Most people will have the strong desire to conceive a child at some point during their lifetime and society places a high premium on the size of the family either it is nuclear or extended. The reason most couples go to seek medical assistance for conception maybe because they want more babies or they are not able to have a live birth even though they often get pregnant.
World Health Organization (W.H.O) 2017 has defined “Infertility is a disease of the reproductive organ characterized by the failure to achieve a clinical pregnancy after 12 months of regular, unprotected sexual intercourse”. There are basically two types of infertility which are primary and secondary.
Primary Infertility: This simply means a woman has never been able to bear a child, either because she cannot get pregnant or because she is not able to carry a pregnancy to live birth.
Secondary Infertility: When a woman is unable to bear a child, either due to the inability to become pregnant or the inability to carry a pregnancy to live birth following either a previous pregnancy or a previous ability to carry a pregnancy to live birth, she would be classified as having secondary infertility.
EMOTIONAL ASPECTS OF SECONDARY INFERTILITY
In a traditional family setting especially Africans, having an only child may be almost as stigmatizing as not having any and the sex of the only child may even make matters worse e.g. having a boy as an only child may be more acceptable than having only a girl. For some couples, it may just be those dreams which may include siblings who play with each other in the backyard and support each other throughout their lives. Despite already having a child, secondary infertility can be just as stressful as primary infertility for some patients. It is normal and justifiable to feel a sense of sadness, frustration and yearning. You do not have to feel guilty for feeling sad. It is important to appreciate the fact that you are already a mother or can actually get pregnant. It is important to seek help as quickly as possible and not dwell in guilt.
Generally, the rule of thumb is if the woman is 35 years old or under and has been trying to conceive for one year without successful pregnancy or over 35 years old and trying to conceive for six months it is time to seek advice from a reproductive endocrinologist/Fertility Specialist.
CAUSES OF SECONDARY INFERTILITY
Why would a woman who has previously gotten pregnant and had a live birth suddenly not be able to conceive again? This can be so worrisome to the couple. Below is a list of the possible causes of secondary infertility:
·Advanced Reproductive Age: women are born with all the eggs (oocytes) they will ever have in their lifetime resting in their ovaries. As a woman ages, they experience what is referred to as diminished ovarian reserve. This implies that the quality and quantity of a woman’s egg decreases with time. A year or two between children can greatly affect a woman’s fertility.
·Complications of the reproductive system: pelvic adhesion, endometriosis, or fallopian tube abnormalities can impact the structures of your reproductive system making it more difficult to achieve a healthy pregnancy. These fertility issues can be pre-existing or develop after a previous pregnancy.
·Male factor infertility: Time is not something that only that affects a woman’s fertility, sperm quality and quantity decreases in men also as they age. Change in health or medication usage may also affect male fertility.
·Lifestyle: Weight gain affects both male and female infertility excessively. It can contribute to ovulatory dysfunction in women and can also contribute to erectile dysfunction in men. Smoking also affects the fertility of both men and women.
Other causes of secondary infertility include:
·Impaired sperm production or sperm delivery in men.
·Fallopian tube damage in women.
·Ovulation disorders e.g. polycystic ovarian disease/Syndrome
·Endometriosis
·Medical Conditions in both men and women
·Complications related to prior pregnancy or surgery.
·Risk factors change for you or your partners such as age and use of certain medications.
Secondary infertility can be caused by any of the factors above, a combination of them, or unexplained. Just like primary infertility, secondary infertility can also be diagnosed; however, the cause of infertility may sometimes remain unexplained. Basically what this means is that the doctor cannot pinpoint the reason why you are not able to conceive again and this is seen in about 20% of all cases.
To be continued next week…
