If you are facing problems getting pregnant the second time or carrying another baby full term? Well, you might not be alone. Women with a child struggling to conceive for the second time is a growing problem with close to 30% cases of infertility being related to “Secondary Infertility.”
Secondary infertility is defined as the inability to become pregnant or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications. In most cases, couples who face this problem do not consider themselves as ‘infertile’ since they have already conceived in the past. A situation such as this can be quite overwhelming and traumatic for a couple especially because conceiving their first child was not a difficult task. We say, “Most patients we meet don’t think infertility can occur with people who already have kids. But the truth is that this problem is quite common and growing in our country.
Couples might experience a gamut of emotions such as anger, confusion, self-blame, depression etc. It is therefore critical to seek help immediately from a doctor. Some of the leading causes of secondary infertility include:
- Malefactors: When there is a decrease in sperm quality and quantity due to a host of reasons such as age, smoking, medications and recreational drug use.
- Previous history of Sterilization: If there is a death of a previous child, and the couple has undergone sterilization, and they wish to have another child, they could opt for reversal of Sterilization. If this option fails, then the couple can only conceive through IVF treatment.
- Lifestyle causes such as weight gain or being underweight: In women, the increase in weight, in turn, causes an increase in Insulin resistance which impacts the testosterone levels and ultimately prevents normal ovulation. If she is underweight and has an irregular period, she should be counselled to gain weight. Whereas in men, increased weight leads to increased estrogen and this leads to impaired sperm production.
- Maternal age: Maybe by the time she wants to have her 2nd child, she has run out of most of her eggs as every woman is born with a certain number of eggs. Increased maternal age also means a decrease in egg quantity and quality and chances of miscarriages also increase.
- Pelvic/ Tubal factors: Pelvic adhesions caused by endometriosis or previous MTP following first pregnancy or previous abdominal surgeries.
- Hormonal disruption/ imbalance: Hormonal disruption/ imbalance after the first pregnancy “If you encounter secondary infertility, there is no reason to panic.
There are many treatment options available which include medication such as Clomid and Injectable hormones (gonadotropin)which increases the number of eggs for fertilization. In cases when there is enough number of eggs, doctors may recommend the next course of action which could be sexual intercourse, intrauterine insemination (IUI) or In-Vitro Fertilization (IVF). Donor eggs can be used if the woman has very low ovarian reserve even after taking medication."