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Secondary Infertility: Get the Treatment You Need


a blog by David Kreiner, M.D., F.A.C.O.G., Mar. 31, 2010

Sometimes my patients who have difficulty conceiving their second child feel like second class citizens in the infertility world. Unlike their infertile peers without children, they perceive that friends, family and even their doctor’s offices do not have the same sympathy and concern for them as they do for others without a child. I have had patients with secondary infertility express guilt and anger in addition to the routine sadness often associated with the inability to conceive.

Those of you with secondary infertility need to know that you are not alone in feeling this way. My patients all express this alienation which exacerbates the depressing effects of infertility. Women with secondary infertility have as much a right to fertility care as anyone else, as well as the same respect and attention.

Secondary infertility has some unique medical characteristics that are worth discussion. Those of you who have had a caesarian section, ectopic pregnancy or abdominal surgery are more likely to have a tubal factor causing your infertility. Scar tissue can form that can obstruct, or displace a fallopian tube making it more difficult for the tube to pick up an ovulating egg or for the fertilized egg to make it to the uterus.

Issues such as borderline sperm counts and endometriosis typically make it more difficult to conceive so it’s not unusual that though it took longer than expected to conceive the first time around, the second time you are not experiencing any success at all.

We perform a semen analysis and hysterosalpingogram and consider the potential benefit of laparoscopic investigation. Alternatively, if the semen analysis is not too bad and the HSG is normal, patients may benefit from insemination with hormonal stimulation. Otherwise, in vitro fertilization either with minimal or full stimulation will offer significantly superior success rates.

Facing secondary infertility may be as difficult emotionally as infertility for those without prior pregnancies. However, treatment options are available that are highly successful in delivering you the family of your dreams.

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