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Secondary Infertility: We Hear From Two Couples Who Struggled the Second Time Around

When you’ve just had a baby, the experience tends to make you go one of two ways: you either want to repeat the process again immediately, or you are determined to make contraception your best chum from here to eternity.

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What Is Secondary Infertility

When you’ve just had a baby, the experience tends to make you go one of two ways: you either want to repeat the process again immediately, or you are determined to make contraception your best chum from here to eternity. Seldom is any thought given to the notion of pregnancy not happening for a second, or subsequent time – and if you’ve had one baby without any trouble conceiving, why would it? Your fertility is something you have control of. Isn’t it?

Sadly, that’s not always the case, and for some women, even after one, two or three babies, secondary infertility can occur, and that can send shockwaves through even the most ‘with it’ mum.

Globally, although infertility rates have hardly changed in the last 20 years, secondary infertility has increased very slightly. A World Health Organisation study undertaken in 2010 and published in PLOS Medicine analysed 277 national surveys from 190 countries, and found that secondary infertility rates have risen by 0.4 per cent, while primary infertility levels have decreased by 0.1 per cent.

Of course, a woman who had a baby easily at 20 would perhaps not expect to try to conceive quite so quickly if she left it until she was 40 to have her second – but for mums still in their twenties and thirties, secondary infertility can be a bolt from the blue.

What is secondary infertility?

Professor Sheena Lewis from Queen’s University Belfast says that couples who are worried about experiencing secondary infertility should seek the same prompt investigation that those with primary infertility should – and that means flagging it up with their doctor after a year of unsuccessful trying.

“With secondary infertility a thorough history and examination on what may have changed in either the man or the woman since their last pregnancy is an important starting point,” she says. “This systematic approach will whittle out many of the causes. Investigations include tests of ovulation (Day 21 progesterone test), tests on egg quality and reserve (AMH test), tests on sperm volumes and activity (semenalysis) and tests on sperm DNA.”

Age is obviously a huge factor, and some women may have conceived with ease in an earlier relationship, but find they are struggling with secondary infertility when they try again for a baby with a new partner, or after a long gap between children.

“The woman’s age is one of the most important factors in conceiving a baby naturally or with the help of fertility treatment,” Professor Lewis says. “Age can cause a decline in fertility in many ways; the menstrual cycle can change and ovulation patterns shift, and the quality of the eggs a woman produces deteriorates with age too.”

Medics will also look out for ovulatory and tubal patency (blocked tubes) problems which can develop during a woman’s reproductive lifetime, perhaps as a result of medical conditions such as pelvic inflammatory disease or endometriosis.
Testing the male partner’s sperm quality is particularly important, Professor Lewis adds, as there is now a growing body of evidence to suggest that men’s fertility also wanes after 35.

“We used to think that a man’s fertility didn’t change with age. After all, Picasso fathered a child at 81, but research from the past few years shows that the quality of men’s sperm also declines over time, and this can result in secondary infertility too.”

Professor Lewis also cites lifestyle hazards, where couples do not take enough care of themselves to protect their ongoing fertility after having their first baby.

“The couple may be eating a fast food diet with too few antioxidants, smoking tobacco or taking recreational drugs; perhaps they’re drinking more alcohol, becoming heavier or have developed chronic illnesses such as diabetes since they conceived their last child,” she says.

“In the event that the cause of the infertility remains unexplained and assisted conception (IVF or ICSI) is the solution the findings from the Sperm Comet test can help direct treatment to the most effective way forward,” she concludes.

Case Study 1 – Karen, mum of three

“I thought secondary infertility would rob me of my longed-for third baby.”

“I got pregnant straight away when I was 25,” says mum-of-three Karen. “I had our first daughter Camilla, and then, just 23 months later, her sister Madeleine was born.”

Eager to have another baby after Madeleine, and to keep a small age gap between the siblings, Karen and her husband started trying to extend their family once more when Madeleine was a year old – and they had no reason to think they would have any problems.

