SECONDARY INFERTILITY

You conceived your first baby on the first try. No stress, no counting on the calendar, not even quite sure you were ready. So the next one should be just as simple, right?
Unfortunately, your first experience with conception does not necessarily predict what will happen the next time around.

Secondary infertility is difficulty conceiving after a previous pregnancy, whether it ended in a birth or a miscarriage. It occurs in nearly 12% of couples, and its incidence has increased by 60% in the last 20 years. Many couples delay seeking help because they assume everything will fall into place as it did the first time.

The most common cause of secondary infertility is increasing maternal age. In general, women are delaying childbearing. Almost 15% of women are waiting to have their first child until after age 35. So by the time they are ready for number two, they may be close to 40. While 40 is nowhere near too late, fertility rates decline rapidly. In fact, the chance of pregnancy for a woman who is 40 is only 7% per month and by age 44, the chance decreases to less than 1%.

Many women are surprised to hear that their diet and overall health cannot overcome the effects of aging. You are born with all the eggs you have. They age as your body does and lose the ability to form a healthy embryo. At age 40, almost half of your eggs are genetically abnormal and unable to grow. And at age 42, over 80% are abnormal. For this reason, it is so important that women over 35 do not miss any opportunities to conceive. Using an ovulation kit or an app to predict ovulation can insure that you know when is the fertile time of your cycle to optimize your chances.

After a baby, many women find it difficult to lose the extra weight they had gained. This, too, can cause fertility problems. Women who are overweight have higher levels of estrogen, because estrogen is stored in fat cells. When estrogen levels are elevated, the normal cycle of ovulation can be shut down. Women may find that their periods become less predictable or they may skip them all together. If your periods are more than 35 days apart, talk to your doctor about dietary changes you can make to lose weight or about medications that can help you to ovulate.

Women may also have difficulty conceiving the second time around because they simply do not have the time or energy for sex. Having a toddler, or two, at home leaves many moms exhausted. The last thing on their mind after a day of work, making dinner, chasing a little one, and organizing the house is being intimate with their partner. As much as they love their partner, sex can feel like a chore. In these cases, identifying the most fertile times of the month – with the help of an ovulation calculator – can focus a woman’s energies to the times that they are most likely to conceive.

Even though you have been pregnant before, you may feel very emotional about your inability to conceive the second time. You may feel guilty for waiting so long to try again, and wonder if you have ruined your chances. You wish you had more time for sex and feel stressed about juggling the duties of a wife and a mother. You may be frustrated that you haven’t been able to lose the weight from your first pregnancy and feel like you’ve sabotaged your chances of adding to your family. Whatever you are feeling is normal. You shouldn’t feel like you are being ungrateful for the child you already have. The good news is that the prognosis for secondary infertility is better than for women who have never had a pregnancy. Nearly 60% of women will conceive within 3 years without any medical intervention. If you have been trying for more than a year, or for more than 6 months if you are over 35, be sure to talk to your doctor about ways to optimize your chances of conceiving the second time.

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