Today we look in to the causes of secondary infertility. This condition is when a couple have conceived their first child with no problems, but then struggle to conceive again.
The definition for secondary infertility is the same as ordinary infertility:
- Inability to conceive after trying for a year or more if you are under 35 years of age
- Inability to conceive after trying for for 6months or more if you are over 35 years of age
But it applies to women who have already had a successful first pregnancy.
It is surprisingly common. Of women who struggle to conceive in the west, it is estimated that one third suffer from secondary infertility.
The difficulty with secondary infertility is that the specific causes for it are often difficult to identify. However, here are a few that may be applicable:
Age
Many health care professionals agree that the mid 40’s is probably the natural end of the female reproductive years. Most women trying to conceive for the second or third time are generally older than first time mothers.
According to the American College of Obstetricians, women at age 40 have around a 5% to 10% chance of getting pregnant naturally. This compares to a 25% chance for women in their 30’s. These odds are greatly improved with treatment options such as IVF.
Blocked tubes
Damage to, or around, the reproductive organs can affect the ability to conceive. In particular, scarring of the fallopian tubes from surgery or ectopic pregnancy can prevent conception.
In the uterus, scarring can also lead to problems with the menstrual cycle or prevent an egg from implanting.
Using surgery to clear the problem can be useful. However, many fertility specialists recommend going straight to IVF, where the fertilized egg is implanted directly in the uterus, bypassing the fallopian tubes altogether.
Excess body weight
Often, women who have previously given birth are slightly heavier than they were before they gave birth. It is logical that weight gain can increase the possibility of secondary infertility, although there is little research in this area.
The issue with weight gain seems to be the hormonal shifts, which are experienced by overweight women. These shifts can disrupt ovulation patterns creating a risk for infertility.
Past infections
Like scarring from surgery and ectopic pregnancy, infections can also scar the fallopian tubes and uterus. Pelvic inflammatory disease, which can be caused by sexually transmitted infections is a leading cause. But so is previous surgery, particularly in the case of infection following a caesarean section.
Another possible cause of infertility is where the lining of the uterus becomes inflamed over a long period due to chronic endometritis. This is one of the leading causes of secondary infertility and may affect as many as 40% of women who are diagnosed with the condition.
Other suspects
As with ordinary infertility, the other suspects in otherwise fertile women play their part in secondary infertility:
- Polycystic ovary syndrome: this is a common condition in which a hormonal imbalance can increase the risk of infertility
- Endometriosis: this is another relatively common condition, which occurs when the uterine lining material grows outside the uterus, causing inflammation and scar tissue on the reproductive organs
- Fibroids: these are noncancerous benign growths in the uterus, which can block fallopian tubes and affect the uterus, making conception problematic. The prevalence of these increases with age, which might explain why, for some sufferers of secondary infertility, earlier pregnancy was easier to achieve
- Hormonal problems: anything that affects the normal cycle of hormones can affect fertility. For instance, thyroid conditions such as hyperthyroidism can cause a hormone shift, which impacts on ovulation
However, these factors may not provide all the answers as there is limited research into the area of secondary infertility. But if you are diagnosed with this problem, all is not lost!
Women can still achieve pregnancy by overcoming many of the issues that cause secondary infertility. For instance, IVF can provide good chances of success where there are problems with the fallopian tubes.
Secondary infertility is a barrier, but often not an insurmountable one and medical science continues to lower that barrier decade-by-decade.
