Talk it out. Once you realize you’re entitled to your emotions, find an outlet for them. Talking about your feelings and your struggles can be a huge release and allow you to receive the support you need. If your family or friends don’t understand your sadness (or you find it hard to contain your baby envy around friends with more than one child), seek out people in your same situation. Find a support group for people with secondary infertility — online or in your area. And consider joining WTE's Trying to Conceive group to find moms who are also coping with secondary infertility.
For healthy couples in their 20s or early 30s, the chance that a woman will get pregnant is about 25 to 30 percent in any single menstrual cycle. This percentage starts to decline in a woman’s early 30s. By age 40, a woman’s chance of getting pregnant drops to less than 10 percent per menstrual cycle. A man’s fertility also declines with age, but not as predictably.

When Sarah Bozinovich and her husband, Joe, decided to start a family, they were amazed by how quickly they were on the road to parenthood. "I went off birth control in April and was pregnant in May," says Bozinovich, of Mokena, Illinois. About a year and a half after their daughter's arrival, the couple was ready to expand their family. But they'd try for more than two years and endure many medical tests and fertility treatments to have the second child they so badly wanted. Like many other parents, they struggled with secondary infertility, the inability to conceive or carry a baby to term after having one or more children. Says Bozinovich, who was 27 when her problems began, "It's so surprising because no one could tell me why I couldn't get pregnant, when I got pregnant so easily before."


May you accept your body – even if you are an infertile man. We struggled with male factor infertility in our marriage, and it strengthened our marriage and our faith in God. May you feel God’s blessing on you even if you can’t conceive children naturally. May you walk in faith, and trust that He knows what He is doing. Don’t give up on your God, for He is loving and compassionate.
If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women's health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.[62]

The treatment options for unexplained infertility are several and the treatment results are promising. Expectant management can be recommended if the woman is under 28-30 years of age and the infertility duration is less than 2-3 years. In vitro fertilization (IVF) has revolutionized the treatment of infertile couples, as well as profoundly increasing the basic understanding of human reproduction. IVF can be used as both a diagnostic and a therapeutic tool in couples with unexplained infertility. The pregnancy rates with IVF are good, at 40% per treatment cycle. In addition, the outcome of pregnancies among women with unexplained infertility is generally comparable to that of spontaneous and other pregnancies using assisted reproductive technologies.
One of the biggest challenges is balancing enjoying the child you have with wondering if you'll ever get the larger family you want. "I watched my daughter take her first steps and thought, 'Maybe I'll never have this again,'"‰'' Bozinovich says. (Her problem was never pinpointed, but, happily, she went on to have two more children.) That is tough, the experts agree. "Worrying about what's happening next robs you of the pleasure of the moment," says Dr. Davidson. "It's not easy, but counseling and talking yourself through the rough moments can help you say, 'I'm doing the best I can, and meanwhile I'm living my life.'"‰"

In 2006, Canadian clinics reported an average pregnancy rate of 35%.[11] A French study estimated that 66% of patients starting IVF treatment finally succeed in having a child (40% during the IVF treatment at the centre and 26% after IVF discontinuation). Achievement of having a child after IVF discontinuation was mainly due to adoption (46%) or spontaneous pregnancy (42%).[14]
Infertility is, in all its forms, a most private, hidden anguish. Nobody wants to discuss the finer points of their reproductive system in public. And the desire to have a child can, if thwarted, be so overwhelming that just a glimpse from a car window of someone with a BabyBjorn can be enough to produce such a flood of tears that you have to pull over. How can you possibly articulate that level of pain to the casual inquirer?
Progesterone elevation on the day of induction of final maturation is associated with lower pregnancy rates in IVF cycles in women undergoing ovarian stimulation using GnRH analogues and gonadotrophins.[23] At this time, compared to a progesterone level below 0.8 ng/ml, a level between 0.8 and 1.1 ng/ml confers an odds ratio of pregnancy of approximately 0.8, and a level between 1.2 and 3.0 ng/ml confers an odds ratio of pregnancy of between 0.6 and 0.7.[23] On the other hand, progesterone elevation does not seem to confer a decreased chance of pregnancy in frozen–thawed cycles and cycles with egg donation.[23]

