By Brenda Banura
Some women conceive easily the first time but can’t get a second child. Brenda Banura looks at secondary infertility, the reason why women are unlucky the second time round.
Patience has so many siblings and as a result, her parents always had financial problems. This forced them to take the children to sub standard, cheap schools. She thus promised herself to have few children that she would be able to take care of with ease.
At first she wanted two children but then she thought those were few. She then thought of having three but since she hates odd numbers, she settled for four children. At 27, she gave birth to her first born and was ready for another one two years later. But Patience is now 32 and after three years of trying to get pregnant, she has not yet conceived a second child.
Do not let the thought that this happens to a few women cross your mind because Othaman Kakaire, a gynaecologist at Mulago Hospital, says out of every 10 women he sees, six have the same complaint as Patience’s.
This condition is known as secondary infertility. Kakaire defines secondary infertility as a condition where a woman who has conceived before or a man who has impregnated before engages in regular unprotected sex but fails to procreate for over a year.
“In men, if you are unable to erect or the erection is too weak to allow you to penetrate, or the sperms in the semen are too few, absent or abnormal, then you may not impregnate a woman.” Save for the inability to erect, Kakaire says secondary infertility is not a symptomatic disease so do not expect any signs. There are certain things about one’s lifestyle that may make one vulnerable and cause this condition.
If you are the kind that has many sexual partners, chances of contracting sexually transmitted infections like gonorrhea and chlamydia are high. These infections can block the fallopian tubes where fertilisation takes place and once this happens, it is impossible for a woman to conceive.
Another lifestyle contributing factor is psychological stress for both partners. You could be stressed because of work or relatives who are demanding to see you have children. Also, men whose way of life requires them to stay in places with a lot of heat are vulnerable to secondary infertility.
Because too much heat affects sperm production, it is not advisable to go to the sauna a lot; this also puts male chefs at a risk, given the nature of their humid work environment.
The gynaecologist adds that obesity, which is usually a result of one’s lifestyle, can also cause this condition. “When one is obese, the fats in the body produce oestrogen, a substance that interferes with the proper functioning of one’s reproductive hormones starting from the brain. Obesity in men also affects the sperm production, as do taking alcohol and smoking,” he warns.
The brain Apart from one’s life style, secondary infertility can be a result of problems in the brain. In the brain are two organs; the hypothalamus sends a message to the pituitary glands and controls the reproductive function; and the pituitary sends messages commanding the release of ova. If either is damaged, for example by a tumor, the messages will not be sent or received and that is how secondary infertility comes about. The ovaries will not be released and you may not even have periods. Excess bleeding following child birth also destroys the pituitary glands.
The ovaries Kakaire says sometimes when people get tumors in the ovaries, surgery is carried out to remove them. “If this surgery is conducted by a non-professional, they may remove the ovaries as well without consulting you.” The ovaries can also get infected by viruses which destroy the follicles that normally grow and later burst to release eggs.
The fallopian tubes Apart from the fallopian tubes being blocked, permanent family planning, where the tubes are tied, means you cannot give birth again. Unclean delivery can also come with infections that damage the tubes, or other infections of the organs near the tubes, for example; a poorly managed appendix. Induced abortion can also damage the fallopian tubes and according to Kakaire, this is the commonest cause of secondary fertility among women in Uganda.
The uterus “The uterus can be destroyed by fibroids. The edomatia (part of the uterus) may also be destroyed if you undergo dilatation & curettage (the widening/opening of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping. It is also sometimes used for first trimester, the doctor says. This procedure is also carried out if one has abnormal vaginal bleeding.
Kakaire calls upon people to avoid unwanted pregnancies, which call for considering abortions. Keeping in good body shape, feeding well and treating infections early helps one avoid this condition. “If you cheat and catch an infection, do not treat yourself alone; you have put your partner at risk, so ensure that they too get treatment before the infection damages any organs.”
Treatment is available for some of the conditions for instance, surgery can take out fibroids and in-vitro fertilisation (IVF) can be done if fallopian tubes are blocked or the man’s sperms are of poor quality. Excessive prolactin production can be treated.
You just have to go to a professional to help you out and ensure that both of you go. “If you are not conceiving for over a year, go as husband and wife and see a gynaecologist for a checkup instead of seeking help from traditional healers. It is wise that you get the problem sorted out early. Your patience will be highly required,” concludes the gynaecologist.
Source: Daily Monitor
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