Unexplained Secondary Infertility

Unexplained infertility 

Many couples never find out why they can't conceive, as no cause is found for their problems despite extensive tests. In some cases, it is thought that this could be down to age, despite apparently normal test results, but in most eases it is just a matter of doctors not being able to get to the root of the problem. Sixty per cent of those with unexplained infertility will conceive naturally within three years, but that still leaves many others with no idea why they can't have children.

Unexplained Secondary Infertility

Unexplained infertility can be a difficult diagnosis to live with, and some women find it hard not to blame themselves, wondering whether it is something they have done in the past which has caused the problem, or even something they are still doing unawares. Not knowing what you are up against can make the whole experience particularly difficult.

'I have unexplained infertility, which is not reassuring at all. All it means is that they haven't found anything with the tests they have these days. I think unexplained infertility is a bit of a cop out. You think, is it me? Is it my problem I'm not conceiving because I'm stressing out so much? Is it the food l'm eating? Is it because I'rn 37?' Lana, 37

Secondary infertility

Women who have already been pregnant don't expect to have problems conceiving again, but in fact as many as a third of the patients at fertility clinics will have had a child, or a pregnancy, in the past. This is known as secondary infertility.

Some conditions which affect fertility can develop after a first pregnancy, such as endometriosis, hormone imbalances or sperm problems. An untreated infection after a previous delivery can leave scar tissue, or block the fallopian tubes. Women who have had a caesarean section, especially during the later stages of labor, are at slightly greater risk. Sometimes secondary infertility is simply down to age. If a couple have relatively minor fertility problems and start trying for a first child when they are fairly young, they may still manage to conceive, but if the minor problems are combined with age, it can make all the difference. In some cases, secondary infertility will remain unexplained.

It is important not to assume you cannot possibly have a fertility problem just because you've already conceived before. If you've been trying unsuccessfully for another baby for more than a year, it is worth having some basic tests carried out.

Possible causes from your male partner 

Most male fertility problems involve sperm. There may be a low sperm count (not enough sperm in the semen), there may be problems with sperm motility (the sperm aren't moving properly) or with sperm morphology (the sperm may be abnormal). Having a varicocele in the testicles, which is a bit like a varicose vein, can damage sperm, as it affects the blood flow. Some sperm problems are hormonal and some may be genetic, whereas others are caused by infection, but quite often there is no obvious cause for the problem.
 
Sometimes there is agglutination in the semen sample, which means the sperm are stuck together in clumps and can't fertilize an egg. This is often caused by anti-sperm antibodies in the blood, which may be the result of injury or surgery.
 
In some cases, there are simply no sperm in the semen sample at all. This is usually due to some kind of blockage, but can also happen when a man doesn't have a tube linking his testicles to his penis (the vas deferens), when the muscles that pump the sperm out aren't working properly or because no sperm are produced in the testicles.

 
It is important to remember that smoking, excess alcohol and recreational drugs can all affect sperm production, and male fertility problems can be caused by these lifestyle factors.
 
'My partner has poor sperm morphology. There were a very tiny percentage of normal sperm, and all the rest were not normal. I think sometimes he felt slightly guilty about it. I would have much preferred it if it had been me. That would have made it a lot easier. But it wasn't. It's nobody's fault, it's just one of those things that happen.' Anna, 33. To find out more, you can check out Unexplained Secondary Infertility.

 

Unexplained Infertility Causes

Environmental hazards
 
Every day we are exposed to chemicals and toxins, but there is little clear evidence as to how they may affect our reproductive systems. Part of the problem is that there are just so many potentially damaging substances in everyday products like household cleaners and pesticides, solvent-based paints, additives and preservatives. Although individual chemicals or toxins may have been tested and declared safe, we don't know the cumulative effects of being exposed to so many all at once. It is clearly impossible in the twenty-first century to lead a life free from pollutants and chemicals, but you can try to limit your exposure by cutting back on your use of these products in your home.

Unexplained Infertility Causes

 
There may be more specific hazards in the workplace. We know that exposure to radiation and pesticides can have a harmful effect on the human reproductive system, and there are suggestions that other substances could inhibit fertility, although there is not always clear scientific evidence. Agricultural workers may be exposed to pesticides, and wood workers, smelters, anesthetists, nurses, pharmacists and dental assistants may all come into contact with chemicals that may affect their fertility.
 
Lead, mercury, nitrous oxide and formaldehyde have been linked with reduced fertility, and if you are exposed to any of these on a daily basis, or have concerns that other chemicals you use at work may be affecting your fertility, you should talk to your doctor.
 
I'm Not Pregnant Yet

You've decided to try to have a baby. You've thought about it, you've had the discussions and now you're ready. You've thrown away the contraceptives, and you've started trying. At first, it's great... you're flail of optimism and ready to go, you're thinking of names and planning how you'll decorate the baby's room. When your period arrives the first month, you're not too bothered. After all, you knew it might not happen right away. Then another month passes, and another, and period after period after period, and you find yourself starting to worry ...
 
How long should it take?
 
When you've spent most of your adult life trying not to get pregnant, it is only natural to assume you'll conceive as soon as you allow it to happen. Most of our sex education centres on the idea that unprotected intercourse will lead to unwanted pregnancies, and it never occurs to most of us that we might find that we can't get pregnant when we want to.

In fact, less than a third of couples conceive straight away, and it is perfectly usual for it to take a few months.
Around 75 per cent of women will conceive in the first six months of trying for a baby, rising to about 85 per cent after a year. These are the average figures for all ages, and on the whole women who are older are more likely to take longer to conceive. For those between the ages of 35 and 39, there's just a 60 per cent chance of getting pregnant after a year of trying. 

Although this does clearly illustrate that women become less fertile as they get older, it doesn't mean that all women over 35 will necessarily have problems. The majority of women of this age who want a baby will still get pregnant without any medical help. In general, the longer you have been trying to conceive without success, the less likely it is to happen, and couples who have been trying for a baby for more than three years have around a 3 per cent chance of conceiving during each cycle at the most.

 
'We grow up being told that if we miss one contraceptive pill, that's enough to get pregnant if you have unprotected sex. We believe that we've created a situation of choice, where we can choose what we want to happen to our bodies and when we want it to happen, and, of course, nature plays tricks on us.' Siobhon, 41. To find out more, you can check out Unexplained Infertility Causes.