The educational health content on What To Expect is reviewed by our medical review board and team of experts to be up-to-date and in line with the latest evidence-based medical information and accepted health guidelines, including the medically reviewed What to Expect books by Heidi Murkoff. This educational content is not medical or diagnostic advice. Use of this site is subject to our terms of use and privacy policy. © 2020 Everyday Health, Inc
Sunni Muslim nations generally allow IVF between married couples when conducted with their own respective sperm and eggs, but not with donor eggs from other couples. But Iran, which is Shi'a Muslim, has a more complex scheme. Iran bans sperm donation but allows donation of both fertilised and unfertilised eggs. Fertilised eggs are donated from married couples to other married couples, while unfertilised eggs are donated in the context of mut'ah or temporary marriage to the father.[176]
Apart from poor egg quality at advanced maternal age, older women are also less likely to respond to ovarian stimulation hormones that cause the release of multiple eggs. Being able to produce a dozen of eggs significantly increases the odds of success. It allows your fertility practitioner to choose the egg with normal genetic makeup and best likelihood of implantation. In both nature and IVF, not all eggs are suitable to produce a pregnancy. Ideally, you would produce 8-15 eggs after ovarian hyperstimulation so that some of them are genetically normal and perfectly matured.
The Fallopian tubes are the site for fertilization before the embryo makes its way to the uterine cavity for implantation. If the Fallopian tubes are damaged, fertilization may not occur. If one Fallopian tube is blocked, it may be due to inherent disease involving both Fallopian tubes; even if the other Fallopian tube is open, it may not be able to provide the appropriate nurturing environment for fertilization and early embryo growth to take place.
The goal of this treatment is to increase the number of sperm that reach the Fallopian tube and subsequently increase the chance of fertilization. IUI provides the sperm an advantage by giving it a head start, but still requires the sperm to reach and fertilize the egg on its own. Depending on your fertility diagnosis, IUI can be coordinated with your normal cycle or with fertility medications.
Uterine exam. Your doctor will examine the inside lining of the uterus before you start IVF. This might involve a sonohysterography — in which fluid is injected through the cervix into your uterus — and an ultrasound to create images of your uterine cavity. Or it might include a hysteroscopy — in which a thin, flexible, lighted telescope (hysteroscope) is inserted through your vagina and cervix into your uterus.
Book an appointment with Miss Despina Mavridou for any general infertility concerns, preconception advice, fertility consultation, ovarian reserve screening, polycystic ovaries, endometriosis, follicle tracking (natural and treatment cycle), ovulation induction, fertility assessment and fertility preservation-egg freezing, intrauterine insemination, IVF and HyCoSy.
In order to have a successful IVF pregnancy, the first few weeks need special care. When you undergo IVF, you will be continuously monitored throughout the process by skilled doctors. Constant supervision reduces the complications associated with pregnancy. By understanding the IVF process and following your doctor’s instructions, you can enjoy the journey of your healthy pregnancy.
Only 30 percent of patients who receive 100 mg of Clomiphene a day will produce more than three follicles. Patients that produce less than than three follicles have about half the chance of getting pregnant than those that produce greater than three follicles. Patients that receive fertility medications but do not do an insemination have only half the success rates compared to those who do.
I had a wonderful experience at CHA Fertility Clinic and got pregnant on my first cycle.  My son will turn two this year and I immediately contacted them when we were thinking of having a second child.  The doctors and staff are so kind, informative, and helpful, and they really put my mind at ease.  We had looked at other fertility clinics … Read More
Cytoplasmic transfer is where the cytoplasm from a donor egg is injected into an egg with compromised mitochondria. The resulting egg is then fertilised with sperm and implanted in a womb, usually that of the woman who provided the recipient egg and nuclear DNA. Cytoplasmic transfer was created to aid women who experience infertility due to deficient or damaged mitochondria, contained within an egg's cytoplasm.
Sometimes problems getting pregnant for a second or subsequent time are related to a complication that occurred in a prior pregnancy or prior to delivery (damage to the uterus, for instance). But most often, secondary infertility is caused by the same factors that would cause primary infertility — issues like advanced age, obesity, ovulation problems and so on.
If a couple has been actively trying for over a year, it may be time to consider seeing a specialist. One thing we hear time and time again from our Glow Fertility Program partner physicians is that they wish their patients would come in sooner. Seeing a specialist as soon as you suspect you may have a problem trying to conceive can save you both time and money.
In general, the cost of IVF is higher than for IUI, but IVF confers the highest pregnancy rates per cycle. It is impossible to put a precise figure on the two treatments for comparison as much will depend on your personal treatment program. You can see some ballpark figures on the website of the Society for Assisted Reproductive Technology. It also contains an overview of the differences between IUI and IVF.
IVF using no drugs for ovarian hyperstimulation was the method for the conception of Louise Brown. This method can be successfully used when women want to avoid taking ovarian stimulating drugs with its associated side-effects. HFEA has estimated the live birth rate to be approximately 1.3% per IVF cycle using no hyperstimulation drugs for women aged between 40–42.[63]
In vitro fertilization (IVF) is a treatment for infertility or genetic problems. If IVF is performed to treat infertility, you and your partner might be able to try less-invasive treatment options before attempting IVF, including fertility drugs to increase production of eggs or intrauterine insemination — a procedure in which sperm are placed directly in your uterus near the time of ovulation.
Bachelor's Degree in Medicine & Surgery from the University of Navarra, with specialty in Obstetrics and Gynecology from the University of the Basque Country. He has over 30 years of experience in the field and works as a Titular Professor at the University of the Basque Country and the Master's Degree in Human Reproduction of the Complutense University of Madrid. Vice-president of the SEF. More information about Gorka Barrenetxea Ziarrusta
There can be medical causes of SI, says West. "The thyroid is always something we check. Birth can put the thyroid out of kilter." Anwen, a woman in her 40s, tried for five years to have a second child. "I had my daughter when I was 30," she says, "which, at the time, seemed very early. I was the first among all our friends to have a baby." She decided to try for a second when her daughter was three. "But a year went by and nothing happened. I went to the GP and he told me not to worry. 'If you've already given birth, there won't be a problem,' he said. But my daughter turned five and I still wasn't pregnant." Eventually, Anwen persuaded her GP to refer her to a fertility consultant who, after some simple investigations, informed her she had polycystic ovarian syndrome. "He said I'd probably had it all my life and that my daughter was an amazing one-off. I had no idea that anything was wrong." She was given a prescription for the fertility drug Clomid; two months later, she conceived her son.
Abdominal adhesions (scar tissue) bands of scar tissue that form between abdominal organs and tissues. Symptoms of abdominal adhesions are pelvic or abdominal pain. Abdominal adhesions on the intestines can cause bowel obstruction, which is a medical emergency. Treatment for abdominal adhesions is generally surgery to cut the adhesions away from the internal tissues and organs. There is no way to prevent abdominal adhesions.
This information is designed as an educational aid to patients and sets forth current information and opinions related to women’s health. It is not intended as a statement of the standard of care, nor does it comprise all proper treatments or methods of care. It is not a substitute for a treating clinician’s independent professional judgment. Read ACOG’s complete disclaimer.