“Despite our experiences with Camilla and Madeleine, it ended up taking 18 months to get pregnant again,” Karen explains, “but it wasn’t to be and sadly we lost the baby at eight weeks.”

To add to the couple’s misery, their loss was dealt with by an ‘awful’ doctor: “He said that lots of women have miscarriages that early and didn’t even realise, which might be true but was not much comfort to me. I actually told him: ‘You’re never just a little bit pregnant’.”

Mismanagement of the miscarriage meant Karen did not have a dilation and curettage (D&C) – a common procedure after the loss of baby. She ended up in hospital with an infection, which was when her thoughts focussed on her fertility, and whether she would be able to go on to ever have another successful pregnancy.

“I became a bit obsessed because I read that if you get an infection it can cause infertility. It had taken me 18 months to conceive the baby I ended up losing, so I was determined to get checked out, and see what was going on.”

A private endoscopy showed Karen’s fallopian tubes were clear, and a battery of other tests found no causes for concern either. But this didn’t ease her fears.

“Every time they said that nothing was wrong it made me try to find something that was simply because then they could solve it and I would get pregnant,” she says. It took two more years for Karen to conceive again, but this time she lost the pregnancy at nine weeks.

“I was devastated. I had miscarriage counselling and all I could think about was having another baby. It was becoming a strain on our marriage and because I was so busy thinking about this third child I wasn’t enjoying the two adorable daughters I already had.”

For Karen, a successful third pregnancy eventually happened six years after her second daughter was born, and after complementary therapy including supplements and kinesiology.

“We were about to go down the IVF route, and after five years of really taking care of myself and not drinking I let my hair down at a party. I assumed I was feeling so rough in the days after because of a hangover, but actually I was pregnant. It was an amazing pregnancy, and I was just so happy to eventually have the daughter I felt had been missing from our family.”

Case Study 2 – Francesca, mum of three

“Don’t stress – and don’t put your life on hold for it!”

“I was 34 when I had my first baby back in 2002. Although I had PCOS, I didn’t need fertility treatment, although I had been having some ‘exploratory’ tests in the lead up to becoming pregnant,” Francesca says. “The year after my first child was born we started thinking about having another, but as time went on nothing happened. We asked to be referred, and was subsequently advised to cut down significantly on carbohydrates and to take Metformin – both tactics to reduce insulin, as I were insulin-resistant which tends to go hand in hand with PCOS.”

Francesca says she then took this to the ‘extreme’ and cut out all carbs and lost weight, but still she didn’t become pregnant.

“I was then eventually ovarian drilling, and if that didn’t work, they would try Clomid,” she explains. “I was offered a cancellation appointment for the drilling and despite being desperate for another baby, I was a huge wimp and just couldn’t face doing it – I am petrified of hospital and procedures and I needed a bit more time to get my head around the thought of it. However, by the time the next available appointment came round I found out I was pregnant!”

Francesca flags up the importance of being in the right mind space to conceive – and not planning your entire life around pregnancy.

“Shortly before I fell pregnant, I remember very consciously thinking ‘right, get on with life’. It had been placed on pause for so long while I was waiting to get pregnant. It was always as though I couldn’t make a decision… whether to go on holiday, whether to change jobs, always because everything resolved around ‘but what if I get pregnant?’ So I decided to just get on with everything. I set up a new business, I converted the nursery into my office and then ‘it’ happened and I firmly put that down to a healthy diet, the Metformin, and finally stopping stressing about it all!

“Prior to that my life was a rollercoaster and each month I’d imagine I was pregnant. I’d have symptoms that were premenstrual but I was convinced were pregnancy. I’d work out when this imaginary baby was due and at what point I’d be telling all my friends. The crushing disappointment each month was hideous.

