Bringing a new baby into the world is a cherished dream for many couples, but for some, the process can be unexpectedly difficult. Millions of people throughout the globe suffer from infertility, characterised as an inability to conceive despite regular, unprotected intercourse. Understanding the definition of infertility and the many types of infertility is critical for people on this journey, as it can lead to an accurate diagnosis and personalised treatment options.
What Is Primary Infertility?
Primary infertility occurs when a couple is unable to conceive after at least 12 months of regular, unprotected sexual intercourse if the woman is under 35 years old or after 6 months if the woman is 35 or older and has never previously had a successful pregnancy.
Causes of Primary Infertility
Primary infertility is caused by factors that can affect both males and females. Common causes in women include ovulatory disorders such as PCOS, early ovarian insufficiency, and hormonal abnormalities. Increasing age can be one of the major causes of primary infertility in females. Blocked fallopian tubes, uterine fibroids, endometriosis, and congenital abnormalities are all possible contributors. In men, primary infertility is generally due to conditions such as low sperm counts, poor motility, irregular shape, hormonal shortages, or conditions such as varicocele. Lifestyle issues such as smoking, excessive alcohol consumption, obesity, and exposure to toxins and chemicals may impact both genders.
What is Secondary Infertility?
Secondary infertility is defined as the failure to conceive or carry a pregnancy to term following one or more previous successful pregnancies. It affects couples who had previously been able to conceive but are now having difficulty doing so.
Causes of Secondary Infertility?
Secondary infertility can be caused by a variety of causes, including age-related loss in fertility, hormone imbalances, ovulation abnormalities, or endometriosis and fibroids. Previous pregnancies might result in scarring or damage to the fallopian tubes, uterus, or cervix. Male variables, such as decreased sperm count or motility, can also be involved. Lifestyle changes, stress, and weight swings may have an additional impact on fertility.
Key Differences Between Primary and Secondary Infertility
Pregnancy History
Primary infertility occurs when a couple has never achieved a successful pregnancy, while secondary infertility happens after one or more successful pregnancies.
Psychological Impact
Couples with secondary infertility may face added emotional strain from societal expectations due to prior success, while those with primary infertility often grapple with the fear of never experiencing parenthood.
Causes
Primary infertility often stems from congenital or developmental issues, whereas secondary infertility may result from complications in previous pregnancies, ageing, or lifestyle changes.
Time of Onset
Primary infertility is present from the start of trying to conceive, while secondary infertility develops after a previous pregnancy.
Diagnosis for Primary and Secondary Infertility
Medical History and Physical Exam
A comprehensive history and physical examination will screen for possible underlying diseases, previous pregnancy, and irregularities in the monthly cycle relevant to infertility, plus a study of lifestyle variables that may or may not contribute to infertility.
Semen Analysis (Spermogram)
Semen Analysis is designed to discriminate casual male infertility disorders from sperm count, motility, morphology, and quality of semen.
Hormonal Testing
Ovulation and sperm production are assessed using hormone levels such as FSH, LH, prolactin, testosterone, and thyroid hormones.
Ultrasound and Imaging
Pelvic ultrasounds, hysterosalpingography, and laparoscopy can detect uterine abnormalities, ovarian difficulties, and obstructed fallopian tubes.
Ovarian Reserve Testing
Tests such as AMH levels and antral follicle count determine a woman’s remaining egg supply and overall reproductive potential.
Treatment Options for Primary and Secondary Infertility
Fertility Medications
Clomiphene citrate, letrozole, and gonadotropins are medications that induce ovulation in females and help in the treatment of primary infertility, whereas hormonal therapies cure male infertility.
Assisted Reproductive Technologies (ART): – Intrauterine Insemination (IUI)
Assisted Reproductive Technologies (ART) include intrauterine insemination (IUI), which involves inserting sperm directly into the uterus. Severe infertility situations are treated with more modern methods, such as in vitro fertilisation (IVF).
Surgical Treatments
Surgery corrects structural abnormalities such as fibroids, obstructed fallopian tubes, and varicocele in men.
Lifestyle Modifications
Improving diet, maintaining a healthy weight, stopping smoking, and controlling stress all increase fertility in both couples.
Counselling and Emotional Support
Counselling and support groups can help couples deal with the emotional impact of infertility and treatment.
Emotional and Psychological Considerations
Primary Infertility
Couples coping with primary infertility may endure mental pain due to their concern of never being able to conceive. Feelings of inadequacy, alienation, and dissatisfaction are frequent, and cultural expectations can exacerbate the emotional strain. The uncertainty of never having a child can cause anxiety and sadness, and couples may face pressure from family or friends.
Secondary Infertility
Secondary infertility might be more emotionally difficult because of the loss of expectations following a previous successful pregnancy. Couples who have previously been parents but are unable to conceive may experience loss, remorse, or self-blame. The comparison to previous fertility might heighten the emotional impact, resulting in emotions of dissatisfaction and worry.
When to Seek Medical Advice?
Couples should consult a doctor if they have been unable to conceive after 12 months of regular, unprotected intercourse if the woman is under 35 or 6 months if the woman is 35 or older. If there are any reproductive health problems, irregularity in menstrual periods, painful intercourse, or a history of pregnancy issues, one should visit a doctor immediately. Early intervention helps in finding the root causes of infertility and offering its treatment.
Conclusion
Infertility, whether primary or secondary, can be emotionally and physically challenging, but many treatment options are available. You can seek medical advice on the management of primary and secondary infertility in males and females as well as understand its causes from our fertility specialists at an Oasis Fertility Clinic near you. Additionally, you can also use the live chat or call 1800-3001-1000 for immediate assistance.
FAQs on Primary & Secondary Infertility
How many years is primary infertility?
Primary infertility is defined as the failure to conceive after one year of unprotected intercourse with no prior pregnancy.
Is PCOS secondary infertility?
PCOS can induce primary infertility, but it can also lead to secondary infertility if a woman has previously been pregnant.
Is it harder to conceive a second child?
Having a second child can be more difficult due to age, health problems, or diseases such as secondary infertility.
What is the age limit for infertility?
Women’s fertility reduces dramatically after the age of 35, but men’s fertility decreases gradually after the age of 40.