Secondary infertility: Are you experiencing problems second time around?

What is secondary infertility and why does it affect couples who successfully achieved parenthood the first time around?

There are many reasons why a couple discover they are unable to conceive or maintain a pregnancy after successfully conceiving previously.

For some couples, secondary infertility comes as a consequence of getting older. Sperm quality may no longer be the same, even though men’s biological clocks move more slowly than women’s.

As a woman ages, her egg reserve depletes and the quality of the eggs deteriorate.

Fertility is highest for women in their twenties and egg quality and quantity deteriorate after 35.

A woman who had a child in her twenties may find that after 35 she has fewer good quality eggs. When the ovarian reserve is depleted, Reproductive Endocrinologists (REs) recommend the use of donor eggs and IVF.

Type II diabetes is one ailment that often affects a woman’s ability to bear a child. High glucose levels, associated with the illness make implantation difficult and often trigger early miscarriages. Experts advise women with type II diabetes to maintain healthy blood sugar levels, starting three months before trying to conceive.

It is not just a woman’s problem. Just because a man was able to impregnate a woman at some past time does not mean that he is forever fertile.

A man who is already a biological father could develop varicocele a condition in which the movement of semen is obstructed. Varicocele is present in 75 to 80 per cent of cases of male secondary infertility.

Another condition that affects male fertility is testicular torsion, usually resulting from trauma to the testicles. Men who play sports that expose their testicles to potential blows are often among those who face secondary infertility due to testicular torsion.

Your male partner who may have been fertile previously may have developed an illness such as diabetes that reduces his fertility.

Type Two Diabetes reduces fertility in men who with this ailment have lower volumes of semen and sometimes experience retrograde ejaculation (where the ejaculate does not make it into the woman’s reproductive system).

In cases of male infertility, REs will recommend IVF (In Vitro Fertilization) with donor sperm.

Infections such as STDs (chlamydia, syphilis and gonorrhea) lead to pelvic inflammatory disease or PID.

The problem with PID is that, for many women, serious signs do not emerge until when the damage has been done.

PID brings with it inflammation which then results in blocked fallopian tubes. When the fallopian tubes are blocked the egg cannot travel to the uterus to implant. Sperm may also find it difficult to make it to the egg to be fertilized. Sometimes infections that cause PID stem from previous births or D and Cs (Dilation and Curettage). Additionally, previous caesarian sections can cause scarring that make conception difficult.

If your fallopian tubes are blocked you can consider recanalization but a more certain road to conception is through IVF. IVF bypasses the tubes altogether making it easier.

Hormone imbalances that may not have existed during a previous pregnancy may now exist. These throw the messages in the reproductive system out of sync and lead to ovulation disorders such as anovulation. Ovulation inducing medications, such as Clomiphene, are used to boost ovulation if the fallopian tubes are not blocked and the male partner’s sperm count is suitable.

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