It's a question that plagues many women trying to get pregnant again: Can I really be infertile after already having kids? Unfortunately, the answer is yes. Secondary infertility, the inability to get pregnant after already having children, accounts for over half of the cases of infertility in the United States.
Significance
It happens more commonly than you may think. The National Center for Health Statistics estimates there are more than three million woman struggling to conceive after already successfully having at least one child. Many women, however, operate under the misconception that fertility is static and don't think that trouble getting pregnant again means they're infertile. This begs the question: How can a woman know if she's infertile the second time around?
Identification
Secondary infertility isn't always as noticeable as primary infertility. A couple that is unsuccessfully trying to have a first baby tends to seek a medical opinion sooner than a couple that already has kids and is having trouble conceiving. However, the criteria defining fertility concerns remain the same no matter whether it's your first baby or your fifth. If you've been trying to conceive for a year without luck, it's time to seek fertility assistance. Some doctors take it a step further and tell patients if they've previously had babies and haven't gotten pregnant again after six months of trying, it's time to come in.
Types
There are a number of things that can affect and contribute to secondary infertility, not the least of which is a change in partners. If you're trying to conceive with a different spouse it may seem as though you're infertile, when the cause may be your partner--something which wasn't a factor the first time around.
Time can also play a role. Both egg and sperm quality can decrease as men and woman age, making the odds of conception much lower. There are a number of other physical explanations, including endometriosis, medication interactions, uterine fibroids or polyps, irregular ovulation and trauma from previous deliveries or miscarriages.
Prevention/Solution
Secondary infertility isn't always a permanent condition. After consulting with your doctor, you and your partner may undergo a number of diagnostic tests to measure hormone levels, egg, sperm and cervical mucus viability and to determine whether there are any physical abnormalities which need to be addressed. The results of these tests can help in the creation of a plan which may include things as simple as charting attention to body temperature and ovulation, or as complex as taking fertility drugs or surgical implantation procedures.
Considerations
Secondary infertility can take a heavy emotional toll. Well-meaning friends and family can often overlook the pain and guilt involved in not being able to get pregnant and remind a couple how lucky they are to already have a child. It's important to let friends know how you feel and build a strong support system of people who will allow you to grieve the loss of a dream.
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