“It was a relief when I just stopped and decided to be grateful for what I had and got on with doing other things – and when I did that, I became pregnant! My second child was born when I was 39, but that’s not the end of my story because I then went on to have a surprise baby when I turned 40 – so no matter how hard you are trying now, and how desperate you are, never give up hope!”

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NEWS: Get access to adult photos of the Cryos sperm donors

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Adult Cryos Sperm Donors Photos

Viewing adult photos of Cryos sperm donors is now a reality. Visit dk.cryosinternational.com today and get access to the new feature.

At Cryos it is now possible to access adult photos of sperm donors on our website, thus adding another dimension to your search for the perfect donor.

The unique chance to see both childhood and adult photos of your sperm donor, provides you with a more comprehensive idea of who your sperm donor is and moreover of the features of your future child. We hope that this extra dimension will upgrade your experience making your decision of a sperm donor easier.

The 5-6 adult photos are taken by a professional photographer and are a part of the donors extended profile where you also have access to childhood photos, an audio recording of the donor’s voice, a handwritten message, an emotional intelligence profile, and finally our staff impressions of the donor, amongst other exclusive features.

The adult photos require special access on our website. Visit our website and find out more and get access to this new feature now.

Please note that the person in the photos is a model and not a Cryos donor.
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Fertility 360

Fertility And Sex: Why Her Orgasm Matters

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Why her orgasm matters

For many couples, trying to conceive can make sex feel less fun and more pressured. Instead of being an intimate and enjoyable experience, baby-making sex can start to seem like a finely choreographed routine. Often, the female orgasm is one of the first things to go, but the maleorgasm is not the only orgasm that matters when it comes to fertility.

Before I dive into discussing the potential benefits of the female orgasm for fertility, it’s important to note that reaching climax is not technically essential for conception. If you never, or rarely, achieve orgasm, don’t worry, you can still get pregnant! Around 1 in 10 women don’t experience orgasm, ever. What’s more, the exact nature of the female orgasm remains somewhat elusive. Some experience orgasm through clitoral stimulation, some through vaginal intercourse, some through both, and others through something else entirely, or not at all.

Even without reaching orgasm, sexual arousal is itself beneficial to fertility. Like an orgasm, arousal is, first and foremost, a good indication that sex is enjoyable. Sexual arousal and climax causes significant changes in your levels of neurotransmitters including noradrenaline, oxytocin, prolactin, dopamine, and serotonin. These ‘reward’ neurohormones help you bond to a sexual partner and make it more likely that you’ll have sex more often, thereby increasing your chances of conception.

Second, orgasm and arousal have a range of physiological effects that might aid conception, which I’ll discuss in a moment. And, third, sexual arousal and orgasms for everyone can help sperm-producing partners avoid feeling like they’re being used just for their sperm. In fact, some studies show that male partners who engage in cunnilingus prior to vaginal intercourse have greater sexual arousal and produce more semen!

HOW ORGASMS ENHANCE FERTILITY

The female orgasm can help relieve stress, and promote healthy circulation and balance in the body. Stress is a key cause of diminished libido and may also reduce the chances of conception by raising levels of the stress hormone cortisol. Conversely, good sex can help raise levels of oxytocin and the other neurohormones mentioned above. These help you to relax and bond to your partner.

Published in 1967, the author even went as far as suggesting that the increase in these hormones after orgasm help support conception by temporarily incapacitating you. Put simply, this ‘poleax’ effect means you’ll feel so relaxed that you’ll stay lying down, which may increase your chance of conceiving. Whether staying supine does make conception more likely is still under debate, but I’m all for promoting relaxation, so if this theory provides added motivation, go for it!

CERVICAL TENTING

There is some suggestion that orgasm affects the shape and function of the cervix. These effects, which may include cervical ‘tenting could enhance the likelihood of conception by promoting the movement of sperm into the uterus and beyond. If you are curious as to what your cervix looks like during different stages of your cycle, check out these photos.

