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Secondary Infertility – Understanding Your Options

Guest Post by Dr. Larisa Corda

FertilityWhat is Secondary Infertility?

Secondary infertility is defined as a problem becoming pregnant after you have conceived at least once before. People often underestimate how common this actually is, especially after the age of 35 when natural fertility declines much more significantly. In fact, this is the most common type of infertility amongst women.

What Causes Secondary Infertility?

Aside from the effect of age and the impact this has on egg numbers and quality, secondary infertility may be due to the onset of new medical or gynaecological conditions, such as fibroids, or Asherman’s syndrome if, for example, you’ve had operations to your womb in the past. It could be if you suffer from endometriosis or PCOS that these conditions have got worse.  In addition, your lifestyle habits may have changed and your partner’s sperm may not quite be what it used to be, or you may have a new partner.

When to Seek Help with Secondary Infertility

Secondary infertility often has a lot of guilt associated with it. Many couples feel hesitant about seeking help and tend to delay, partially due to the worry of feeling judged by others, including their doctor, since they may already have a child. There’s also the sense of frustration associated with being able to get pregnant at least once before, and not understanding why it may be taking longer than before. Holding off seeing your doctor can have an impact on your success, so if you suspect there is a problem or you’ve been trying for a year if under 35, or 6 months if 35 or over, it’s vital you go and see your GP first to start some initial investigations.

These can include simple blood tests to look at hormone levels, as well as a semen analysis and pelvic ultrasound scan to look at the womb and ovaries. Sometimes further tests are undertaken that look at fallopian tubes as well.

Treatment Options

Treatment can range from continuing to try naturally if the tests are normal, to taking drugs such as clomid to help induce ovulation, to intra uterine insemination, to IVF and ultimately donor eggs or sperm. If there’s anything that needs to be fixed surgically, this can be done before treatment and may in itself be enough to allow you to get pregnant, such as treatment to endometriosis.

With the help of your doctor, create a plan as to what you are willing to try and within what sort of time frame, so that the experience doesn’t feel like an endless void and you instead create certain goalposts you which motivate you, but do not leave you in despair if they have to be changed or shifted.

Just because you have been pregnant before does not mean the second time round is any easier, especially if the first pregnancy ended in miscarriage or never came to be realised. The pursuit of another can often bring up emotions of sadness, fear, anger and disappointment and so it’s important to manage this stress with the help of a counsellor, who can enable you and your partner to navigate your journey and deal with any pressure from relatives, friends or even your younger child, about having a sibling.

Remember it’s OK to ask for help, and having been pregnant before is often a good prognostic sign. But things may have changed in terms of the health of you or your partner, and the sooner this is investigated, the better the chance of being able to do something to help you both to conceive.

Accept Your Feelings

Anger, sadness, and anxiety are common among parents struggling to expand their family. "Having a child already doesn't make going through infertility any easier," says Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health, in Waltham, Massachusetts, and author of Conquering Infertility. Meeting with a mental-health professional or seeking out blogs and online groups for secondary infertility can help. The website of  the National Infertility Association, resolve.org, is a good place to start.

If You Pursue Treatment, Prepare for Logistics

Undergoing fertility treatment requires precise scheduling of frequent tests and procedures—a tricky proposition when you're a parent. "I've had to go to the doctor early in the morning three times a week for testing," says Bozinovich. "Who can you find to babysit at 7 a.m. on a weekday?" (The answer: a grandparent or, when all else fails, a nurse at the doctor's office.) Your instinct might be to keep your treatment a secret, but it can make your life easier to enlist a friend or relative to help with child care. Also, choose a doctor's office you're comfortable with. You'll be spending a lot of time there; a compassionate staff can make treatment easier.

 

Testing

Testing for secondary infertility is the same as testing for primary infertility. Both the man and woman need to be checked.

Maybe you’re with a new partner, and one of you has had a child and the other has not. Does the “proven fertile” partner really need fertility testing?

The answer is yes. They do.

As mentioned above, having had a children doesn’t mean you can’t experience infertility.

 

Treatments

Treatments for secondary infertility are the same as for primary infertility. Treatments may include:9

Fertility drugs, often starting with the most commonly prescribed fertility drug Clomid

* Injectable fertility drugs, known as gonadotropins

* IUI

* IVF, sometimes in combination with other assisted reproductive options

* Surgery, usually laparoscopic surgery, to repair blocked fallopian tubes, or to remove fibroids or endometriosis deposits

As you seek out a solution for your fertility problems, you may have friends and family that don’t approve of your decisions.

They may wonder why you’re “trying so hard.” Why don’t you “just relax?” It happened last time, it’ll happen again.

These friends and family are wrong. Be assured that your need for treatment is the same as someone with primary infertility.

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Dr Larisa CordaGuest Post by Dr. Larisa Corda: www.drlarisacorda.com

Dr Larisa Corda is an Obstetrician and Gynaecologist in the NHS. She also appears frequently on ITV's This Morning as a Fertility expert. She qualified from Imperial College London and trained in the UK and Australia, gaining a wide understanding of women’s health. She believes in an holistic approach to treatment that addresses many lifestyle factors as well as a combination of Eastern and Western principles, that underpin The Conception Plan she has devised, as seen on TV. Larisa supports the use of natural and mild IVF techniques to assist conception where needed.

To follow Dr Larisa’s advice and tips, including The Conception Plan, go to www.drlarisacorda.com and @drlarisacorda on Instagram.