What Is Secondary Infertility?
Secondary infertility is when a couple already have one or more previous children and they then begin to experience difficulty in getting pregnant with a subsequent child. It can affect either the man or the woman, or both partners.
What Causes Secondary Infertility?
There are a number of causes, including:
- Endometriosis developing or worsening after the birth of a first child
- Damage caused by sexually transmitted infections, resulting in pelvic inflammatory disease
- History of a previous ectopic pregnancy. Removal of one of the fallopian tubes can reduce fertility by 50%. Removal of both means that you cannot achieve a natural conception
- Previous childbirth injuries, particularly cearean section - scar tissue on the uterus can cause adhesions to form which can prevent an embryo from implanting, as well as increasing the likelihood of a low lying placenta, uterine rupture during pregnancy and uterine rupture during labor
- Hormonal contraceptive methods which may disrupt or stop ovulation. For instance, if you've been having depo provera injections, it may take up to 18 months after you stop, before they wear off
- Immune infertility - if you have a new partner, your mucus may not be compatible with his sperm and may either destroy it or be too thick for it to pass through your cervix
- Premature menopause
- Advanced maternal age - perhaps you have waited until your late thirties or early forties to have a second child
- Men may suffer from blockages in the tubes that carry the sperm, poor quality sperm or an abnormal immune system response to sperm where they produce antibodies to them
- Sperm count and quality is also affected by stress, smoking and poor diet so if you've been through a family trauma, this may be a reason why you can't get pregnant
- Chronic illnesses like high blood pressure and serious conditions like cancer can also affect your chances of getting pregnant, particularly if you've opted for chemotherapy.
What Can Be Done To Help Me?
Treatment is dependent on what is causing the problem. If, after a year of unprotected sex, you are not pregnant, you should see a fertility specialist. He will carry out tests to determine whether you are fertile. Adhesions on the womb can be diagnosed by ultrasound scans and a laparoscopy and there are surgeries available to remove tissue which may increase your chances of success. If you don't ovulate or you've had cancer, you could use donor eggs or sperm and if there has been a previous ectopic pregnancy. Your lifestyle will also be looked at in detail and you may be asked to follow and pre-conceptual plan. If you are suffering from stress, you will be offered counseling.
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