If you have been pregnant before and delivered a healthy baby, then it is reasonable to presume you can do so again. This is why a diagnosis of secondary, or indeed, tertiary infertility can be so frustrating. You struggle to find an explanation for why you were able to conceive easily before, yet getting pregnant again seems elusive.

 

(If you have secondary fertility issues due to experiencing recurrent miscarriage, please click here for more information.)

 

What can cause secondary fertility issues?

 

There are many possible causes, some are quite straight-forward to address, while others are more complex. 

 

Advancing age- If you were 32 on your first pregnancy and are trying again now aged 36, the intervening years may have led to a decrease in your egg quantity and quality. I.e. Diminished ovarian reserve. While a woman can't do anything about the amount of eggs she has left, she can support the development of those egg follicles as they mature. It takes 3-4 months for an oocyte to mature within the follicle before finally being released during ovulation. Changes to diet and lifestyle during this time frame may make a difference to the health and quality of the egg follicles giving you a higher chance of conception, whether naturally or via assisted fertility methods. Acupuncture may also be used to increase circulation of nutrient-rich blood to the ovaries to enhance egg quality.

 

Secondary health conditions- If you had a pre-existing condition prior to your first pregnancy such as Hypothyroidism or another auto-immune diseasee, this may disimprove after your initial pregnancy making it more difficult to conceive next time around. Equally, if you have recently started taking new medication or have experienced an acute or chronic illness since your first pregnancy this may make it difficult for you to conceive or put you at greater risk for miscarriage. 

 

Nutrient deficiency- You may be deficient in certain nutrients post-pregnancy and these deficits would need to be corrected in order for you to conceive again. Motherhood is a joy, but the sleepless nights, irregular eating habits and limited time for exercise can take their toll, making conception more challenging then it was the first time around. If you have formed the habit of smoking, drinking alcohol or eating lots of salt/sugar since the first pregnancy your body will be nutritionally depleted and a period of abstinence may be necessary to recover optimal health so that pregnancy is achievable again.

 

Male Fertility- Your partner's sperm quality may have diminished due to stress, changes in diet/lifestyle or due to taking new medications since the conception of your first born. Extreme exercise regimes or a sedentary lifestyle would both have a negative impact on the sperm. If a semen analysis has shown up a 'normal' result, consider a DNA fragmentation test to ensure the genetic material contained within the sperm is viable.

 

Weight gain- during or after your first pregnancy weight gain may make it more difficult to conceive when you decide to start trying again as it can affect hormonal balance in both men and women. In women, you are more likely to experience ovulatory dysfunction due to increasing testosterone levels as a result of insulin resistence. In men, rising oestrogen levels may interfere with sperm production. Changes to diet and lifestyle with an emphasis on safe and consistent weight loss would be advised. 

 

Anatomical-  If you had a C-section or complications on your first pregnancy there may be anatomical issues, such as pelvic or uterine adhesions affecting the ability of the sperm to meet the egg. This would need to be addressed by corrective surgery to enable another pregnancy to take place. E.g. to address blocked fallopian tubes or Asherman's syndrome.

 

What are my treatment options?

 

There are various treatment options available, depending on what is the original cause of your secondary fertility issues. If your issues are anatomical in nature, then corrective surgery may be required. 

 

If you suspect your fertility issues are due to chronic health issues that have not been responsive to treatment with medication or you feel 'run down' and not as healthy as you were for your first conception and pregnancy than a consultation would be adviseable. 

 

For more information on the consultation process, clicke here

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