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April 27, 2020
क्या है पीसीओडी और पीसीओएस

क्या है पीसीओडी और पीसीओएस

27
April
2020

How to deal with secondary infertility?

Author Name: Dr. Shubhali Sharma || Mentor Name: Dr. Ramesh Gaikwad on April 27, 2020

The inability to conceive or have a full-term pregnancy after having had children without difficulty before is called secondary infertility

If the road to motherhood for the first time around was like a cinch, you expect that you will be able to conceive second time just as effortlessly as first one. However,that may not always be the case for every couples who desire to expand their family further . Most couple are very anxious and upset when they are they not able to conceive for the second time,because they could conceive so easily before.

secondary infertility is an emotionally complex situation it’s influence on individual’s life and relationships can be significant. It can be hard to find support from family and friends, especially when a couple already has/have children.

Common causes of secondary infertility are:

1. Problems with ovulation,( irregular ovulation or anovulation)
2. Endometriosis
3. Fibroids
4. Recurrent miscarriage
5. Problems with the endometrium(asherman’s syndrome)
6. Adhesions or uterine scaring
7. Blocked fallopian tubes
8. Male factor ( decreased or absent sperm count and motility, ejaculatory problems)
9. Unexplained
10. Obesity, hormonal disorders

Why you can not Conceive second time?
Biggest question which haunts those who experience secondary infertility.
Secondary infertility may strike when…

You’re older: Age is a major cause of secondary infertility.as the age increases fertility in female decreases as number of eggs in ovary decreases.

You’re with a new partner: your new partner may have undiagnosed infertility problem..
An underlying fertility problem has worsened: Previously undetected subclinical PCOS and endometriosis have worsened. Maybe your ovarian reserves was low. As the age increases it further deteriorates rapidly.

You’ve gained weight: fertility is affected by weight. Being over or underweight can can hamper normal ovulation in women, and it can adversely impact semen parameter in men.

You have a new health problem: Either of coupler has developed diabetes or hypertension or hormonal imbalance.
The last pregnancy or birth caused a fertility problem: Previous D&C procedures or pelvic infection may cause uterine adhesions or fallopian tubes block .

Previous C-section may cause scar tissue, which can negatively impact your fertility.
Azoospermia or oligospermia: either due to testicular infection, cancer or surgery
Erectile dysfunction: due to diabetes excess weight gain or other medical illness, retrograde ejaculation.

No clear reason for secondary infertility: many times, no one can tell you specific reason for failing to conceiving second time.
Unexplained infertility is also one of the cause of secondary infertility

When should you visit the fertility expert?

• It takes about six months to close to a year for you to conceive If you are younger than the 35 year. Couple who fail to conceive after a year must seek assistance from fertility specialist.
• If you are older than 35 years of age and have tried for six months, it is recommended for you must seek for assistance from a fertility specialist and you may even consult an expert after trying for three months.
• However, if you or your partner are above forty years of age you will perhaps want to start your journey for a second pregnancy consider meeting fertlity expert at earliest.

Testing
Both partner needs to get tested
history and physical exam for both partner
For female partner evaluation of ovulation, imaging of the uterus and fallopian tubes and hormonal assay.
For male partner semen analysis needs to be done to identify the cause of infertility
What is the treatment for secondary infertility?

Treatment is usually individualised based on the test report of both partner
Fertility treatment for women
1. ovulation induction with oral pills or injectable gonadotropin
2. Surgery in case of fibroid, adhesions or blockage.

Fertility treatment for men :
1. Medical management of erectile dysfunction
2. Surgery for varicocele or ejaculatory duct obstruction

Assisted reproductive technique (ART)
Intrauterine insemination (IUI)
in vitro fertilization (IVF)
Intracytoplasmic sperm injection (ICSI)
Sperm or egg donation
Laser assisted hatching(LAH)
Surgical sperm aspiration
Preimplantation genetic testing(PGT)

Even if you did not require help the first time, it’s completely fine to ask for both emotional support and medical help.Whether you’re working towards your first child, second child, fertility treatments will surely help you achieve a happy and healthy family.

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