The experts from The Agora Gynaecology and Fertility Centre answer our questions about fertility problems, treatments and support.
What’s the difference between primary and secondary infertility?
Primary infertility is when someone has been trying to conceive for over a year without success and has never been responsible for a pregnancy before. Secondary infertility is when a couple or individual has conceived in the past, and maybe even has a child, but is struggling to get pregnant.
What causes secondary infertility?
There are many reasons and they are often similar to primary infertility. These include for a woman a decline in her ovarian reserve (egg numbers), ovulation disorders or damage to the fallopian tubes and in men impaired sperm quality or quantity.
Other than these physical causes it is not unusual for a couple to find it difficult to make time for themselves when looking after a young child and intercourse may be infrequent, difficult or painful. The lack of sleep can also affect overall heath, libido and the amount of time and energy a couple may have to keep trying.
Sometimes a woman has experienced a difficult childbirth and is left with possible complications or psychological trauma that needs to be professionally addressed. We now recognise that many women suffer from posttraumatic stress or postnatal depression and there a good treatments out there for both.
When should I see a doctor for secondary infertility?
Although it is advisable to see a fertility specialist after trying unsuccessfully for over 12 months, if you are over 35 or you have a family history of early menopause, we recommend you come much sooner even if you have just started trying to conceive.
This is because a woman is born with all the eggs she will ever have and loses hundreds of them every day of her reproductive life. It doesn’t matter if she is pregnant, on the pill or menstruating. It’s like a silent time bomb ticking.
In your 20s your fertility should be excellent but as you reach your mid-thirties it starts to decline. But everyone’s different and some women lose their fertility at a much younger age than others.
What about male infertility?
Male infertility is on the increase and is thought to be related to many different lifestyle factors such as poor nutrition, excess caffeine or alcohol consumption, smoking, taking recreational or body building drugs, obesity and a sedentary lifestyle.
A male fertility MOT is a sensible choice for all men who want to become parents as knowing is better than not knowing so that lifestyle changes can be made not only to improve your chances of conceiving but to enhance your overall wellbeing.
At the Agora we recommend both men and women take a Fertility MOT test which includes the most important fertility investigations followed by a Consultation with a Fertility Expert to either reassure you all is well or to help you make decisions about any treatment that could help you well before it is too late.
Are infertility rates rising?
As many as one in seven couples trying to conceive are affected by infertility, a substantial increase on infertility rates of 20-30 years ago. This is due to a number of factors. Many couples are waiting longer to start their journey, wanting to finish their education or progress their career or simply because they have taken more time to find that special person they want to spend the rest of their life with.
As we have explained, a woman’s chances of conceiving start dropping particularly from their mid- thirties and men often have a problem that they can so easily address.
Why does secondary infertility lead to so much stress?
The emotional side of infertility can be difficult to accept and even discuss with even those you are closest to but it does affect many people and dealing with it represents a large part of the work we do with our patients.
Simply opening up about how you feel, talking about the impact of struggling to conceive on your relationship with your partner or your friends is an important first step in helping you deal with the pain and often isolation of infertility.
Many of our patients find it difficult to be around babies and children when trying to conceive for the first time… but if you already have a child, many of your social group will involve pregnant ladies and small children, providing a constant reminder of how much you want a sibling for your child…
How can I find help and support for that stress?
At the Agora we understand the stress of infertility and regard Patient Support and wellbeing as a priority in everything we do. We offer a number of different options to our patients including a closed facebook group and buddy system which we find really helps our couples share their experience with other people in similar situations. We also offer professional independent counselling and group support.
Ultimately, if you really want a sibling for your child, we invite you to first come and find out what might be wrong with a fertility MOT. Only then can we provide you with both the scientific expertise and emotional support to take you on probably the most important journey you will ever make as we help you complete your family.
The Agora Clinic, Ellen Street, Brighton & Hove, BN3 3LN