When we see a family with one child, we sometimes wonder when they will have another child, but what we may not realize is that it’s not always as easy to have a second child. Infertility can affect anyone at any point in life. Having successfully conceived one pregnancy is no guarantee of being able to conceive again, and some couples find themselves facing the painful reality of secondary infertility.
What Is Secondary Infertility?
A couple may be diagnosed with infertility if they have been having unprotected sexual intercourse for one year if the woman is under 35 years of age or for 6 months if the woman is older than age 35. They may be diagnosed with secondary infertility if they have had one or more children without the need for fertility treatments but are unable to get pregnant again. Some factors can lead to secondary infertility in men include:
- Weight gain, which can interfere with sperm production and healthy male hormone levels
- Smoking, which can affect male hormone levels and sperm health
- Sperm quality and quantity, which can be affected by hormone levels, age, medications, lifestyle factors and other factors
- Age, which can increase the risk of spontaneous abortion and autosomal defects due to sperm abnormalities
- Varicoceles, abnormally dilated veins around the testicle which can diminish sperm parameters over time
Semen Analysis
Many things can affect a man’s fertility over the years, including diet, lifestyle factors and age. Sperm quality and quantity can be the biggest factors in fertility, which is why both the American Society for Reproductive Medicine (ASRM)and the American Urologic Association (AUA) now recommend that all men in couples having difficulty conceiving, including those with a history of fertility, complete a semen analysis when trying to conceive.
A semen analysis offers couples who are trying to conceive information about nearly half of the fertility equation. This analysis can identify sperm abnormalities, the volume of semen, how long it takes the semen to liquefy, the motility of the sperm, the normal shaped sperm cells, the fructose or energy supplies in the sample, and the pH. Tests can be performed through a male fertility specialist or a reproductive urologist and can be a great first step towards parenthood, providing men and their doctors with extensive information to help them identify potential areas of concern.
Treatment Options
Fertility treatments are tailored to each individual’s needs. Today’s Assisted Reproductive Technology (ART) is designed to increase the odds of conception for couples with infertility by identifying and lowering the barriers whenever possible. Some treatments that can be used to address secondary male infertility include:
- Lifestyle changes to address specific risk factors, such as weight loss or smoking cessation
- In vitro fertilization, which can be effective when severe sperm abnormalities are present by uniting only healthy sperm and egg thereby improving the odds of conception
- Addressing medication issues, which can affect testosterone levels and interfere with sperm production
- Repairing varicoceles when they are associated with worsening semen parameters
Because treatment options can become limited as time passes, early testing and intervention are critical. Sperm analysis can provide valuable insight to men and their partners and can improve their odds of successfully conceiving a healthy pregnancy, according to male fertility specialist Dr. Parviz Kavoussi. Dr. Shahryar Kavoussi, a reproductive endocrinologist, coauthored a study on prior male fertility history that was published in “Fertility and Sterility,” emphasized that prior fertility cannot predict future fertility and that semen analysis can be an invaluable part of an infertility evaluation in men who want to become fathers.
