Secondary Infertility : What is it and Why does it happen
‘Secondary infertility’ adds up to about 20-30 per cent cases of total infertility cases that happens in India. As per reports instances of women facing problems getting pregnant for the second time is a growing concern especially in urban India.
I already have a child, so why can’t I get pregnant again?……you are facing Secondary Infertility
We have a kind of thought process that goes like, if you succeed with first pregnancy then it would happen naturally second time too….but this not be the case. The fact is, it is extremely difficult for couples to believe that they will have to take some medical intervention to become parents again.
Secondary Infertility is defined as “When a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth.”
So this includes women
Who repeatedly and spontaneously miscarry
Whose pregnancy results in a stillbirth
Are unable to carry pregnancy to a live birth (failed/successful first pregnancy)
Secondary infertility: Why does it happen?
Female Reproductive age is the main culprit. With age, chance of getting pregnant naturally diminishes. Women are born with all of the eggs (oocytes) they will ever have. As women age their ovarian reserve diminishes, which means that their egg quantity and quality decreases with time.
Status of the pelvic organs. Presence of fibroid or a polyp in uterus could be the trouble maker
Weight too could be the problem. Being over or underweight alters ovulation in women. It also can impact sperm health in men.
Lifestyle diseases like diabetes, blood pressure, cardiovascular problems and even depression can lead to secondary infertility
The everyday stress of being a parent can also be a contributing factor. Sleep deprivation, busy household, managing a toddler all can add to it.
Secondary Infertility Treatment Options
Treatment option does not mean head straight to IVF clinic. The truth is many fertility treatment options are available like infertility medications to intrauterine insemination. But the key point is more you delay, more difficult it’s going to be. Medical team suggests that couple should meet fertility specialist if they are unable to get pregnant again after six months of trying if they are over 35, or one year of trying if they are under 35.
Very much like primary infertility, secondary infertility screening will also include looking for hormonal, environmental, immunological and physiological causes.
Semen Analysis – Male patients will have to go for semen analysis to determine motility and sperm count
Female check up – This would include ultrasounds to determine whether ovulation and egg release is happening normally, X-ray to look for blocked fallopian tubes etc
Once detailed check up and discussion are carried out expert could suggest the treatment procedure.
This could start with
Nutritional Care – Couple will be provided with education and strategies on how to optimize health for conception and pregnancy. Special diet plans would be drawn for couples who have lifestyle diseases.
Drug care – The next step would involve fertility medication (medicine +/-hormone treatment) or drugs in combination with intrauterine insemination. Intrauterine insemination is a form of artificial insemination that involves placing a concentrated semen sample in your uterine cavity to improve chances of conception.
Couples will have to go for in vitro methods like In Vitro Fertilization (IVF), Intracytoplasmic Sperm Injection (ICSI), Reproductive Surgery, Gamete Intrafallopian Transfer (GIFT) or Zygote Intrafallopian Transfer (ZIFT)
One thing to be understood is going through Secondary infertility is as tough as Primary infertility. Emotional well being and Family support is essential for this journey to become successful.