Difference between primary and secondary infertility

It is only possible to diagnose infertility or sterility, in the case when at the beneficial circumstances, regular sexual intercourses during 1-2 years without contraception with the healthy semen analysis of the man, the woman is younger than 40 years, it is impossible to get pregnant. It is crucial to understand that the age of the woman is an important factor. The older is the woman the more time does she need to get pregnant.

Before diagnosing yourself with “infertility” on your own, the most important recommendation is to visit the gynecologist and reproduction specialist and let the experts find out what your problem is.
Infertility is the result of some diseases, usually of inflammation nature. There are many factors that may induce infertility, some of them are as follows:

• hormonal disorders;
• autoimmune diseases;
• endometriosis;
• obstruction of fallopian tubes;
• improper development of the genitals.

There is absolute and relative infertility. Absolute infertility is when the woman presents pathological irreversible changes, for example, the absence of uterus or ovaries. The infertility due to other causes is relative and may be treated with medical manipulations.

Infertility forms

Taking into consideration the variety of infertility causes, the following sterility forms may be identified:

• Uterus form: uterus pathologies, for example, double uterus, uterine tumors, malformations, underdevelopment of the uterus and other pathologies;
• Tube form: obstruction, weakening of intra tube fimbriae that move an egg to uterus and as a result of that the egg can’t get to the uterus;
• Immune form: it is a rather uncommon case when a woman develops an immune reaction against the embryo or sperm;
• Endocrine form: problems with hormones (it may be ovary polycystosis, too high level of prophylaxis, too low level of progesterone).

Understanding primary and secondary infertility

Four conditions are necessary to get pregnant:

1. Ovulation
2. Patency of fallopian tubes
3. Suitability of the uterine cavity and endometrium for embryo implantation
4. Sperm fertility

The infertility is believed to be primary if a woman has never been pregnant or if the pregnancies that occurred resulted in miscarriages or stillbirths.

The secondary infertility is the form of infertility in which the woman can’t get pregnant, but in the past, she was pregnant at least once and it resulted in labours and birth of a child. Secondary infertility may not depend on the course and end of the previous pregnancy.

The statistics say that every 6th woman who terminated the pregnancy in the past suffers from secondary infertility now.

Relationships in couple and infertility

It is necessary to remember that infertility is the problem of two partners. Very often, it happens that the infertility factors are present both in man and woman and often partners react differently to this fact.

The reaction to the diagnosis “infertility” depends on the person’s character, their life experience, attitude to failures and problems. What is more, men and women have different attitudes to infertility.

Most of the women who dream of giving birth to a child carefully monitor their menstruation cycle, count their ovulation days, that is why every menstruation when they are anticipating to get pregnant, causes them severe psychological sufferings. Men usually endure their problems without any complaints, they believe that it is unacceptable to discuss their reproductive issues.

When a couple faces such an issue, the most important rule is to communicate constantly and stay sincere in the relationships. Infertility introduces a certain level of tension to the relationships that is why it is necessary to show tolerance and patience to each other. Usually, a woman tries to constantly discuss the problem, and the whole world will be revolving around her desire to get pregnant, while the man has to provide the necessary support and in this case, the couple will manage to overcome this crisis.

Assisted reproductive technology

Neither primary, nor secondary infertility is a verdict. Fortunately, the medical advances and the availability of special reproductive methods may help to feel the joy of desired parenthood. Here are some methods for secondary infertility treatment:

• Intrauterine insemination - administration of a specially prepared sperm in uterine cavity;
• In vitro fertilization - fertilization of the egg with spermatozoon outside the woman’s body;
• TESA: collecting the spermatozoa from testicular tissues, if the spermatozoa are absent in the man’s ejaculate or if their number is too low, so this procedure may be beneficial when the sperm motility is decreased;
• ICSI: intracytoplasmic introduction of sperm into the egg, in IVF, the spermatozoon is injected into the egg with a special needle, if the sperm motility characteristics are insufficient;
• PICSI: the sperm is injected only after confirming the maturity of the egg, and this procedure increases the chances to obtain embryos of high-quality;
• Cryoprograms: those are modern possibilities of reproductive cells and embryos vitrification in order to use them later when the circumstances for the couple are more advantageous.
• Donor programs: In case, the eggs are absent in woman or the sperm characteristics are poor, it is possible to use donor eggs or donor sperm, or both;
• Surrogacy, it is used in exceptional cases, when a woman can’t carry the child.