only a few years later, it might not be problematic. However, a few years can make much difference. If the woman has crossed the age of 35, the fertility capability of her drops considerably.

How Common is Secondary Infertility?

Secondary infertility is characterized as being unable to become pregnant or to carry a child to full term, following the birth of at least one child or at least one conception. Secondary infertility statistics is shockingly widespread and is the reason behind half of the cases of infertility. As per the Centre for Disease Control, 11% of couples who have a child or children face secondary infertility later in their life.

Let’s suppose that you have primary infertility and then with the help of ART (Assisted Reproductive Technology) and medical treatment, and you were able to have your child. It is very much possible that the cause of infertility might still be there in your body, amplified as you have aged. Also, the medical reasons for secondary infertility aren't any less challenging to analyse and treat than primary infertility.

What are the Main Causes of Secondary Infertility?

Various factors can lead to secondary infertility. These might be female related, male-related or a mix of both. The most common causes of secondary infertility are:

Age - It's an undeniable fact that you and your partner are both older at this point. Regardless of whether it's a year or two since you last got pregnant, your ovarian reserve could be drained and the more aged you are, the more difference a year can make. With age, sperm quality also declines.

Living with Your Child - The ordinary tensions of parenthood can likewise be a contributing aspect. Lack of sleep, managing the baby along with work pressure in case you're managing childcare, work and a bustling house all along can make it more difficult to engage in sexual relations.

Lifestyle Factors - There's no denying life has changed since you moved towards becoming parents, carrying additional post-infant weight, getting less rest and being exhausted most of the time will all affect your capacity to produce a child normally. It may appear odd to have been able to make a baby the first time and not the second or third time, but there are numerous reasons why this may be happening, and they are:

Female Factors that Influence a Woman’s Age

One of the significant reasons for fertility issues is the woman's age. Regardless of whether a female has been pregnant previously or not, egg reserve and quality have decreased with age. The decline in fertility in ladies is most prominent once they are past their mid-30s.

If you gave birth to your first youngster in your mid-30s and are attempting again in your late 30s or 40s, then your odds of getting pregnant gets considerably diminished because of advanced age, and there could be issues related to:

Ovulation

Several times women have conditions that influence ovulation, for example, Polycystic Ovarian Syndrome (PCOS), or even age. In these sort of cases, getting pregnant for the second time may become difficult than the first time, along with the long and unpredictable cycles that make it hard to find out the exact time of ovulation.

Weight Gain

Likewise, in a case that you might have put on weight after your first pregnancy, with age, this may make it harder to get pregnant. Gaining weight can prompt ovulation irregularities in women and influence sperm production in men. A proper diet with regular exercise at least once in two days can positively affect your odds of pregnancy.

Egg Reserve

Egg reserve or ovarian reserve is the number of eggs present in the ovaries at any given point of time. Also, it plays a significant role in achieving pregnancy. Moreover, advanced age additionally contributes to the issue of the low ovarian reserve where both the quality and quantity of eggs diminishes.

Tubal Factors

There may be a blockage in the fallopian tubes where the egg meets the sperm for fertilization. A blockage may be due to scarring of tissues due to a prior medical procedure, pelvic contamination or different causes like endometriosis. The obstruction could be at the level where the tubes open into the uterus, or at the distal ends of the tubes. It can prompt the development of infectious fluid inside the tubes, and the condition is known as Hydrosalpinx that can influence the implantation of the fertilized egg.

Issues with the Uterus

Also, it is common to find uterine fibroids and endometrial polyps in older women, which in a way can also affect a woman’s fertility. Previous miscarriage is an important factor that might prevent women from getting pregnant again.

Male Factors Influencing Fertility

Sperm Issues

A man's fertility can change after some time, and health problems or medication can influence sperm count and quality. Regardless of whether you are with a similar partner, male secondary infertility factor deficiency adds on to the fertility issues, and it must be checked with a semen analysis test.

How can Secondary Fertility be Diagnosed?

Primary infertility and secondary infertility investigations or diagnosis are mostly the same. Both men and women should be diagnosed for secondary infertility. If you've been attempting to get pregnant for a year or more, you ought to go and see your specialist and try to get some expert advice from fertility specialists. In case you're more than 35, it demands that you seek medical help after six months, as your fertility decreases with age.

