According to Dr Andrew Zuschmann, fertility specialist, obstetrician and gynaecologist at Demeter Fertility, secondary infertility is "a delay in conception of 12 months or more for a couple who have been pregnant before, whether or not that pregnancy resulted in the birth of a child".
It’s a problem that affects a large number of couples -- one in six Australian couples will experience infertility at some point in their reproductive lives -- and can be particularly devastating due to a lack of sympathy given to families who already have one or more children. Often, secondary infertility is not fully understood or recognised by family, friends and even the medical profession with many a well-meaning individual offering up the frustrating advice to "keep trying"!
If getting pregnant with your first child was a cinch -- or even an accident -- you may be shocked to find you’re having trouble getting lucky with number two. But getting pregnant once doesn’t necessarily mean you can get pregnant twice. There are no guarantees about falling pregnant at any time; in fact, in any one cycle a woman only has a 20-25 per cent chance of conceiving and that percentage falls with age.
"Secondary fertility can affect anyone," says Dr Zuschmann. "I see it more commonly in couples who had a delay with their previous pregnancy and couples in new relationships hoping to start a second family where age might have an effect," he says.
Just because the stars aligned for your first pregnancy also doesn’t exclude you from a pre-existing condition that might make conceiving more difficult. Polycystic ovarian syndrome, endometriosis and fibroids all affect fertility and can occur at any time during your reproductive years. If you suspect you may have a problem, consult your GP for advice and treatment.
Getting pregnant with baby number one was easy. For a start, sex was probably a much more frequent occurrence without a toddler in the house. Now, you have less time to get naughty in the bedroom so you may have to choose your horizontal dancing days with a bit more care.
Conceiving isn’t as simple as putting an egg and some sperm in the same place. According to Dr Zuschmann, we need eggs, sperm and a way for them to be able to get together in order to achieve pregnancy and there can be obstacles at any step of the way leading to secondary infertility.
Just like baking a cake, the conditions have to be right for conception to succeed. So if you’re having sex less often, you will need to find out when your fertile days are if you’re to have any success in getting pregnant.
If you’re not interested in charting your temperature each day, or spending a fortune in ovulation predictor kits, your best bet is to have sex every two to three days after the completion of your period.
Whether you had a relatively painless, drug-free natural birth or experienced a nightmare you’d prefer to forget, your first pregnancy and birth may be playing a part in your current conception woes.
If you contracted an infection after the delivery of your first child you may have developed adhesions that can affect the proper functioning of your fallopian tubes. This is less likely after a vaginal birth but can occur with major abdominal surgery such as a caesarean section.
Pelvic inflammatory disease (PID) can contribute to secondary infertility so it is important to see your GP if you notice any fever, pelvic pain or abnormal vaginal discharge after the delivery of your first child.
When you’re up all night with an unsettled toddler, it’s all too easy to say yes to a second (or a third) cup of coffee during the day. But something as simple as too much caffeine could be all that’s standing between you and baby number two.
Several studies have shown that excessive daily caffeine intake by women may increase the time it takes for them to conceive. In fact, in one UK study, consumption of more than 300mg of caffeine a day lengthened the time it took to conceive.
If you’re trying to get pregnant and have slipped back into your pre-pregnancy coffee-consuming days, try to limit the amount of caffeine you drink to under 300mg a day. Better still, switch to decaf and that’s one less habit you’ll need to break when you finally see those two pink lines!
Just because your partner’s sperm won the race last time, doesn’t mean they’ve somehow proven themselves for all eternity. Just like your eggs, the quality of sperm declines with age. Exercise, stress and proper nutrition all play a role -- for both men and women -- in the fertility dance.
About 40 per cent of infertility has to do with the male factor so if you notice a bit of extra weight on your loved one, or some bad habits creeping in, try to do something about it together.
"Lifestyle factors are important," says Dr Zushmann. "Stopping smoking, optimising weight and minimising alcohol and caffeine are important for both partners," he says.
Secondary infertility can be a devastating blow to couples who are having trouble growing their family. If you have been having regular, unprotected sex for 12 months and still haven’t fallen pregnant, it’s time to see a doctor. For those nearing or over 35, see your GP after six months of regular, unprotected sex.
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