Trying Again?

Just because you've had one baby doesn't mean the next one will come easily.

By Samantha Phillips

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Jan Abraham became pregnant easily with her daughter Jordana. But it was a different story when she and her husband, David, tried to conceive a second time.
    “My husband and I were dismayed when I couldn’t get pregnant again,” Abraham says. “I knew I had to act quickly since I was 37 and we had been trying for almost a year, so we went to see a fertility specialist.
    “Fertility treatment is not a day at the beach — I had various invasive procedures including a laparoscopy [a surgery to examine the fallopian tubes] — but they didn’t find anything wrong,” says the Philadelphia resident. “Finally, after two courses of Perganol [human menopausal gonadotropins, a medication given by injection to stimulate egg production] and one miscarriage, I became pregnant with my two beautiful twin girls. The treatment turned out to be well worth it, but our marriage had to be strong to go through it, because I was crying about half the time. Also, our insurance didn’t cover the treatments, so the cost became an issue.”
    While women who have difficulty conceiving a second child may feel isolated, they’re not alone. They are among the 3.3 million who have been unable to become pregnant again after having previous children, according to the Centers for Disease Control and Prevention’s (CDC’s) 1995 National Survey of Family Growth (the most recent year for which data are available).

What is infertility?
Be definition, infertility is a couple’s inability to conceive after having at least one year of unprotected sex. The main reason for secondary infertility is that the quality of a woman’s eggs declines as she grows older, according to Jamie A. Grifo, M.D., Ph.D., director of the Division of Reproductive Endocrinology at the New York University Medical Center Program for IVF, Reproductive Surgery and Infertility in New York.
    The survey by the CDC supports this finding: In 1995, 4.4 percent of 15- to 24-year-olds were infertile, 6.6 percent of 25- to 34-year-olds were infertile, and 8 percent of 35- to 40-year-olds were infertile.
    “Since couples are delaying childbearing, by the time they try to conceive their second child, there is a larger percentage of eggs with chromosomal abnormalities that cannot lead to a successful pregnancy,” Grifo says.
    Other possible reasons for secondary infertility include disease in the man or woman; decreased sperm count; blocked fallopian tubes; or a large weight gain or loss, which can throw off a woman’s ovulatory cycles, according to Sandra Ann Carson, M.D., professor of obstetrics and gynecology at Baylor College of Medicine in Houston and co-author of The American Society for Reproductive Medicine’s Complete Guide to Fertility (NTC Publishing Group, 1999).

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