Your specialist can test to check whether you are ovulating and will likewise check your partner for any issues with the nature of his sperm. Having had a child doesn't mean you can't encounter fertility issues. After discovering what is causing your infertility, the doctor might suggest the next course of action.

The tests for females are blood works to check for hormones, ultrasound, CT scan or laparoscopy to determine any problems in the female’s reproductive system. A test to check the ovarian reserve is also done. In the male partner, the primary criterion is the semen analysis, which checks the various aspects of sperm like sperm count, sperm morphology (shape) and sperm motility (ability to move).

Secondary Infertility at 40

Since fertility declines with age, old couples planning their second baby at 40 might face infertility issues. Infertility in this group of men and women should be considered and treated from a wider perspective as they face many age-related health troubles as well and not just limited to reduced AMH or androgen deficiency, or even psychological disorders that impede conception of pregnancy. However, with the use of advanced technology and modern labs, today IVF treatment has helped couples overcome all such issues related to their primary or secondary infertility.  

What are the Treatment Options for Secondary Infertility?

The secondary infertility treatment options will be the same as that of primary infertility. Your specialist might put you on presc.riptions drugs to enhance your ovulation, artificial insemination or IUI may be recommended to overcome fertility issues, or IVF can be a viable treatment if IUI has failed and in some complex cases.

Infertility Drugs: Common oral medicines like Clomiphene Citrate and Letrozole, which are utilised to stimulate the ovarian follicles to release more eggs. Injectable solutions, for example, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are likewise customarily used to induce the growth of more matured eggs in one egg retrieval cycle. Both the combination of hormones is regularly utilized with Intrauterine insemination (IUI) and In Vitro Fertilization.

Intrauterine Insemination (IUI): A semen test from the male partner or donor is assessed, and the sperm is extracted from it. Afterwards, they are put into the female’s uterine cavity during ovulation. This makes the sperm available close to the fallopian tubes where it could easily meet the egg for fertilization.

In-Vitro Fertilization (IVF): IVF could be a possibility for many couples. Eggs are fertilised with sperm outside the body which develops into an embryo that is then transferred directly into the uterus.

Intracytoplasmic Sperm Injection (ICSI): If a man is suffering from very low sperm count, very poor morphology, and even in cases of poor motility then ICSI can be considered where a single sperm is injected into the egg, thereby reducing fertilization failure. ICSI has a high fertilization rate.

Conclusion

We all may feel that we have total control over our actions while it may not be the case every time. Infertility issues can happen to anyone and at any point in time, although you didn’t have any problems before. When you face any difficulty in conceiving, seek medical advice as soon as possible so that the issues could be tackled well in time.

So, in case you are having trouble in conceiving, Medicover Fertility has experts in fertility treatment and has helped many people in overcoming their fertility issues. Talk to our fertility consultants and get a free consultation by calling us at +917862800700. 

FAQs

Q – What is Primary and Secondary Infertility?

A – Primary Infertility is the condition seen in a couple who have never had a baby. And, Secondary Infertility suggests the inability to get pregnant following a past conception.

Q – Who is to be responsible for Infertility - Male or Female?

A – Infertility is not a female issue only. In harsh terms, around 33% of infertility cases are related to males, and another 33% of factors are related to female. For the rest 33% of infertility cases, it is caused by a mix of both the factors, in around 10 – 15 per cent of cases; it is unexplained.

Q – What are the most typically recognized Male Fertility Factors?

A – The most well-known male fertility factors incorporate azoospermia (nil sperm count) and oligozoospermia (low sperm count). In a few men, the duct for sperm entry might be obstructed because of inherent physical issue or due to some past injury, and this may cause azoospermia. Sperm cells may be having abnormal morphology or decreased motility. In uncommon cases, fertility in men is caused by a hereditary factor-like cystic fibrosis or some chromosomal variations.

Q – What are the Natural Remedies for Secondary Infertility?

A – Although there are no such natural remedies for secondary infertility, however you can boost your fertility or maintain it by maintaining a healthy lifestyle and eating habits.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338792/

https://www.ncbi.nlm.nih.gov/pubmed/3699169 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132591/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132591/