Take two: Secondary infertility

Difficulties getting pregnant a second or third time are common. KELLY EDEN talks with DR SARAH WAKEMAN about secondary infertility and what we can do about it. 

You’re ready to add a second child to your family and because there was no problem having your first, you assume everything will go to plan. But six months go by, a year, and still no baby. This is the situation many New Zealand parents find themselves in – they know they can have children, so what’s going on?  

”This is very common,” Dr. Sarah Wakeman explains. “When a couple are not able to become pregnant or are experiencing a delay in conceiving, but have conceived in the past, we call that secondary infertility.”   

Secondary infertility can occur for a number of reasons. Couples often wait a few years after their first child to try again and this means they are now a bit older. As we know, fertility drops as we age: for example, sperm counts decrease in men. A small percentage of women also enter menopause earlier than average, at around age 35–40 instead of the usual 50. Other health reasons can also be to blame. The woman may have developed a new problem that’s affecting her fertility, such as a pelvic infection, or complications from her first child’s birth may be preventing pregnancy. 

Other lifestyle and health changes can affect our fertility too – weight gain in women can lead to irregular ovulation, smoking affects the fertility of both men and women, some medications and possibly even too much caffeine are also factors.  

Dr Wakeman suggests coming in early if you think secondary fertility could be an issue. “After 6–12 months of trying, or sooner if you know you have had a problem or conception has taken a long time in the past,” she says. She recommends couples increase their chances of pregnancy by timing intercourse and being aware of the right time to try. “Have sex everyday or every second day leading up to ovulation,” she says.   

If couples are concerned about future pregnancies, because of their age for example, she recommends planning ahead. “You can come for advice before even trying to conceive, your fertility can be assessed and women can consider freezing eggs and men banking sperm. You can make small lifestyle changes, too.” 

IVF is the most commonly known fertility treatment but there are often simpler and less expensive options for couples to try first. Ovulation induction is one of these – a tablet medication which makes the women produce eggs more regularly. Intrauterine insemination cycles are another lower cost option: the man’s sperm is prepared and introduced into the woman’s uterus at the time of ovulation. The least invasive and cheapest option is getting advice about lifestyle and health changes that can help increase fertility without medical intervention.

 “Secondary infertility is common and help is available,” says Dr Wakeman. “Having been pregnant in the past is a positive sign for future pregnancy. Also, if couples have one child they may still be eligible for government-funded fertility treatment.” 

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