Anger, sadness, and anxiety are common among parents struggling to expand their family. "Having a child already doesn't make going through infertility any easier," says Alice D. Domar, Ph.D., executive director of the Domar Center for Mind/Body Health, in Waltham, Massachusetts, and author of Conquering Infertility. Meeting with a mental-health professional or seeking out blogs and online groups for secondary infertility can help. The website of  the National Infertility Association, resolve.org, is a good place to start.
Previous tests should be carefully reviewed to ensure that the diagnosis is, in fact, "unexplained," and that no test has been omitted or missed. It may sometimes be necessary to repeat certain investigations. For example, if a previous laparoscopy has been done by a single puncture and reported as normal, it may be necessary to repeat the laparoscopy with a double puncture, to look for early endometriosis. 
Intracytoplasmic sperm injection (ICSI) is where a single sperm is injected directly into an egg. Its main usage as an expansion of IVF is to overcome male infertility problems, although it may also be used where eggs cannot easily be penetrated by sperm, and occasionally in conjunction with sperm donation. It can be used in teratozoospermia, since once the egg is fertilised abnormal sperm morphology does not appear to influence blastocyst development or blastocyst morphology.[86]
Disclaimer: The information you enter is not stored by CDC and is only used to estimate your chances of success. The IVF success estimator does not provide medical advice, diagnosis, or treatment. These estimates may not reflect your actual rates of success during ART treatment and are only being provided for informational purposes. Estimates are less reliable at certain ranges/values of age, weight, height, and previous pregnancy and ART experiences. Please see your doctor and/or healthcare provider for a personalized treatment plan that is best for you.
Women are born with about 1 million to 2 million eggs but release only 300 to 400 through ovulation during their lifetimes. Usually, you release just one each month. The egg travels along one of the two fallopian tubes that connect your ovaries to your uterus. If the timing is right, sperm may fertilize it on its way to the uterus. If fertilization doesn't happen within 24 hours of the egg leaving the ovary, the egg dissolves. Sperm can live for about 3 to 5 days, so knowing when you are ovulating can help you and your partner plan sex for when you're most likely to conceive.

