in this issue
Sonja Kristiansen, MD
Medical Director & co-founder
of
the
Infertility Center
of Houston, Dr. Kristiansen is double board certified in
Reproductive
Endocrinology and Obstetrics & Gynecology and
specializes in surgical and IVF procedures.
She has
advanced training in hysteroscopy, laparoscopy, and
microtubal reconstruction. She also works with
female endocrine abnormalities relating to
menstrual and reproductive development.
Quick Links...
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Greetings,
There is very little "secondary" about secondary
infertility, a term used to describe the condition of
infertility after the person has already conceived or
given birth in the past. It can be just as emotionally
devastating as primary infertility, which refers to those
who've never been able to conceive.
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What Makes Secondary Different?
Since so many of us have pleasant memories or
relationships with our siblings, it's common to want the
same in life for your child. Secondary infertility,
especially when experienced by someone who
previously conceived and gave birth with little or no
problems, can be a harsh awakening to the fact that
even our best intentions for our families can be
side-tracked. Because of the previous relatively
positive
experience, infertility during subsequent attempts to
get pregnant can feel bewildering and even
scary. "What has gone wrong with my body, when it
seemed to work just fine before?" is a question that
might sum up the dismay that those with secondary
infertility feel.
It's very important to consider the partner in the
process, especially if there's been a change since the
last pregnancy. While it can certainly be a touchy
subject to approach, the fact is that men are
responsible for approximately half of all diagnosed
infertility cases. If a woman has changed male partners
since her last pregnancy, it's possible that the new
significant other may have a role to play in getting
treated for infertility.
Additionally, people with secondary infertility
experiences a sort of social limbo, caught between the
normally fertile world and people with primary infertility
who've never been pregnant. They don't feel
understood by either group and, in fact, even shunned
by the "primaries" who can't understand
why "secondaries" can't "just be happy with what
you've got."
So, it's understandable that people experiencing
problems getting pregnant when it was never a problem
before are quite hesitant to come to a fertility
specialist. Are they being ungrateful for the child or
children they already have? Is their desire really worth
the pursuit with assisted reproductive technology?
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How Secondary Is the Same
It is natural and normal to grieve the loss that comes
from being unable to provide a sibling for your child.
Likewise, when the biological yearning for a baby
develops in a woman, regardless of reasons, it is a
longing that cannot be easily dismissed. The good news
is that experts treat secondary infertility with the same
level of interest as primary infertility.
The causes of secondary infertility can be identical to
those of primary. All of the things that happen to a
woman's body to cause her trouble getting pregnant a
first time can occur at any time later in a woman who
has been able to conceive unassisted.
It's important to remember that our bodies don't stop
developing at young adulthood. In fact, women's bodies
change throughout their lifespan, sometimes quickly,
sometimes slowly, whether dramatically or with
subtlety. Many women in their 30's, for example, may
already have witnessed changes in their menstrual
cycles, regardless of their fertility efforts. Simply as a
result of this ongoing development, a woman who is
fertile in her early 20's cannot be assured that her
fertility will be intact in her 30's or later.
Besides this natural development, much of which is
steered by genetics and some by lifestyle, a number of
things can be encountered -- infection or other
disease, bodily trauma -- that can change one's
fertility status over time, often with no indication. For
this reason, it's important that a patient experiencing
secondary infertility have a very thorough medical
history taken that includes all of her previous
reproductive experiences -- from contraception usage
and any fertility risks, to details on all previous
conceptions, pregnancies, deliveries, and post-partum
periods.
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Can You Have Another Baby?
The answer to that question will naturally vary
according to your diagnosed cause and any chosen
treatment plans. Some experts believe that, depending
on the cause and treatment, women who have already
successfully conceived and given birth have a built-in
natural advantagement in the process. Their bodies
have already experienced the dramatic changes in
hormone levels that occur with pregnancy, and their
reproductive system has functioned in an optimal
manner before -- it could very well be that a little
fine-tuning may be all that's necessary to right the
system
again.
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In Closing
As always, I welcome your questions. Regardless of
whether you have been pregnant before or not, I and
my staff are here to help you make decisions about the
treatments available to help you build your family.
Sincerely,
Sonja B. Kristiansen, MD
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