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Infertility Cubby

The Second Time Around
by Chelsey Langland

In the game of infertility pain, no woman is viewed with as much suspicion as a woman who is experiencing infertility while having a living child at home. The pain of secondary infertility is minimized or ignored, not only by a woman's family and friends, but even by other infertile women. If you are experiencing infertility after having given birth, this article is for you.

First, it's important to understand the terminology. Primary infertility is what happens when a woman fails to conceive her first child within a year, or is otherwise diagnosed as infertile before conceiving a first pregnancy. Secondary infertility occurs when a woman has no issues in conceiving a first or subsequent child, but experiences trouble when trying for a second or subsequent child. Thus, a woman who was infertile and conceived, either through blind luck or through some sort of ART, would still be labeled as primarily infertile when she attempted to conceive a later child. Most of the time, however, a woman is labeled as secondarily infertile if she has been pregnant before.

Why would a woman suddenly have fertility issues when the first conception was so easy? The reasons are probably as varied as the women themselves, but a few possibilities might include:

  • an abdominal surgery (including a c-section) or an infection that might have caused pelvic adhesions. This scar tissue can bind up the fallopian tubes, making it difficult for the egg to get to the uterus;
  • an underlying health problem could have worsened, making conception difficult. This is especially true if thyroid health (either hyper- or hypo-) has been an issue for you;
  • the aging process. Women's fertility declines after age 25, and dips sharply after age 35. As ovarian reserve diminishes, it becomes difficult to produce an egg that has the ability to be normally fertilized; and
  • a variety of male factor issues. One culprit is varicoceles (small varicose veins which form in the testicles). These damaged veins create heat in the testicles, impairing the production of sperm. Varicoceles are thought to grow worse over time, so a sperm count that was normal a few years ago might be damaged today.

So, what can you do? It seems that secondary infertility often gets a short stick, even from medical providers. You may be told, "It's obvious you can have a child. Go home and relax." But, if that answer doesn't give you any comfort, you can try the following ideas:

  • chart your cycles. This can give your doctor a good idea about how your cycles are working, and whether you are ovulating;
  • depending on how long you have been trying, start basic infertility testing. Check your partner's sperm parameters (count, morphology, and motility) and maybe have a hysterosalpingogram (HSG), a test which checks to see if your fallopian tubes are open; and
  • use ovulation predictor kits to determine your most fertile times.

Infertility of any kind is difficult to experience, and this very much includes secondary infertility. There are things you can do, especially if you are able to be a strong advocate for your own medical care. Hopefully, without too much delay, you will be able to have the family you have always envisioned

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