"Secondary Infertility: Understanding and Coping"

I just got finished listening to a podcast from Conceive Online dealing specifically with secondary infertility. In this podcast, Beth Weinhouse, Conceive’s editorial director, discusses with Dr. Mark Leondires of Reproductive Medicine Associates of Connecticut, the causes of secondary infertility and just how common this problem actually is.

I'd strongly advise listening to the podcast if you are struggling with secondary infertility, but I have also come up with a basic summary.

"Secondary Infertility: Understanding and Coping"

- Over 3 million couples struggle with secondary infertility (SIF)

- More couples struggle with SIF than primary infertility (PIF). SIF makes up around 60% of all cases of infertility

- Don't wait! For SIF, don't wait a year to see an RE. It is okay to go after 6 months TTC

- Stress play a major roll in SIF, and there are in fact different stressers than PIF

- Are the same tests used for primary and SIF? Yes, you need to have the same tests run or work-up to determine next steps.

What are the tests needed?

- Evaluation of reproductive age - this includes a Day3 Follicle Stimulating Hormone (FSH) test

- Size of ovaries on Day2, 3 or 4

- Tubal patency test

- Fallopian tube test - may or may not be used, depending on whether you had a c-section for your first pregnancy

- A good RE should be able to do all of your tests and evaluation within one month and quickly move on to your treatment plan.

Causes of SIF:

- Age related decline

- Menstrual cycle changes - shorter cycles, spotting, polyps, fibroids, etc.

- C-section, or any major surgery since your first pregnancy, can cause damage to the fallopian tubes

- Thyroid disease

- Women need to remember that if you've had one or more m/c since your first pregnancy, you also need to see an RE by six months TTC

- It is more likely that women who have been diagnosed with SIF will fall into the "unexplained" category

Three Tiers of Treatments:

- Tier One - Oral therapy w/ IUI
- Tier Two - Injectable therapy w/IUI
- Tier Three - IVF

- Patients with SIF tend to be more aggressive more quickly in their therapy, moving more quickly to IVF

Success Rates*:
- Oral Medications w/IUI - 10-15%
- Injectable therapy w/IUI - 40-50%
- IVF - 70-80%

* These rates are not per cycle, but accumulative rates after several cycles of trying*

Emotional Factors:

- Those with SIF are not as accepted in the general fertility community because we already have a child(ren). Perhaps if people understood that SIF is more common that PIF, there     would be a different attitude towards us.

- There is a lot of pressure for us to have another child, not only on ourselves, but from other outside factors

- We're already aware of how amazing it is to be a parent

- We feel like a failure because we know what our bodies have already been capable of

- We want a sibling for our child

- Our child is asking us for a brother/sister (which is absolute heartbreak and torture)

We need to take care of ourselves as a "whole" person

- Exercise

- Diet

- Seeing a therapist or being a part of a support group

- Acupuncture