Secondary infertility

Secondary infertility is defined as the inability to conceive or carry a baby to term after previously giving birth. 

Secondary infertility can be linked to fertility issues in either the male or female partner. 

About one-third of all cases is due to the female; another third can be traced to the male. In the remaining 30% of cases, secondary infertility is either linked to both partners or its cause is unknown.

Factors that can contribute to secondary infertility in women and men include:

Advanced maternal age 

Impaired sperm production or low-sperm count!or sperm not moving in the right way.

Damaged Fallopian tubes that prevents an egg from traveling to the uterus or the sperm from meeting an egg.

The tube which carries eggs from the ovaries to the uterus can become blocked due to pelvic infections like chlamydia or gonorrhea. 

Problems with the release of an egg from the ovary.

Uterine conditions:

Endometriosis with scarring from, where tissue similar to the tissue that lines the inside of the uterus grows outside of the uterus on other pelvic organs.

Conditions of the uterus, such as uterine fibroids or adenomyosis.

Complications related to a past pregnancy or surgery.

Risk factor changes such as age, weight and use of certain medications

Polycystic ovary syndrome-a hormonal disorder causes high levels of male sex hormones and prevents regular ovulation and menstruation.

Excessive weight gain in both men and women

Lifestyle factors including smoking and heavy alcohol use

Certain medications

Secondary infertility can be diagnosed as unexplained. 

About 1 in 5 cases of secondary infertility are identified as unexplained.

Diagnostic and therapeutic procedures for secondary infertility are the similar to those used for primary infertility, include: 

Oral or injectable fertility medications, 

Intrauterine insemination, In vitro fertilization (IVF).

Clomid is an oral medication that stimulates hormones that produce eggs in women with ovulation problems.

Uterine surgery may clear scar tissue, polyps, and fibroids that impact fertility.

In vitro fertilization (IVF) is a procedure in which eggs are surgically retrieved from the uterus, fertilized in a lab with sperm, with the resulting embryos transferred back into the uterus. 

Causes of secondary infertility in men include:

40 years or above: Semen quality usually declines after age 40. 

Low testosterone levels, crucial for sperm production but can decrease due to aging or genital injuries.

Prostate enlargement can reduce sperm count and restrict ejaculation. 

Prostate removal: Removal of the prostate as a treatment for cancer or other conditions can cause sperm to flow in reverse. 

Late-onset hypogonadism: 

The chances of infertility increase by 10% for every 20 additional pounds a man gains.

Treatment options for men include:

Intrauterine insemination in which sperm is inserted directly into a woman’s uterus: in men that have low sperm count or poor sperm quality.

Testicular surgery can repair testicular varicocele, that affects sperm quality and count.

Lifestyle-related infertility, such as infertility caused by excess weight gain, can be reversed using weight management strategies.

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