One
thing we learn early on is that practice makes perfect. Or at least,
practice makes us better. So when parents who have successfully
delivered one or more healthy babies discover they can't get pregnant
again, it comes as a shock.
Those set on
multi-child families can feel heartbroken, caught between those who
have never been able to conceive and friends whose children have
siblings. Inevitably, couples dealing with secondary infertility are
questioned, even by strangers wanting to know if they intend to raise
an only child or have more children.
"Our society is funny in that way," says Diane Lostrangiaolo, a Seattle
mother. "We don't ask personal questions about money, but about
children, people feel they can ask and probe."
Lostrangiaolo and her husband started trying to have a second child
when their biological son was 3 years old. "People would ask questions
and it would bother me so much," she recalls. "I wouldn't show it right
there, but when I got home, I would fall apart."
What is secondary infertility?
Secondary infertility is defined as a couple's inability to conceive
after a year of unprotected and appropriately timed intercourse when
one or both partners have previously had children.
In reproductive medicine circles, even two miscarriages classify a
woman as experiencing "recurrent pregnancy loss." In this situation, as
with an inability to conceive at all, couples are advised to seek help
from a reproductive specialist.
Seattle fertility expert Lee Hickok, M.D., finds that many couples are
in a state of disbelief when they are not able to conceive again. "It
helps them to know that others are like them," adds Hickok of Pacific
Northwest Fertility and IVF Specialists, which is closely affiliated
with Swedish Medical Center. Between 60-70 percent of the couples
seeking treatment at the clinic face secondary, rather than primary,
infertility.
While "there is a better chance that someone will get pregnant in cases
of secondary infertility," Hickok says, the diagnosis and treatment of
both kinds of infertility are the same. Is the female partner is
ovulating normally? Does the male partner have a normal semen analysis?
In about half of the cases, the cause of infertility is attributable to
the male.
Factors in secondary infertility
Secondary infertility often brings other issues into play, including
the mother's weight (obesity interferes with ovulation) and progressive
conditions such as endometriosis. Still, the single biggest factor in
secondary infertility is the female's age.
Consider the numbers, for they are staggering. When a woman is 30 years
old, there is a 20 percent chance that well-timed sex will lead to
conception. By the time a woman is 45 years old, the likelihood that
well-timed sex will lead to conception is a mere 1 percent, according
to Hickok. His sketch of how a woman's fertility declines after age 30
looks similar to a drive down Hurricane Ridge. It is a steep descent,
and were it not for modern medicine, it would be irreversible.
What are the options?
The good news for all infertility patients, secondary and primary, is
that this field has made enormous strides in the past two decades.
Fertility drugs remain the first solution for women with ovulation
problems. These are taken either orally or injected.
As a last resort, there is in vitro fertilization (IVF), which involves
combining the eggs and sperm in a lab. Once embryos are developed, they
are placed into the uterus. While a medical intern in 1984, Hickok
helped deliver the first baby conceived by IVF. Then, the success rate
for embryo transfer was 20 percent. Now, it is about 50 percent. But
the process isn't cheap. With the accompanying medications, each IVF
treatment runs about $13,000.
Adoption as an option
Years after they discovered they could not bear another baby of their
own, Diane Lostrangialo and her husband pursued an international
adoption. Lostrangiaolo, the executive director of New Hope Child and
Family Agency in Shoreline, became comfortable with the idea of
adoption more quickly than her husband. Looking back, she describes
that as a difficult period in their lives. After many prayers, tears
and heart-to-heart talks, the couple was ready to move forward. "It
took my husband many years to get to the place of being there to make
it work," she adds
In her role at New Hope, Lostrangialo advises parents with their own
biological children on the struggles and strengths of adoption. "Those
parents know more about the risks of pregnancy," Lostrangialo says. "In
cases of domestic adoption, it can be very difficult for a parent who
carried a child and was intentionally very healthy to transition to a
case that might involve prenatal exposure to drugs or alcohol."
In their book, A Few Good Eggs: Two Chicks Dish on Overcoming the Insanity of Infertility,
authors Julie Vargo and Maureen Regan advise women to gather as much
information as they can and find a doctor who will listen to your
needs. They add: "Fasten your seatbelts. It's a bumpy road ahead."
Still, statistics offer hope, Hickok notes: For nearly three-fourths of
the couples wishing for more children, that road can indeed lead to a
bigger family.
Hilary Benson
lives in the Seattle area. Her work has appeared in ParentMap and
Metropolitan Living magazine. She has also reported for KING-5 TV.
Resources
Dr. Hickok recommends the following resources for parents experiencing secondary infertility:
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