J.
08-22-2004, 09:27 AM
From http://infertility.about.com/cs/secondaryif/a/2ndryIF_p.htm, in connection
with an ongoing thread:
Secondary Infertility
For a percentage of adult couples desiring children, infertility is a problem
they not only don’t know they have but, in fact, are sure they don’t have.
Their first children are conceived with ease and they have no reason to believe
that making that child a big sister or big brother will be any more
difficult…until they actually try to do so. Much has been written on whether
secondary infertility is more or less psychologically devastating and while the
debate will rage on, all agree that for anyone who wants children (or more
children) the emotional pain is real and intense.
“Why me (us)?”
Secondary infertility is generally defined as the inability of a couple to
conceive after a year of unprotected and appropriately timed intercourse when
one or both partners have previously conceived children.
Causes Of Infertility
Both male and female factors may be involved and in about one-quarter of the
cases the cause is multi-factorial.
Age
The most prevalent cause of secondary infertility may be age. Much has been
written about aging and women’s fertility. Women are born with all of the
oocytes they will ever have and female fertility peaks in the mid-twenties to
mid-thirties. Menopause, of course, occurs when there are no more oocytes. The
decrease in fertility by 35 years of age is marked. By age 40 the spontaneous
pregnancy rate is significantly lowered and at age 45 the chances of natural
conception with unprotected and well timed intercourse are, at best,
approximately 6% per cycle. Older oocytes (eggs) have been around longer and
have been exposed to more environmental factors which may contribute to a
decrease in egg quality. Single gene mutations may be responsible for
spontaneous interruption of early pregnancies therefore it is not surprising
that along with the decrease in natural pregnancy rate comes an age related
increase in spontaneous abortion (miscarriage) rate. When one also considers
that many spontaneous abortions occur before a woman even knows that she is
pregnant it is easy to see why female age is a significant factor in the
etiology of secondary infertility.
Less has been written about male age and fertility. Men, after all, normally go
on producing new sperm throughout their adult life. Newer studies, however,
have shown a decrease in both the quality and quantity of sperm produced by
older men. Thus paternal age is no longer an insignificant factor to consider.
Couples Factor
One factor that occasionally contributes to the creation of a secondarily
infertile couple is the introduction of a “new partner”. A female or male
who has previously successfully conceived may become secondarily infertile with
a new partner.
Pathology
Successful conception relies upon the production of healthy sperm and oocytes
that meet and fuse in a supportive environment. Interruption of any step along
this complex pathway may result in infertility.
In women, tubal blockage and abdominal adhesions are responsible about one
third of the time for the diagnosis of infertility, ovulatory issues
(anovulation, premature ovarian failure, ovulation irregularities) are
responsible about 25% of the time though this, as previously mentioned,
increases significantly with age and uterine factors (including endometriosis,
a condition where uterine tissues are located outside of the uterus) are
thought to be a contributing factor in approximately 30% of. Once again, it is
important to remember that there may be multiple etiologies in the same couple
and that many of these etiologies may develop after the first successful
conception.
In men, acquired defects in spermatogenesis, blockage in the semen delivery
system and impotence are the primary contributing factors to infertility. Some
of the causes of these problems are relatively reversible and easy to correct
others less so.
Reply to jmhjmd at aol.
with an ongoing thread:
Secondary Infertility
For a percentage of adult couples desiring children, infertility is a problem
they not only don’t know they have but, in fact, are sure they don’t have.
Their first children are conceived with ease and they have no reason to believe
that making that child a big sister or big brother will be any more
difficult…until they actually try to do so. Much has been written on whether
secondary infertility is more or less psychologically devastating and while the
debate will rage on, all agree that for anyone who wants children (or more
children) the emotional pain is real and intense.
“Why me (us)?”
Secondary infertility is generally defined as the inability of a couple to
conceive after a year of unprotected and appropriately timed intercourse when
one or both partners have previously conceived children.
Causes Of Infertility
Both male and female factors may be involved and in about one-quarter of the
cases the cause is multi-factorial.
Age
The most prevalent cause of secondary infertility may be age. Much has been
written about aging and women’s fertility. Women are born with all of the
oocytes they will ever have and female fertility peaks in the mid-twenties to
mid-thirties. Menopause, of course, occurs when there are no more oocytes. The
decrease in fertility by 35 years of age is marked. By age 40 the spontaneous
pregnancy rate is significantly lowered and at age 45 the chances of natural
conception with unprotected and well timed intercourse are, at best,
approximately 6% per cycle. Older oocytes (eggs) have been around longer and
have been exposed to more environmental factors which may contribute to a
decrease in egg quality. Single gene mutations may be responsible for
spontaneous interruption of early pregnancies therefore it is not surprising
that along with the decrease in natural pregnancy rate comes an age related
increase in spontaneous abortion (miscarriage) rate. When one also considers
that many spontaneous abortions occur before a woman even knows that she is
pregnant it is easy to see why female age is a significant factor in the
etiology of secondary infertility.
Less has been written about male age and fertility. Men, after all, normally go
on producing new sperm throughout their adult life. Newer studies, however,
have shown a decrease in both the quality and quantity of sperm produced by
older men. Thus paternal age is no longer an insignificant factor to consider.
Couples Factor
One factor that occasionally contributes to the creation of a secondarily
infertile couple is the introduction of a “new partner”. A female or male
who has previously successfully conceived may become secondarily infertile with
a new partner.
Pathology
Successful conception relies upon the production of healthy sperm and oocytes
that meet and fuse in a supportive environment. Interruption of any step along
this complex pathway may result in infertility.
In women, tubal blockage and abdominal adhesions are responsible about one
third of the time for the diagnosis of infertility, ovulatory issues
(anovulation, premature ovarian failure, ovulation irregularities) are
responsible about 25% of the time though this, as previously mentioned,
increases significantly with age and uterine factors (including endometriosis,
a condition where uterine tissues are located outside of the uterus) are
thought to be a contributing factor in approximately 30% of. Once again, it is
important to remember that there may be multiple etiologies in the same couple
and that many of these etiologies may develop after the first successful
conception.
In men, acquired defects in spermatogenesis, blockage in the semen delivery
system and impotence are the primary contributing factors to infertility. Some
of the causes of these problems are relatively reversible and easy to correct
others less so.
Reply to jmhjmd at aol.
