Women

Your first bundle of joy came along easily, so providing him or her with a sibling should be a reproductive stroll in the park, right? Not always...

You’ve started your family, and now you want to expand it or complete it. Your firstborn came along with ease, after nothing more than a romantic dinner with pink champagne and a night of passion, so you assume making your next child will be a similarly lovely and effortless affair.

After all, everyone around you seems to be expecting number two, number three or even number four, so soon, you will be too, won’t you? So why, if that’s the case, is that thin line on your pregnancy test stubbornly refusing to turn blue?

Secondary infertility is the term doctors have given to describe difficulty in conceiving after at least one successful pregnancy and delivery and it appears to be on the rise.

You’ve started your family, and now you want to expand it or complete it.

With the average woman now increasingly likely to become a first-time mum in her early thirties, age appears to be the primary factor. Midwife and fertility expert Zita West has seen an increase in cases in recent years at her clinics, and agrees that delaying a first child is a key cause.

“Women are having their babies later in life and by the time they reach their late thirties they’re in a panic to have number two,” she says.

“But when you’re older it takes longer to get pregnant. Some women who delay then plan to have their children in quick succession, but it takes on average 18 months to get over childbirth and get your body back to normal, and too many women underestimate the impact. Breastfeeding and irregular cycles, exhaustion caused by looking after your baby, being too busy or tired for sex – all these factors come into play.”

Gynecologist Dr. David Walsh says, age factors aside, fallopian tubal problems are a major cause of secondary infertility.

“If a woman’s had, for instance, a caesarean section for her first child, or if she needed an evacuation of retained placenta after delivery, these increase her risk of developing an ascending pelvic infection affecting and damaging the delicate fallopian tubes,” he argues.

Breastfeeding and irregular cycles, exhaustion caused by looking after your baby, being too busy or tired for sex – all these factors come into play.

Breastfeeding and irregular cycles, exhaustion caused by looking after your baby, being too busy or tired for sex – all these factors come into play.

“She may have had a low-grade temperature a few weeks after birth, offensive discharge, pelvic pain, but may not have realized the problem, what with so much else on her mind. She’ll recover, of course, either with or without antibiotics, but the tubes are so fragile that it doesn’t take much to damage them, and this can compromise future fertility.”

A third category, says Walsh, is where there is other gynecological disease present, such as fibroids or endometriosis. A woman may succeed first time, but then struggle a second time around when age-related endometriosis, for instance, combines with diminished ovarian reserve of eggs, to result in secondary infertility.

Furthermore, although media stories of older men becoming fathers naturally are perennially popular and give the impression that men are fertile until death, sperm quality begins to decline gradually after 40, and the problem could lie with the man in around thirty percent of couples experiencing difficulty conceiving again.

A third category, says Walsh, is where there is other gynecological disease present, such as fibroids or endometriosis.

A third category, says Walsh, is where there is other gynecological disease present, such as fibroids or endometriosis.

Dietary concerns

One area many women neglect is their dietary needs. Dietitian Margot Brennan says that postnatal recovery takes time, and she agrees that new moms often get so wrapped up in ensuring their child is looked after and fed well, that they can get complacent with their own eating habits. Poor nutrition is likely to lower fertility.

“With healthy eating, it takes about three months for your nutritional stores to return to normal after you’ve had a baby and if you’re breastfeeding too it will take three months after you stop,” she says. “If a woman is juggling work, house and home, as well as baby, she can neglect herself. Up to a third of women don’t meet their iron requirements and a third don’t meet their calcium needs either. It’s a huge problem.”

With healthy eating, it takes about three months for your nutritional stores to return to normal after you’ve had a baby – and if you’re breastfeeding too it will take three months after you stop,

With healthy eating, it takes about three months for your nutritional stores to return to normal after you’ve had a baby and if you’re breastfeeding too it will take three months after you stop,

Brennan says that you should consume a little red meat to restore iron levels reduced after pregnancy, in the form of lean beef, for example, rather than fatty burgers, and that folic acid supplements should be taken too if you’re looking to conceive. Oily fish and a selection of fruit, vegetables and complex carbohydrates should be on the menu too. “New moms or moms with young children are often sleep deprived and exhausted,” she adds. “Women in this situation have a tendency to snack and nibble on starchy or sugary carbohydrate foods like white bread and biscuits to keep them going and give them some quick energy. But if they do this they could be compromising their protein intake, and their levels of trace minerals such as zinc. And being overweight will also effect fertility.”

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