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Secondary infertility is the inability to conceive a second child after a successful first pregnancy. Many couples who want to provide their child with a sibling try a variety of fertility procedures.

Secondary infertility is the inability to conceive a second child after a successful first pregnancy. Many couples who want to provide their child with a sibling try a variety of fertility procedures. The key is choosing the right method. Here are some of their stories.

Elena and Frank welcomed a bouncing baby boy named Frederick into their home in August of 2008. Both having grown up as only children, Elena and her husband very much wanted a second child. They started trying again just as soon as Frederick finished breastfeeding. Elena had mostly normal periods, but at the end of 2009 Elena was still not pregnant. In January 2010 Elena had a complete workup at her gynecologist's office. The medical exam found no evidence of any kind of structural problem, but her estrogen levels from her first pregnancy were still so high that she was not ovulating. High estrogen levels essentially made her ovaries act as if she were still pregnant and it was not time to ovulate. But within just 28 days of taking the fertility drug Clomid (clomidene sulfate, also known as Serophene), Elena was pregnant with their second child. Fortunately for Elena and Frank, Elena did not suffer any form of cervical or fallopian overgrowth that would interfere with reception of the sperm or release of the egg. And the doctor hit on just the right dose of Clomid on the first try.

Some women trying to get pregnant have to wait longer. In March 2005 Anne delivered a healthy baby girl. She used birth control pills in late 2005 through 2007, when she and her partner decided they wanted to try for a second pregnancy. Anne stopped taking oral contraceptives in January 2008 but didn't get pregnant for six months. Her doctor told her that it wasn't unusual not to get pregnant right away after stopping the Pill, but at the end of a year, Anne and her partner started getting concerned. It didn't help Anne feel good about the situation that her sister had delivered two children during the same time. Anne's doctor put her on a 100 mg dose of Clomid. The first month there was no response. The second month there was no response. The third month Anne didn't have her period-but it wasn't because she was pregnant. After 60 days, the doctor gave Anne progesterone to induce a period, and it was 14 days later, nearly at the end of the maximum allowable Clomid treatment, that Anne was able to conceive a greatly desired second child.

In some cases, however, the problem is not estrogen. This was the case for Susan. Susan and her husband Sam had always wanted to have four children. Susan bore three children with ease, but she grew heavier and heavier with each child. After the birth of her third child, Susan had gained a total of 88 pounds (40 kg). Susan and Sam continued to try to make another baby, but she simply did not get pregnant. Since Susan and Sam were both over 40, they went to see their doctor after just six months of trying. The doctor offered a very simple approach to restoring fertility: Eat less, and lose weight. After losing just 16 pounds (7 kg), Susan was pregnant again. The change in her weight led to a change in insulin sensitivity which led to a change in testosterone levels which led to a change in luteinizing hormone that made ovulation possible. But Susan and Sam didn't care about the chemistry. They rejoiced that there was a way to conceive another child.