There are several factors contributing to secondary infertility.
Sponsored by FertilitybrSpecialists of Texas
Written by Dr. Rebecca Chilvers
Have you been trying to conceive again but have had difficulty? Are you baffled by the delay since youbrconceived after having children so readily in the past? You are likely dealing with what is known asbrsecondary infertility, and you are not alone. brApproximately one in 10 couples experience infertility after having hadbra child in the past without fertility treatments, either together or with abrformer partner. Approximately one-halfbrof infertile couples fall into the category of having secondary infertility,brmaking it just as common a problem as primary infertility where the couple hasbrnot conceived in the past.
People with secondary infertility face unique stressors as well as somebrsimilar emotions to those with primary infertility, but they often suffer inbrsilence because there is no visible sign they are infertile. They might have family and friends or evenbrtheir other children asking them why they have waited so long to have anbradditional baby, and they might have a sense of guilt or sorrow at not havingbrprovided a sibling for their current child. Because they have a child or children, theybrare quite often around families with children and babies who are frequentbrreminders of their goal not yet attained.
These couples might be more apt to "keep trying" when it hasbrbeen difficult because of not wanting to believe they could have infertility orbrbecause they have received advice to keep waiting or to simply work on issuesbrsuch as stress reduction. They oftenbrfind themselves busy with life, caring for their current child or children and mightbrhave inadvertently delayed truly coming to terms with the possibility thatbrthere could be a medical problem hindering their fertility.
For couples in this situation, it is important to remember severalbrthings can change with time and affect one's ability to conceive. For starters, the patient and/or her partner mightbrhave had subfertility in the past that was undiagnosed — yet did not hinderbrthem from conceiving — but has worsened over time and led to infertility. In addition, there are several factors that oftenbrcontribute:
1. Advancing maternal age. Maternalbrage is the single most predictive factor for reproductive success as fertilitybris directly affected by the age of the egg. brIt might have been some time since the birth of the couple's last child,brand this affects both egg quantity and quality such that there is a reducedbrchance of conception and an increased chance of miscarriage with age.
2. Weight gain or loss. For women, being above or significantly belowbrone's ideal body weight can impair ovulation and lead to impairedbrfertility. For men, being overweight canbrlead to reductions in testosterone and elevations in estrogen, which can adverselybraffect sperm production.
3. Pelvic adhesive disease. Prior surgery or pelvic infections since orbrwith the birth of the last child can lead to adhesions — scar tissue thatbrprevents the fallopian tubes from receiving an egg from the ovary.
4. Changes in the uterus. As women age, there is a greater chance theybrwill have uterine fibroids — smooth muscle tumors that can affect chances ofbrconception depending on their size and location. Additionally, if someone has had a pastbrprocedure to their uterus, she could have scar tissue within the uterus itselfbrthat needs to be addressed. Soft tissuebrgrowths such as polyps can also form in the uterine cavity and contribute tobrinfertility.
5. Changes in sperm parameters. Sperm quantity and function can changebrdepending on a man's health status and his current use of medications, as wellbras environmental exposures such as chemicals and temperatures. For example, infections such as chlamydia andbrdisorders such as diabetes can lead to infertility.
If you have been trying to conceive but find it has been difficult inbrspite of having children in the past, please take this important step and makebran appointment at Fertility Specialists of Texas. We have convenient office locations,brincluding one in Grapevine across from Baylor Regional Medical Center. If youbrare a woman under 35, it is prudent to seek a specialist for a formalbrevaluation if you have been trying to conceive for six to 12 months. If you are a woman 35 or older, six months isbra sufficient time to try to conceive on your own before a formal evaluation. For all age groups, women who know they havebra reproductive disorder or whose partner has a known abnormality affecting hisbrsperm count should seek the care of a specialist sooner.
At my office, the initial visit focuses on a detailed history and anbrexamination and will lead to some testing to complete the evaluation, includingbrone to examine the fallopian tubes, the sperm and the ovarian reserve (relativebrnumber of eggs a woman has left). Frombrthat point, there are several resources available for overcoming infertility,brand you will be counseled regarding which options are advisable for yourbrspecific needs. Some available treatmentsbrare ovulation induction with oral or injectable medications, intrauterinebrinsemination (IUI) and in vitro fertilization (IVF). Please visit Fertiliy Specialists of Texas forbrmore information.
Rebecca Chilvers, M.D. is board-certified in Obstetrics and Gynecology and has completed a sub-specialty fellowship in Reproductive Endocrinology and Infertility. She received her undergraduate degree at Baylor University and her medical degree at Louisiana State University Health Sciences Center. She completed her residency and sub-specialty training at the University of Texas Medical Branch in Galveston, where she also earned a Master of Medical Science degree.
In addition to being experienced with in vitro fertilization and fertility treatments, Dr. Chilvers is one of the few women reproductive endocrinologists in North Texas who has received specialized training on the da Vinci Robotic Surgical System, a minimally-invasive option she uses for complex surgical procedures, including myomectomies and tubal reversals. Dr. Chilvers is well-versed in all aspects of infertility and enjoys helping patients with in vitro fertilization, preimplantation genetic diagnosis and fertility preservation via egg freezing.
She and her husband, Dean, currently live in Frisco with their daughter, Natalie.