IVF has many steps, and it takes several months to complete the whole process. It sometimes works on the first try, but many people need more than 1 round of IVF to get pregnant. IVF definitely increases your chances of pregnancy if you’re having fertility problems, but there’s no guarantee — everyone’s body is different and IVF won’t work for everyone.
The eggs are retrieved from the patient using a transvaginal technique called transvaginal oocyte retrieval, involving an ultrasound-guided needle piercing the vaginal wall to reach the ovaries. Through this needle follicles can be aspirated, and the follicular fluid is passed to an embryologist to identify ova. It is common to remove between ten and thirty eggs. The retrieval procedure usually takes between 20 and 40 minutes, depending on the number of mature follicles, and is usually done under conscious sedation or general anaesthesia.
There is a risk of multiples, which includes twins, triplets, or more. Multiple pregnancies can be risky for both the babies and the mother. It's important to discuss with your doctor how many embryos to transfer, as transferring more than necessary will increase your risk of conceiving twins or more. When embryos have been tested with PGT, typically only a single embryo is transferred.
A Cochrane review came to the result that endometrial injury performed in the month prior to ovarian induction appeared to increase both the live birth rate and clinical pregnancy rate in IVF compared with no endometrial injury. There was no evidence of a difference between the groups in miscarriage, multiple pregnancy or bleeding rates. Evidence suggested that endometrial injury on the day of oocyte retrieval was associated with a lower live birth or ongoing pregnancy rate.[30]
For healthy couples in their 20s or early 30s, the chance that a woman will get pregnant is about 25 to 30 percent in any single menstrual cycle. This percentage starts to decline in a woman’s early 30s. By age 40, a woman’s chance of getting pregnant drops to less than 10 percent per menstrual cycle. A man’s fertility also declines with age, but not as predictably.
Risk of multiples. IUI with fertility medication carries a significant risk of multiple pregnancies, including higher-order multiples (triplets or more). A good clinic will carefully monitor your follicles to make sure that only a safe number are mature before the IUI, but they cannot entirely eliminate the risk. Recent advances in IVF (including blastocyst transfer) mean that most modern fertility clinics now transfer only one or two embryos per IVF cycle. As a result, the risk of multiple pregnancies for IVF patients is much lower than it used to be.

Benign uterine growths are tissue enlargements of the female womb (uterus). Three types of benign uterine growths are uterine fibroids, adenomyosis, and uterine polyps. Symptoms include abdominal pressure and pain, pelvic pain, pain during intercourse, and pain during bowel movements. Diagnosis and treatment of benign uterine growths depends upon the type of growth.
Gathering the eggs. Your doctor gives you an anesthetic and inserts an ultrasound probe through your vagina to look at your ovaries and identify the follicles. A thin needle is then inserted through the vaginal wall to remove the eggs from the follicles. Eight to 15 eggs are usually retrieved. You may have some cramping and spotting for a few days afterward, but most women feel better in a day or two.
Complexity. IUI refers to one procedure. Prepared sperm is placed directly in the patient’s uterus when she is ovulating in order to aid fertilization. IUI may be performed in sync with a woman’s natural cycle or timed with fertility medications to stimulate ovulation. IVF, on the other hand, is a process which consists of several stages and requires more than one procedure: first the ovaries are stimulated using a series of fertility medications, then the patient undergoes egg retrieval in a day procedure under a mild anesthetic, then after embryos have been created and incubated in the lab, they are placed directly into her uterus in the embryo transfer procedure. Even with the use of fertility drugs, going through IUI is less physically demanding than undergoing IVF.

More doctors are suggesting having just one embryo transferred and then freezing the rest. This is known as elective single embryo transfer (eSET), and it can reduce your risk of a multiple pregnancy. When you get pregnant with just one healthy baby, you reduce your risks for pregnancy complications. Speak to your doctor to find out if elective single embryo transfer is best for you.
Apart from poor egg quality at advanced maternal age, older women are also less likely to respond to ovarian stimulation hormones that cause the release of multiple eggs. Being able to produce a dozen of eggs significantly increases the odds of success. It allows your fertility practitioner to choose the egg with normal genetic makeup and best likelihood of implantation. In both nature and IVF, not all eggs are suitable to produce a pregnancy. Ideally, you would produce 8-15 eggs after ovarian hyperstimulation so that some of them are genetically normal and perfectly matured.
Because not each IVF cycle that is started will lead to oocyte retrieval or embryo transfer, reports of live birth rates need to specify the denominator, namely IVF cycles started, IVF retrievals, or embryo transfers. The SART summarised 2008–9 success rates for US clinics for fresh embryo cycles that did not involve donor eggs and gave live birth rates by the age of the prospective mother, with a peak at 41.3% per cycle started and 47.3% per embryo transfer for patients under 35 years of age.

Our specialized team of andrologists prepare each sperm sample with a procedure commonly known as "sperm washing" in one of our andrology laboratories. Sperm washing involves placing the sperm sample in a test tube and then a centrifuge, which results in the sperm collecting in a "pellet" at the bottom of the test tube. The andrologist removes the seminal fluid and places the fluid (media) above the sperm. The most active sperm will then swim up into the media. The final sample consists of the most active sperm concentrated in a small volume of media. A single IUI is usually performed when a patient is using fresh sperm. If a patient is using a frozen sperm sample, the clinician can likely perform one or two IUIs.
Only 30 percent of patients who receive 100 mg of Clomiphene a day will produce more than three follicles. Patients that produce less than than three follicles have about half the chance of getting pregnant than those that produce greater than three follicles. Patients that receive fertility medications but do not do an insemination have only half the success rates compared to those who do.
×