Secondary infertility is defined as the inability to conceive or carry a baby to term after previously giving birth. It is diagnosed when the couple is unable to conceive even after 6 months to 1 year with regular unprotected sexual intercourse.
To classify as secondary infertility, the previous birth/s must have occurred without help from fertility medications or assisted treatments like IVF.
CAUSES
Secondary infertility is just as common as primary infertility. Secondary infertility can affect one or both partners. Sometimes the cause can be unidentified/ unexplained. Secondary infertility is caused by the same problems that lead to primary infertility. Some of the most common causes are:
- Impaired sperm or eggs
- Age > 35 years (especially in females)
- Complications from a previous pregnancy/ previous surgery
- Weight gain issues – increase in body weight/ BMI in both men and women
- Medical conditions/ medications
- Sexually transmitted infections
- Lifestyle factors like drinking alcohol/ smoking
- Hormonal issues like PCOD/ reduced testosterone levels in men/ thyroid issues /diabetes mellitus.
About one-third of infertility cases are related to male infertility, another one-third to female infertility and the remaining one-third are related to problems in both men and women or remain unexplained.
TESTING FOR SECONDARY INFERTILITY
Diagnostic testing procedures for secondary infertility are similar to those used for primary infertility.
Fertility tests common for both men and women involve –
MEDICAL HISTORY TAKING: detailed history is taken to know the cause of infertility. Your doctor might ask you about your lifestyle like
- Diet
- History of smoking or alcohol consumption
- Hormonal problems like PCOD, Thyroid issues
- Previous history of miscarriages
- Problems getting an erection/ ejaculation
- Injury/ trauma to scrotum/ testes.
FERTILITY TESTS FOR WOMEN: involves medical history discussion, especially to check for ovulation or medical cycle issues. Blood tests to check hormone levels and ovarian reserve, pelvic examination.
- BLOOD TESTS: blood samples can be taken to test for a hormone called progesterone to check whether you are ovulating. Other hormones can also be tested like estrogen, Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH) etc.
- ULTRASOUND SCAN: USG or Ultrasound can be used to check your ovaries, uterus and fallopian tubes. Conditions of uterus like endometriosis, fibroids, fallopian tube lesions like blocked fallopian tubes, tubal scarring can affect fertility in women. A special type of ultrasound scan called HSG can be used to check any blockages or abnormalities of fallopian tube. Here a special dye is injected into the uterus through the vagina and then the X-Ray is taken to see for spillage in the pelvic cavity. In case of any blockage in the fallopian tube, it can be visualized on the x-ray and can be treated accordingly.
- LAPAROSCOPY: it involves making a small cut in your lower abdomen to pass a thin tube with a camera at the end(laparoscope) to examine the uterus, fallopian tube and ovaries. Laparoscope can be used both to diagnose and treat few conditions affecting the uterus and fallopian tube.
FERTILITY TESTS FOR MEN: Tests to find out the cause of infertility in men include:
- SEMEN ANALYSIS: it is the basic investigation of infertility in men. Problems such as low sperm count, abnormalities in sperm motility and morphology are usually associated with infertility in men.
- CHLAMYDIA TEST: Chlamydia is one of the sexually transmitted diseases (STDs) that can affect fertility. A sample of urine can be used to check for chlamydia.
TREATMENT FOR SECONDARY INFERTILITY
These include:
- Oral or injectable fertility medication – These stimulate the follicles in the ovary to release more eggs in a single reproductive cycle.
- IUI – It is a procedure in which the semen is injected directly into the uterus for fertilization. IUI increases the no of sperm reaching the egg and thus increases the chance of conception by bypassing the fallopian tube and diseases of fallopian tube.
- IVF – it involves combining/fusion of egg and sperm outside the body and then placing the fertilized embryo back into the uterus for implantation.
Even though you already have a child, secondary infertility can still be painful. We understand your unique goal for what you would like your family to be and we will work with you to make that goal a reality. So please be free to contact/ reach out to our experts at Fertility Foundation/ SISU Hospital.
