Secondary infertility occurs when couples have trouble conceiving the second time around.

Secondary infertility has many of the same causes as primary infertility.

Here are some common causes of secondary infertility.

1. Ill-Timed Intercourse: Couples with one or more children may have hit the fertility jackpot on the very first try with no fertility help. Yet, going back to conceive number two may seem to take forever. Children can disrupt a couple’s ability to have well-timed, stress free intercourse.
2. Irregular Cycles: A normal cycle lasts anywhere from 26-35 days. If a woman has an irregular cycle, it can be difficult to pinpoint ovulation. If a woman is experiencing irregular cycles, a doctor may be able to help regulate a cycle using hormone intervention such as estrogen or progesterone.
3. Age: As women age, egg reserves decline rapidly. By the age of 35, the success for pregnancy at the one year mark falls significantly. By the age of 35, fertility takes a drastic plunge.
4. Male Factor: men who have fathered children can have male fertility issues. A simple semen analysis can determine the moyility and morphology of sperm.
5. Other Factors: There are a variety of other factors that can impair a woman’s fertility the second or more times around. A C-section may cause scar tissue that makes it harder for eggs to implant in the uterine lining. Another common issue is endometriosis. Undiagnosed Polysistic Ovarian Syndrome (PCOS) can keep a woman from ovulating.

The chances of overcoming secondary fertility are very high for the average couple. With a little knowledge, couples have a great chance of conceiving more than one child.

-          track your ovulation

-          consider lifestyle changes to get to a healthy weight

-          drink less

-          give up smoking

In a study of 219 women undergoing IVF, Israeli researchers found the odds of success were greater among women who were entertained by a professional “medical clown” right after they had the embryos implanted in the womb.

This study was recently published in Fertility and Sterility online January 6, 2011: bit.ly/hY769f

We usually talk to patients about scheduling  acupuncture before and after their transfer. It seems like I should also talk about bringing in a clown. I’m partially kidding but what I take from this study is the importance of humor and creating a lighter atmosphere post-transfer. So rather than look in the yellowpages for your local clown, consider renting some of your favorite comedies to watch as soon as you get home from your transfer. Have several movies lined up.

More study details here:

Overall, 36 percent became pregnant, versus 20 percent of women who’d had a comedy-free recovery after embryo transfer. Read the rest of this entry »

Children born at shorter intervals between pregnancies are at increased risk of developing autism, according to new research published online January 10 in Pediatrics.

I want all my patients to be aware of this study for a couple reasons:

1. After baby #1 is conceived via IVF or other fertility treatments, many patients want to start infertility treatment as soon as possible because they’re afraid if they delay they will have just as much difficulty if not more conceiving baby #2. Learning about this study may help you decide when you should time your next pregnancy.

2. Secondary infertility refers to couples who had no trouble conceiving baby #1 but who are now having a hard time conceiving baby #2. The information in this study may help guide you on how you should space your pregnancies.

I don’t want this study to cause panic among my patients but I do what you to know about it.

Here is some information about this study:

“Second-born children who were conceived less than 12 months after their sibling’s birth were at well over 3 times the odds of an autism diagnosis vs those who were conceived 3 or more years later,” lead study author Keely Cheslack-Postava, PhD, a Robert Wood Johnson Foundation Health and Society Scholar and a postdoctoral fellow at Columbia University, New York City, told Medscape Medical News. Read the rest of this entry »

Read the transcript here: http://thefertilityblogs.com/2011/01/january-fertility-treatment-chat-with-dr-aimee/

I recently came up with a way to describe patients who are 45 or younger, with menstrual cycles every month and elevated FSH levels that have been told by their docs they should use donor eggs but just aren’t ready to and want to keep trying. “Donor Egg Limbo” is the best way to describe this scenario and it is one of the hardest places to be in. If you haven’t been there, you don’t know what the struggle is like. I really can’t compare it to any other type of scenario that a human being can experience so that an outsider can relate……This is how you know you’re in donor egg limbo: you’re young, you may or may not have regular cycles or predictable ovulations, you’ve done fertility treatments – maybe even IVF cycles but your FSH level is over 12 and your doctors have given you a less than 5% chance of conceiving with your own eggs. But this is the thing – you’re not ready to use donor eggs, and in fact you don’t think you’d ever go that route. So what do you do in the meantime? You want to keep trying but you don’t feel like you have support from your fertility clinic so what do you do next…….

This is what I tell my patients who are in donor egg limbo: Read the rest of this entry »

If you didn’t know this already, Giuliana and Bill have their own reality show and they’ve been recently chronicling their most recent IVF attempt. Giuliana Rancic is the host of E! News and her husband Bill gained fame when he was the winner of The Apprentice.

This is what I think we can all learn from the show: Read the rest of this entry »

Join us on December 20th at 8PM Eastern
for a  live chat with Dr. Aimee
on the basics of IVF

Click here to join in: http://thefertilityblogs.com/ask-the-experts/chatroom/

You can read the transcript here !

http://thefertilityblogs.com/2010/12/december-ivf-chat-with-dr-aimee/

This year, Oakland Magazine chose five outstanding physicians to profile from the list of 251 doctors named the Best in the East Bay. Each one is a recognized leader in his or her field. See the article below:

Eyvazzadeh, 33, has established a solid reputation as a fertility expert and sees patients from the greater Bay Area and beyond. After attending medical school and completing an internship at the University of California, Los Angeles, she completed her residency in obstetrics/gynecology at the Harvard School of Medicine, served as a fellow in reproductive endocrinology and infertility at the University of Michigan Medical Center and obtained a master’s in public health from the University of Michigan’s School of Public Health.

Did you always want to be a doctor? How did you choose your specialty area?
I’ve known since the age of 3 that I wanted to be a doctor. Both my father and grandfather are OB/GYN physicians, and my grandmother is a midwife. Helping women to conceive is a part of my DNA. Read the rest of this entry »

Exciting research published online in Nature described how scientists have been able to partially reverse aging in mice. Why would a fertility expert be interested in this study? This is why:

Before treatment, aging male mice had smaller-than-normal testes and produced depleted amounts of sperm.

The researchers devised an estrogen-based drug that would switch on the animals’ dormant telomerase gene, known as TERT. The drug, in the form of a time-release pellet, was inserted under the skin of some mice.

A month later, the treated mice showed surprising signs of rejuvenation. Overall, their telomeres had lengthened and the levels of telomerase had increased. This woke up the dormant brain stem cells, producing new neurons. The spleen, testes and brain grew in size.

Is this the answer to ovarian aging for women? Will this type of gene therapy help women with early menopause get pregnant without using donor eggs? Could this kind of treatment rejuvenate aging ovaries the same was as it did aging testes in mice and maybe one day in humans? I find this research fascinating and hope it may one day revolutionize how we treat infertile couples. Read the rest of this entry »