Nancy Umeh, a Nigerian chef and public scientist, has bravely shared her personal journey of secondary infertility, a condition that led her to pursue surrogacy for the birth of her third child. Umeh’s story highlights the often overlooked challenge of secondary infertility, which affects countless couples but remains largely unspoken.
Secondary infertility, which refers to the inability to conceive or carry a pregnancy to term after having previously given birth without fertility treatments, impacts both men and women equally. It is a condition that can be just as difficult as primary infertility and has become increasingly prevalent worldwide, particularly in Africa where studies show that 52% of couples are affected.
Causes of Secondary Infertility
Several factors contribute to secondary infertility, and some of the most common causes include:
- Age: As women age, fertility naturally declines, with a significant drop in chances of conception after the age of 35. Studies indicate that couples dealing with secondary infertility tend to be older than those experiencing primary infertility. For women over 40, the chances of pregnancy success can be less than 5% per cycle due to a decrease in both the quantity and quality of eggs.
- Ovulation Disorders: Conditions like polycystic ovary syndrome (PCOS) and primary ovarian insufficiency (POI) can disrupt the ovulation process, which is vital for conception. Around 40% of women with infertility issues do not ovulate regularly.
- Blocked Fallopian Tubes or Uterine Issues: Fallopian tube blockages, often caused by infections or surgeries, prevent the meeting of egg and sperm. Similarly, issues with the uterus, such as fibroids, endometriosis, or scarring, can impede implantation.
- Infections: Sexually transmitted infections (STIs) can lead to pelvic inflammatory disease (PID), resulting in scarring and blocked fallopian tubes, which can ultimately lead to infertility.
- Male Factors: In men, secondary infertility can be caused by low sperm count, testicular varicocele, or other reproductive issues such as an enlarged prostate.
Symptoms and Diagnosis
The primary symptom of secondary infertility is the inability to conceive after trying for one year, but other indicators include irregular menstrual cycles, painful periods, and hormonal imbalances such as excessive hair growth or acne.
Treatment Options for Secondary Infertility
Treatment for secondary infertility depends on the underlying cause and may include:
- Medications: Fertility medications such as Clomid and letrozole can help stimulate ovulation in women. Infections causing infertility may also be treated with specific antibiotics.
- Surgery: Surgical interventions may be necessary to correct structural problems in the reproductive organs. Procedures like hysteroscopy can clear blockages, remove scar tissue, and treat conditions like endometriosis and fibroids. In men, surgery may be used to remove varicoceles or unblock the epididymis.
- Assisted Reproductive Technology (ART): Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two common ART options. IUI involves placing sperm directly into the uterus at ovulation, while IVF involves fertilizing an egg outside the body and implanting the embryo in the uterus.
Nancy Umeh’s story, along with her decision to pursue surrogacy, sheds light on the emotional and physical challenges of secondary infertility, a journey shared by many but often not discussed. It serves as a reminder of the importance of support and awareness for couples navigating these struggles.
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