Someone who has been pregnant once, but is having trouble getting pregnant the second time, is defined as having secondary infertility. Dr. Ingrid Rodi of Parker Rosenman Rodi Gynecology and Infertility Medical Group in Santa Monica, recently spoke to the Palisadian-Post about this subject. “The best predictor for fertility, in general, is age,” said Rodi, who is board certified in reproductive endocrinology and infertility. “Many people have their first baby at 33 and have no trouble getting pregnant. Now they’re 37 and think it will be that easy a second time, but it may not be.” As women grow older, it becomes increasingly harder to conceive. Menopause, a naturally occurring change, happens sometime between the ages of 40 and 60. Fertility starts to decrease about 13 years before a woman goes through menopause. Rodi says there are a few woman who get pregnant naturally at 47, but they are a tiny percentage, less than one percent. It’s impossible to tell from a woman’s history when she might go through menopause. Some women think that if their mothers went through late, they will as well. Not so. “You can’t tell from your mother’s history,” Rodi said. “A woman inherits her genetics from her father’s side of the family as well.” “Age becomes an issue for another reason,” Rodi said. “There’s an increased chance of miscarriages because of chromosomal abnormalities.” Many women’s groups argue that doctors are trying to scare women into having children younger, which means their careers will suffer. “The decrease in fertility is not a disease, but a natural progression,” Rodi said. “I’m not trying to scare anyone. If we were trying to drum up business for our practice, we’d tell women to wait to have children until they’re 40.” Even when Rodi performs in vitro fertilization (IVF), women under 34 have a success rate of about 50 percent, whereas women over 41 have a success rate of about 15 percent. The general rule, Rodi tells couples who are trying to get pregnant the second time is, if the woman is under 35 and it didn’t take any time to get pregnant with the first child, try for a year. If she still hasn’t conceived, consult a physician. If the woman is over 35, has tried for six months and is not pregnant, it’s time to see a physician. And if a woman had problems getting pregnant the first time and wants to try for a second pregnancy, Rodi advises going back to her physician. Although decreased fertility due to age is the primary reason for secondary infertility, there are other medical reasons that might contribute to the problems. Endometriosis, pelvic infections like chlamydia or gonorrhea, fibroids that require surgery or perhaps even a ruptured appendix can be culprits. Women who have gone through chemo or radiation treatment for cancer after their first child may also experience difficulties getting pregnant the second time. The husband or male partner should also be checked to make sure his sperm count is adequate. Some medications like blood pressure medicine will lower the count. Another factor could be erectile disfunction; although the sperm are there, they aren’t reaching the egg. “Sometimes couples can’t conceive because of decreased sexual frequency,” Rodi said. “They have a baby or a toddler, so they’re more tired. Often the baby is even sleeping in their bed, which means they don’t have sex often enough.” If a couple is trying to get pregnant, they should be having sex three times a week in order to hit the ovulation peak. If the couple is having sex less than once a week, they should use an ovulation kit. Sometimes couples wait too long to try for their second child because there’s a disagreement among partners. One will drag his or her feet too long, until it’s too late to get pregnant naturally. Occasionally Rodi will see couples with problems in their marriage who are fighting and not having sex. “Whereas until the middle of the 20th century, sex generally meant having children and you had to have sex to have children,” Rodi said, “today, you do not have to have children when you have sex and you do not necessarily have to have sex to have children. “That phenomenon led to a delay in having children, which has pointed out to doctors the decrease in fertility as a woman gets older.” For more information go to Rodi’s Web site RodiMD.com or contact 451-8144.
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