THE ‘UP-SUCK’ THEORY

One of the main ways in which female orgasm has been linked to fertility is something called the ‘upsuck’ theory (or, sometimes, the ‘insuck’ theory). This theory proposes that the female orgasm causes uterine and vaginal contractions that actively draw semen up into the uterus and towards the fallopian tubes, thereby increasing the chances of an egg being fertilized.

Scientific evidence to support this theory is rather inconsistent, but there’s certainly no harm in trying! One proposed underlying mechanism of this theory is oxytocin-mediated uterine peristalsis, i.e. the same mechanism that causes uterine contractions during labour could be partially responsible for increasing the likelihood of conception. Indeed, some research has found higher pregnancy rates in women shown to experience this ‘insuck’ phenomenon.

SPERM RETENTION AND FERTILITY

More recently, one small study found that orgasm may increase sperm retention. This study involved women using a syringe to insert a sperm simulant (lube) prior to external stimulation to orgasm. As such, the study’s findings may be especially applicable to anyone undergoing artificial insemination (IUI).

The take-away: Chances are that if you orgasm 1 minute before or up to 45 minutes after insemination (whether artificial or otherwise), you will probably retain more sperm, which may increase your chance of conceiving.

IN CONCLUSION

To sum up, the female orgasm might enhance fertility in a variety of ways, but it isn’t essential to conception.

The take home message is that orgasm and sexual arousal itself have many benefits to fertility, partner relationships and stress relief. Don’t worry though, if you have a low libido, conception can still happen even in the absence of arousal and orgasm!

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What Is Polycystic Ovary Syndrome (PCOS)?

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Polycystic Ovary Syndrome

Polycystic Ovary Syndrome or PCOS is a hormonal imbalance that affects 5 to 10 percent of women of reproductive age across the world, and results in irregular or absent periods, acne, excess body hair and weight gain. It is also a major cause of infertility and yet is frequently misdiagnosed and often missed completely.

PCOS gets its name because under an ultrasound scan, the ovaries can look like a bunch of grapes, each one covered in what look like multiple cysts. In fact, these aren’t cysts at all, but are small, undeveloped follicles.

Symptoms

Not every woman with PCOS will get the same symptoms, but common signs to look out for include:

  • Few or no periods
  • Excess hair on the face or breasts or inside of the legs or around the nipples
  • Acne
  • Oily skin
  • Scalp hair thinning or loss (male pattern baldness)
  • Skin tags (known as acrochordons)
  • Skin discolouration (known as acanthosis nigricans) where the skin looks ‘dirty’ on the arms, around the neck and under the breasts
  • Mood swings
  • Depression
  • Lack of sex drive
  • Weight gain especially around the middle of the body
  • Difficulty in losing weight
  • Cravings and binges
  • Irregular or no ovulation
  • Difficulty in becoming pregnant
  • Recurrent miscarriages

PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. With PCOS, the problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. But linked to this is the very common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone. Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal.

How is Polycystic Ovary Syndrome diagnosed?

The most widely accepted criteria for the diagnosis of PCOS says that you should have two out of these three problems:

  • Infrequent or no ovulation
  • Signs (either physical appearance – hirsutism or acne – or blood tests) of high levels of male hormones
  • Polycystic ovaries as seen on an ultrasound scan

The Seven Nutritional Steps to beat Polycystic Ovary Syndrome

Good nutrition is the foundation of your health and you should never underestimate how powerful it can be. It is the fuel that provides you with the energy to live your life and it gives your body the nutrients it needs to produce your hormones in the correct balance. The better the supply of those nutrients, the more healthily your body will function.

The fundamental aim of my nutritional approach to PCOS is to target a number of areas simultaneously so that you get the maximum effect in the minimum amount of time.

