For many couples who have had a child in the past, the thought of secondary infertility comes with strong feelings of denial. They often believe that because they have one child already, they must be fertile. However, there are many factors, including age, uterine abnormalities, or effects of reproductive surgery that can impact your ability to have another baby
Asherman’s Syndrome is a condition that describes scarring in the uterine cavity. Asherman’s can result from nearly any uterine procedure. Commonly, the scar tissue or “intrauterine synechiae” results from a dilatation and curettage (D&C) to remove the contents of a miscarriage or following a delivery, it can also follow a postpartum infection, pelvic inflammatory disease, radiation treatment of the pelvis, and uterine surgery for the removal of fibroids. While Asherman’s syndrome classically presents with light or absent menses, some patients may experience monthly pain and/or infertility.
A blog by Dr. Daniel E. Stein, RMA of New York, June 1, 2015
Recurrent miscarriage or pregnancy loss is defined as the loss of two or more pregnancies each up to 20 weeks gestation. These losses occur most commonly during the first trimester. There are many possible reasons for recurrent pregnancy loss; however a specific cause is not identified in approximately 50% of cases. While recurrent miscarriages can be emotionally devastating, there is still a great deal of hope for many couples.
Oocyte donation offers women in menopause, women with premature ovarian failure and women with diminished ovarian reserve the opportunity to not only become parents but also to carry a pregnancy. Oocyte quality and quantity decline substantially as a woman ages (and in some instances even before a woman ages); this decline is often the cause of many women’s fertility struggles. Despite marked improvements in IVF techniques, we are often unable to fix diminished egg quality and quantity, and therefore in order to achieve a pregnancy, oocyte donation is required.
Secondary infertility refers to couples who have had a successful pregnancy in the past, but then experience difficulty with conceiving. Part of this may be explained by age, especially if their last pregnancy was achieved in their late thirties or early forties. In young, healthy women, the average monthly pregnancy rate is approximately 20%. As women age, this rate starts to decline, especially after 35 because both the number of eggs, as well as the quality of eggs decline with age. Additionally, the miscarriage rate also increases with age which can usually be attributed to the quality of the eggs.
Over the past several decades, advances in reproductive technologies have provided new possibilities for couples experiencing infertility. IVF has allowed many couples to overcome infertility due to tubal disease, and ICSI has overcome most cases of male factor infertility. As women age, however, traditional IVF has not always been successful in helping physicians identify the healthiest embryo. By the time most women are in their 40’s, 90% of eggs are abnormal. Some eggs possess too many chromosomes, and others do not have enough. In any case, the abnormal embryos may either not implant, may result in miscarriages, or may even result in unhealthy babies. To prevent unhealthy embryos from being transferred and to increase the chance for individuals and couples to achieve a healthy pregnancy, we frequently biopsy embryos prior to transfer and then analyze the embryos using a form of assisted reproductive technology known as Comprehensive Chromosomal Screening (CCS).
After trying unsuccessfully to have a child, many couples are taken aback when they first seek medical treatment at fertility clinics. A veritable barrage of tests awaits, with unfamiliar terminology in the results. Breaking through the jargon and learning the science beneath can be helpful to understanding male fertility.