Secondary infertility is the term doctors use to describe the difficulty in conceiving after at least one successful pregnancy and delivery.
Most of the research points out that delaying a first child until a woman’s early 30s is a key cause of secondary infertility. As reproductive specialist Dr Jacobson points out, “By far the most significant factor for secondary infertility is that of increasing female age. In many instances, there is a delay between first and second children at a time when reproductive function is diminishing.”
Some women plan to have children in quick succession, but it can take, on average, 18 months to get over childbirth and get your body back to normal – and too many women underestimate this.
Although physiologically, Dr Jacobson points out that your body is physically ready to have another child six weeks after pregnancy – something to remember if age is not on your side. But the reality is breastfeeding, irregular cycles, stress, exhaustion caused by looking after your baby and being too busy or tired for sex all do come into play.
Johannesburg gynaecologist Dr David Walsh says that Fallopian tubal problems are also a major cause of secondary infertility. “If a woman’s had a c-section for her first child, or if she needed an evacuation of retained placenta after delivery, these factors could increase her risk of developing an ascending pelvic infection affecting and damaging the delicate Fallopian tubes and this can compromise future fertility,” he says.
Common role players
There could be other issues present, such as broids or endometriosis. A woman may succeed the first time, but then struggle a second time around when age-related endometriosis (for example), combines with a depleted reserve of eggs.
Of course it’s not unusual to hear stories of older men and women becoming parents but on the whole, sperm quality begins to decline gradually after 40 and in around 30 percent of couples experiencing difficulty conceiving again, the problem lies with the man.
One of the areas to look at is nutrition. Poor nutrition is likely to lower fertility. Nutritionists say that with healthy eating, it takes about three months for your nutritional stores to return to normal after you’ve had a baby – and if you’re breastfeeding too, it will take about three months after you stop.
If a woman is juggling work, house and home, as well as baby, she can neglect herself. Up to a third of women don’t meet their iron requirements and a third don’t meet their calcium needs either.
Generally, nutritionists advise that you should consume a little red meat to restore your iron levels which are reduced after pregnancy. Eat meat in the form of lean beef, for example, rather than fatty burgers and don’t forget folic acid supplements which should be taken as well if you’re looking to conceive.
Also read: Pregnancy myths debunked
New moms or even moms with young children are often sleep deprived and exhausted. Many tend to up sugar and energy levels by snacking on starchy or sugary carbohydrate foods – like white bread and biscuits.
The problem is that the quick boost actually compromises your protein intake and your levels of trace minerals such as zinc.
When it comes to the emotions behind secondary infertility, it’s disheartening to try and fail – and each time, dashing your hopes. Experts say that sometimes the desire for a second child is so strong, that a mother may not feel her family is complete without another baby.
Many women feel as if they can’t ask for help and they’re unlikely to get sympathy from, for instance, childless couples who feel they should be grateful for the infant that they do have.
Don’t discount the role that stress itself plays. It’s natural to get stressed because your family is not working out precisely according to the ideal plan and schedule you had always imagined, fretting over time gaps between children and how this might affect school arrangements, nuances or the closeness of the relationship between siblings.
Often, it’s just about accepting that life happens as it happens. It’s unpredictable and stressing about the time table can work against you.
Must read: The precious but not so perfect placenta
Previous birth difficulties and complications
In some instances, many women become so traumatised by their earlier experiences of pregnancy and birth that they become frightened of the process again and in turn subliminally frightened of falling pregnant again.
Conversely, a lot of couples also just happen to conceive when they simply stop “trying”. There’s no hard and fast rule or reason but a lot of parents find that once they simply relax and ease their pressure and stress: voila... it’s baby time!
The good news is that couples can and do normally succeed a second time around, although IVF may be the necessary option for older women. There are also other choices that can be made to get the result you seek: adoption, surrogacy, egg donation.
Either way, do not be afraid of seeking advice or reassurance. Remember that every couple is unique and what may work for one, is invalid for another. Take your time to weigh up your decisions. Help is out there.
Other causes of secondary infertility
Excessively high or low body mass can affect ovulation and fertility, so try to keep your weight at a healthy balance.
Dieting, bingeing and purging can affect ovulation.
Numerous diseases such as diabetes, arthritis hypertension or asthma can affect fertility as can the medication that is used to treat them.
Complications of D&C after a miscarriage can affect fertility and complications of other abdominal or pelvic surgery may also affect fertility.
As you age there is a risk of fibroids which may either prevent a pregnancy or it could cause a miscarriage.
Some theories suggest that if the body becomes too acidic, the functioning of all cells is adversely affected and because of many of us having high-fat acid-rich diets, acid levels rise. Check with your doctor about supplements and drink lots of water and stick to a healthy diet.
Medication for high blood pressure, cholesterol-lowering agents and chemotherapy may reduce fertility.