Overcoming Challenges of Secondary Infertility
What is secondary infertility? Secondary infertility can be a painful setback for a couple that hopes to expand their family. It refers to the inability to conceive or carry a pregnancy to term despite having had a successful pregnancy in the past. While primary infertility, or the inability to have a first child, receives greater attention, the inability to get pregnant again is a growing concern that affects millions of families around the world. This condition can take a toll on a couple’s physical, emotional, and mental well-being, making it essential to recognize, understand and address the challenges that come with it. What causes secondary infertility? Secondary infertility in female This condition is often overlooked because of the misconception that having previous successful pregnancies would mean subsequent pregnancies will occur naturally. If you are wondering how common is secondary infertility, it occurs at about the same rate as primary infertility. It affects about 12% of the women trying for another child. Here are some causes that affect the secondary fertility problem as much as the primary one. – Age As women age, their fertility naturally declines. It is due to decreased quantity and quality of their eggs. This decline typically starts around age 30 and accelerates after age 35. As a result, women trying to conceive later in life may have more difficulty becoming pregnant than when they were younger, even if they have previously had successful pregnancies. – Ovarian reserve Women are born with a finite number of eggs, and this number naturally declines as they age. Women who have previously had successful pregnancies may have a lower ovarian reserve, making it more difficult for them to conceive again. – Uterine issues The uterus or womb is where the fertilised egg implants and grows into a fetus/baby. Thus, any issues with the uterus can impact a woman’s ability to conceive and carry a pregnancy to term. Secondary infertility may be caused by fibroids, scarring or adhesions within the uterus, and polyps. These causes may interfere with implantation or cause miscarriage. – Fallopian tube issues The fallopian tubes transport the egg from the ovary to the uterus/womb. If the tubes are blocked or damaged, it can prevent the egg from reaching the uterus and being fertilised by sperm. Some complications may occur in the form of chlamydia, gonorrhoea and pelvic inflammatory disease. – Endometriosis Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. In some cases, endometriosis can lead to secondary infertility. The scarring and adhesions caused by endometriosis can interfere with the normal function of the fallopian tubes and uterus. It can make the egg and sperm difficult to fertilise and implant in the womb. – Polycystic ovary syndrome (PCOS) PCOS is a hormonal disorder that affects women of reproductive age. It’s one of the most common causes of female infertility and can contribute to the condition. Women with PCOS typically have elevated levels of androgens (male hormones), which can interfere with ovulation and make it more difficult for the egg and sperm to meet. It can result in irregular or absent menstrual cycles, making it harder for a woman to conceive. – Secondary unexplained infertility Unexplained infertility can be a frustrating and challenging issue for couples. It may be due to age-related decline, changes in hormone levels, or lifestyle modifications. Regardless of the cause, it is essential to recognise and address the problem with the same urgency and sensitivity as primary infertility to increase the chances of conceiving. Secondary infertility in male Male infertility can be a contributing factor in cases of secondary infertility. Male infertility is responsible for up to 50% of all infertility cases. Several factors can cause male infertility, including: – Low sperm count or poor sperm motility If a man has a low sperm count or poor sperm motility, it can make it more difficult for the sperm to fertilise the egg. According to World Health Organisation (WHO), a healthy sperm count should be around 15 million per millilitre ejaculation or at least 39 million per ejaculation. Any amount lower than the optimal level is considered to have a low sperm count. – Abnormal sperm shape If a man’s sperm have abnormal shapes, it can also cause fertility problems. It is due to difficulty when penetrating the egg. – Blockages or other structural issues If a male has blockages or other structural issues in his reproductive system, it can interfere with the normal flow of sperm. Some common causes of blockages and structural problems may be vasectomy, Epididymitis (inflammation of the tube that transports sperm) and genetic causes. – Lifestyle factors Lifestyle factors also play a role in affecting secondary infertility. Factors such as smoking, excessive alcohol consumption, and being overweight or underweight can all impact fertility. Many factors can contribute to the fertility problem, and it’s often a combination of factors that leads to difficulty conceiving. It’s crucial for couples who are struggling with secondary infertility to work closely with a doctor to know what causes secondary infertility and develop a personalised treatment plan. How to diagnose secondary infertility? Diagnosing the problem involves thoroughly evaluating both partners to identify any underlying fertility issues. The diagnostic process typically begins with a comprehensive medical history and physical exam, followed by tests and procedures to evaluate fertility and identify potential problems. For women, the diagnostic process may involve the following: Ovulation testing Ovulation testing involves tracking a woman’s menstrual cycle to determine if and when she is ovulating. It can be done using ovulation predictor kits, basal body temperature monitoring, or ultrasound. Hormone testing Hormone testing involves measuring the levels of various hormones in a woman’s blood. It includes Follicle-Stimulating Hormone (FSH), Luteinising Hormone (LH), estrogen, and progesterone. Abnormal hormone levels can indicate issues