What is secondary infertility?
Sometimes, when a couple who are already parents to a child try for second, they find that they are unable to get pregnant – no matter how long or how often they try. This phenomenon is called secondary infertility and figures show that it affects approximately 12% of parents.
Because it is unexpected, secondary infertility can be quite stressful. Parents with secondary infertility often don’t get much sympathy, which makes them feel that they don’t have the right to be sad. For some the guilt is doubled: the inability to give their child a sibling and for not giving their little one all their attention!
Before we come to ways of dealing with the condition, it may be helpful to examine its causes.
The causes of secondary infertility
Some cases of secondary infertility share many of the same causes of primary infertility. Among the possible causes of secondary infertility are:
The age factor
A woman is born with a fixed number of eggs. As the woman ages, her ovarian reserve (the number of eggs she has) reduces. So too does the quality of the eggs: the older a woman is, the less healthy her eggs are. Sometimes, even a couple of years can affect a woman’s fertility.
The reproductive factor
The functioning of the reproductive system can be affected over time. She might have had an infection leading to Pelvic adhesions, intrauterine adhesions, and/or fallopian tube abnormalities can affect the reproductive system and make healthy pregnancy more difficult. While these fertility issues could already have existed, they can also develop after the earlier pregnancy.
The sperm factor
A man’s fertility doesn’t decrease as rapidly as a woman’s, but, it still does. The older the man, the less healthy and active his sperms are. A change in health may also affect male fertility, as do some medications prescribed for certain health conditions.
A gain in weight may affect both male and female infertility. Sudden or excessive weight gain can contribute to ovulatory dysfunction in women. In men it may result in a decrease in sperm production or increase in erectile dysfunction.
These factors contribute to secondary infertility, however, like primary infertility, there may be no discernible cause. Nearly 20% of cases of secondary infertility are estimated to be due to unexplained infertility.
When should a couple suspect secondary infertility?
If you have been trying for over a year to have a second baby, you should see your doctor, who will be able to determine whether you need fertility treatment. If both you and your partner are over 35 (in particular the female partner), you should see a doctor even earlier – say after six months of trying. The longer you wait, the less likely pregnancy becomes.
Treatments for secondary infertility
Just like in the case of primary infertility, the ideal treatment will depend on your age and health. Conditions like pelvic inflammatory disease, painful periods, miscarriage, irregular cycles, or if the husband has a low sperm count or erectile dysfunction affect the treatment you are prescribed. In most cases you would probably be prescribed IVF or ICSI.
Should you turn to a support group?
The first people to talk to is each other – obviously. The next person is your doctor or gynaecologist who will be able to advise you. You could also make an appointment with a counsellor at a fertility centre – many of them are trained clinical psychologists who can help you deal with your worries and stress. And of course, there are plenty of online support groups that you can access.
It’s important to realise that you’re not alone…approximately 1 in 8 infertile couples suffer from secondary infertility.