Understanding Secondary Infertility. Part 2

Besides age, other ‘new’ complications can cause secondary infertility. One problem that may be overlooked is male factor infertility. Although age is not as important to male fertility as it is to female fertility, there are changes that can take place in sperm quality over a period of one or two years. Therefore, just because your male partner had optimal sperm quality a couple years ago, doesn’t mean that he does today, when you are trying to have a second child. There are many reasons for a decline in male fertility, so consider the following scenario:

Jason and Anne got married at age 32. They talked about starting a family right away. Before their first anniversary, Anne discovered the happy news that she was pregnant. Little Angie was born a healthy baby 9 months later. Six months after her birth, Jason went for a routine physical exam where his doctor discovered that he had high blood pressure. This was not a surprise, as Jason’s family has a strong history of high blood pressure and heart disease. To reduce his blood pressure, Jason’s doctor prescribed a medication from the class of drugs known as “calcium channel blockers”. Within 3 months, his blood pressure was under control, and he continued the prescribed regimen without hesitation. Once Angie turned 2 years old, Jason and Anne decided it was time to grow their family. However, this second time around they were still unable to get pregnant even after 1 year of trying, whereas the first time Anne was pregnant within a few months! Since they were experiencing this difficulty, they decided to see a fertility specialist in their area to be evaluated. In evaluating the causes for Jason and Anne’s infertility, the specialist reviewed the medication that Jason was taking for his blood pressure. It turned out that calcium channel blocker medications are known to negatively affect the ability of sperm to fertilize an egg, despite their positive effects on blood pressure. Knowing this, the fertility specialist recommended that Jason see his internist to switch blood-pressure lowering medications to a different class. Upon his advice, Jason consulted with his primary doctor and received a new prescription for a beta-blocker medication, an effective blood pressure lowering medicine from a different class. Six months after the switch, Jason was happy to announce that he and Anne would soon be proud parents for a second time.

This scenario demonstrates that secondary infertility, when diagnosed correctly, can in some cases be treated quite easily. Also, it is important to consider both the male and female partners when evaluating the cause of the problem and making a diagnosis.

Other Factors to Consider

Changes with your normal daily routine or your body may cause secondary infertility. For example, did you start to dramatically increase the amount of exercise you do during the week? Have you gained weight since your first delivery? These are all important issues to consider because they may lower the likelihood of getting pregnant. Keep in mind that these problems are not necessarily insurmountable – sometimes a lifestyle change may be just what the doctor ordered to increase fertility and maximize your chances of becoming a parent again.

Once the cause of secondary infertility is identified, a fertility treatment plan can be designed with you (the couple) and your healthcare team. The treatment may be nothing more than a lifestyle change or a change in a culprit medication that may be lowering your chances of getting pregnant. However, in some cases, treatment may be much more involved. For example, if age-related infertility is the cause of Secondary Infertility, options for parenthood may include In Vitro Fertilization, donor eggs, or adoption. Because the cause of Secondary Infertility is different from one couple to another, the treatment can be dramatically different as well.