Here’s how:

  1. Switch to unrefined carbohydrates (eaten with protein) and never go more than 3 hours without food to keep your blood sugar levels balanced
  2. Eat oily fish and foods rich in Omega 3s to help your body to become more sensitive to insulin so it can overcome insulin resistance
  3. Cut out all dairy products for 3 months to bring levels of male hormones under control
  4. Eat more vegetables and pulses to which helps control male hormones
  5. Cut right back on or cut out alcohol for 12 weeks to allow your liver function to improve
  6. Cut down on caffeine to give your adrenal glands a rest
  7. Cut down on saturated fats and eliminate trans fats to help control the potentially damaging inflammatory processes PCOS causes in the body

PCOS Symptons

Best Supplements for PCOS

The use of certain vitamins and minerals can be extremely useful in helping to correct Polycystic Ovary Syndrome, along with a good diet.

Chromium

Chromium helps to encourage the formation of glucose tolerance factor (GTF), which is required to make insulin more efficient. A deficiency of chromium can lead to insulin resistance.  It also helps to control cravings and reduces hunger. Can help to reduce insulin resistance associated with PCOS

B vitamins

The B vitamins are very important in helping to control the symptoms of PCOS. Vitamin B2 helps to burn fat, sugar and protein into energy. B3 is a component of GTF which is released every time blood sugar rises, and vitamin B3 helps to keep the levels in balance. Vitamin B5 has been shown to help with weight loss and B6 is also important for maintaining hormone balance and, together with B2 and B3, is necessary for normal thyroid function.

Zinc

Zinc helps with PCOS as it plays a crucial role in the production of your reproductive hormones and also regulates your blood sugar.

Magnesium

Magnesium is an important mineral for dealing with PCOS because there is a strong link between magnesium levels and insulin resistance – the higher your magnesium levels the more sensitive you are likely to be to insulin.

Co-Enzyme Q10

Co-Q10 is a substance that your body produces in nearly every cell.  It helps to balance your blood sugar and lowering both glucose and insulin.

Alpha lipoic acid

This powerful antioxidant helps to regulate your blood sugar levels because it releases energy by burning glucose and it also helps to make you more insulin sensitive. It also has an effect on weight loss because if the glucose is being used for energy, your body releases less insulin and you then store less fat.

Omega 3 fatty acids

Omega 3 fatty acids taken in supplement form have been found to reduce testosterone levels in women with Polycystic Ovary Syndrome.

Amino Acids

Certain amino acids can be very helpful for PCOS as they can improve your insulin sensitivity and also can have an effect on weight loss.

N-Acetyl cysteine

In women with PCOS this amino acid helps reduce insulin levels and makes your body more sensitive to insulin. Study using NAC in women who were clomiphene resistant and had ovarian drilling.  After ovarian drilling, the women given NAC compared to a placebo showed a significantly higher increase in both ovulation and pregnancy rates and lower incidence of miscarriage.

Arginine

Arginine can be helpful in reversing insulin resistance. In one study, a combination of both arginine and N-acetyl cysteine were given to women with Polycystic Ovary Syndrome.  The two amino acids help to improve blood sugar and insulin control and also increased the number of menstrual cycles and ovulation with one women becoming pregnant on the second month.

Carnitine

Carnitine helps your body break down fat to release energy and can help improve insulin sensitivity.

Tyrosine

Tyrosine is helpful for women with PCOS who are overweight as it helps to suppress the appetite and burn off fat.

Glutamine

This amino acid is useful for helping with sugar cravings as it can be converted to sugar for energy and so takes away the need to eat something sweet.  It also helps to build and maintain muscle which is important for fat burning.

Branched Chain Amino Acids (BCAAs)

BCAAs include three amino acids leucine, isoleucine and valine. They are important in PCOS because they help to balance blood sugar and having good levels of these BCAAs can have a beneficial effect on your body weight

Inositol

A study used inositol (2,000mg) in combination with NAC (600mg), a significant increase in ovulation rates.

Having a good diet, regular exercise, controlling stress and taking key nutrients will help in getting your hormones back in balance and reducing the negative symptoms associated with PCOS.

More information can be found on www.naturalhealthpractice.com

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