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【medical-news】想再怀孕?近距离观二次不育现象

Trying to get pregnant again? A closer look at second-time infertility
By Cara Chuderewicz, M.D./ Pregnancy
Monday, October 23, 2006

The Gods of Fertility are not always smiling. Thousands of women spend years trying to decode their bodies and unlock the secrets to successful conceiving. They take vitamins, pay careful attention to their ovarian cycle by the day, sometimes by the hour, and even try herbal teas to tip the balance. For women who already have a child, the inability to conceive the second time around causes frustration, embarrassment and anxiety. If it happened once, why is it so hard now?

Overall, one out of every six women will experience infertility - with their first or second attempts at pregnancy. Infertility is generally defined by an inability to conceive after 12 months. The reasons are myriad; however, age-related infertility remains one of the largest barriers to pregnancy.



As more and more women delay child bearing for a career, or to further their education, the numbers of women having difficulty conceiving continues to increase. Much has changed. Couples no longer marry immediately after high school or college and begin families in their early 20s. The stereotypical 1950s stay-at-home mom has been replaced with career driven executives who long ago broke through the glass ceiling. However, putting off child-rearing into your 30s or 40s means sometimes substantial risk.

Many mothers want to know - why can’t I get pregnant a second time? The simple answer is that your body may have a condition that developed or worsened since your first child. We now have a much more streamlined process to provide answers versus testing in place 10 years ago.

Getting checked

There are several major areas we check first through a series of tests. Are the ovaries too old? Are they producing enough eggs? We then move on to hormones - we want to be sure that hormones in the brain are stimulating healthy egg production. We also look at the uterus. Is there a scar from a previous C-section or a piece of placenta that prohibits a new embryo from growing? We use imaging tools to ensure that the uterine lining is clean and that the fallopian tubes are open and free of scarring.

We also check the father. About 30 percent of the time, infertility can be traced to the male. But sometimes, second-time infertility remains unexplainable. At that point, doctors typically prescribe a round of medication with a goal of producing healthy eggs. If that fails, the couple is referred to a specialist.

Dealing with your emotions

Many women facing second time infertility are frustrated. Some became pregnant for the first time within one month of trying to conceive. If you’re young and healthy, it can take up to a year to become pregnant and we usually recommend waiting to be tested until after a substantial amount of time has elapsed. There are exceptions. For those 35 and older, we begin testing after just six months since risk factors begin substantially increasing as a woman ages. Infertility begins to increase in a woman’s early 30s and spikes from 35 to 40. We call pregnant women aged 35 and older "advanced maternal age." This is the period when risks of miscarriage and defects greatly increase. For example, the chance of having a baby with a chromosomal disorder at age 35 is 1 in 200, at 40 years of age that increases to 1 in 65 and at age 45 that increases to 1 in 20.

Second time infertility presents a difficult emotional package, regardless of a woman’s age. Since women already have a child, the feelings may not be as frantic as someone trying to conceive for the first time, however, there are still many questions and concerns. For some, the tests will provide answers, while for others, advanced options will be required.

However, for some women, the answer can be simple - relaxation. A hectic schedule, work-related stress, and the anxiety of trying to become pregnant, can be too much for reproductive organs. A healthy diet, vitamins, meditation or yoga can release these stresses. For some of my patients, I prescribe a vacation.

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翻译前请看此链接的注意事项 Trying to get pregnant again? A closer look at second-time infertility
By Cara Chuderewicz, M.D./ Pregnancy
Monday, October 23, 2006
想再怀孕?近观2次不育现象
The Gods of Fertility are not always smiling. Thousands of women spend years trying to decode their bodies and unlock the secrets to successful conceiving. They take vitamins, pay careful attention to their ovarian cycle by the day, sometimes by the hour, and even try herbal teas to tip the balance. For women who already have a child, the inability to conceive the second time around causes frustration, embarrassment and anxiety. If it happened once, why is it so hard now?

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作者:admin@医学,生命科学    2011-07-04 11:55
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