Practical Solutions For Secondary Infertility

There are two kinds of infertility for women – primary and secondary. Primary infertility is when a woman can’t get pregnant, after trying for a year without using contraception, or six months if she is over 35. Secondary infertility can arise in women if they have had one or more successful pregnancies but can’t seem to get pregnant again.

Utah Fertility Center Family

At the Utah Fertility Center, we understand your feelings of frustration, confusion, sadness or hopelessness. You are not alone, there are approximately 6 million couples in the U.S. alone who have secondary infertility. Fertility can fluctuate, even after having a prior successful pregnancy. Our Practice Director, Deirdre A. Conway, MD recently gave a talk on secondary infertility at the Beat Infertility Summit this spring. Here is what she had to say.

The Utah Fertility Center has helped many couples struggling with secondary infertility after having had successful prior pregnancies. Half of our Utah Fertility Center couples seek treatment for secondary infertility and we can help!

Female Factor Infertility

Your eggs are always as old as you are because you are born with a lifetime’s supply of eggs (pre-eggs) stored inside your ovaries. There are 1-2 million “eggs” known as primary oocytes. They aren’t actually eggs yet and are cocooned inside a follicle, waiting for you to reach puberty. Before puberty, the oocytes continuously die so you may end up with 300,000 to 500,000 as the rest of them break down, absorbed by your body.

Changes to eggs and ovulation cycle: After puberty, your eggs and ovulation cycles also change over time. From puberty onward, you lose eggs every month until you run out of eggs in your 50’s when you hit menopause. Meanwhile, the quality of the eggs changes in your 30’s-40’s. For every menstrual cycle after puberty, your body can release up to 1,000 follicles. The egg cells will divide, and only one of those will mature and be released, ready to be fertilized by sperm. Occasionally, when the oocytes divide, a chromosome pair doesn’t separate, so the egg ends up with 24 chromosomes instead of 23. Should that egg be fertilized, the embryo will have one too many chromosomes and the body will likely select out the abnormal embryo so you get your period.

Polycystic Ovary Syndrome: You have had one or more children, and now carry extra weight. This could trigger a hormone imbalance where you ovulate every 3-4 months instead of monthly, decreasing your chances of conception.

Scarring: Scar tissue in the uterus from having a prior C-section delivery that leaves adhesions, making conception harder

Endometriosis: The embryo implants on the outside of the fallopian tube. This requires surgery to see the tubes which are narrow as toothpicks.

Stress: Stress arising from raising a family, leading to harmful lifestyle choices like alcohol consumption, smoking or a lack of exercise leading to weight gain.

Male Factor Infertility

Men often have lifestyle habits affecting sperm quality and quantity. Often this is work stress, health issues, medications or medical conditions like uncontrolled diabetes. Exogenous testosterone can also be a problem from suppressed production of the hormone in the testicles, lowering your sperm count.

When Should You Seek Help for Infertility?

Women who have been trying to conceive for over a year without using contraception, or after six months if you are 35 or older. However, it’s never too early come in and just be checked out. Feeling stressed or nervous about your inability to conceive is reason enough to come in to “check the boxes” and make sure everything is medically okay.

Testing for Secondary Infertility

Our Utah Fertility Center team will take a detailed medical history, look at any weight gain, worries or concerns you have to tailor testing specifically for your needs. We will do screenings to check egg reserves and ovulation, take blood work to check your hormones to see how many eggs you have left and your progesterone levels after ovulation.

If your secondary infertility stems from anatomical issues, we can do an ultrasound of the uterus and uterine lining to check for polyps, and check your ovaries (should look like little chocolate chip cookies with multiple black spots) to see how many there are.
If the problem is your fallopian tubes, they can only be seen with a special X-ray doing a fallopian tube flush to see if they are open. For men, testing will involve checking the quality and number of your sperm.

Treatment for Female Factor Secondary Infertility

-Ovulation issues are treated by making lifestyle changes to help you lose weight through diet and exercise.
-Hormone problems are treated with medication to induce ovulation so you ovulate monthly.
-Polyps or uterine fibroids are treated with a hysteroscopy to remove any polyps.
-Fallopian tube issues might require in-vitro fertilization, taking the egg out of the body and growing the embryo in a lab until it is ready to be placed back into the uterus.

Treatment for Male Factor Secondary Infertility

We may refer you to a urologist. Those appointments can be done in our own Murray and Pleasant Grovce locations. You may have hormone testing, and artificial insemination May be utilized to pass the sperm into the cervix and up into the uterus using a catheter. Invitro-fertilization can be done to control and assist fertilization further.

At Utah Fertility Center, we are very optimistic when it comes to treating secondary infertility! When it comes to our clients, it is empowering for them as they learn what the problem is so they can choose how to proceed on their fertility journey. If you want help with your infertility, please give us a call today to schedule a consultation.