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Secondary infertility is the condition of being unable to conceive a second child after pregnancy and delivery of an earlier child. A heartbreaking condition for which couples seldom receive sympathy or comfort, secondary infertility is much more common that many people might believe. Although there is no regular effort to collect data about secondary infertility, surveys of American couples in 1995 and 2006 suggest that right now about 3.3 million couples, or 6.6 million people in the USA alone, want to have another child and can't. The most common situation for secondary infertility is remarriage after divorce. After the end of the first marriage, the new couple wants to have their own children.

The problems leading to secondary infertility may lay in the health of the woman, the health of the man, or both. The very most common cause of secondary infertility is age. People wait longer and longer to have babies, and more couples want to have children in their second marriage. By age 45, a woman has only a 6 per cent chance of conceiving a child even if sexual intercourse is perfectly timed with her menstrual cycle. The chances of a woman being able to become pregnant peak around the age of 25 and diminish every year afterwards. Men, too, become less fertile with age, and more prone to various conditions that prevent fatherhood. Especially with men work in trades that require constant exposure to solvents, plasticizers, putties, or gasoline, the cumulative effects of this kind of environmental pollution reduce sperm counts and sperm viability. And most men who want to become fathers again are in a second marriage, according to a scientific survey of 578 male infertility patients sponsored by the American Society for Reproductive Medicine.

About a third of women affected by secondary infertility suffer pelvic adhesions. A pelvic adhesion is scar tissue that forms when the uterus is injured, either during childbirth, or during abortion or uterine surgery. Sometimes scar tissue can stretch over the ovaries preventing the ovulation and thereby preventing pregnancy. Other causes of secondary infertility are much less common. These include failure of the ovaries before menopause, PCOS, secondary effects of chlamydia and gonorrhea, and "hostile mucus" lining the cervix. Endometriosis alone accounts for another 30 per cent of all cases of infertility. It is a significant factor in secondary fertility. And if one or both partners has become "fat and happy," or fat and unhappy, excess weight contributes to a variety of hormonal imbalances that increase estrogen in men and testosterone in women-in some cases, losing weight is what is really needed to treat secondary infertility. The good news about secondary infertility is that there are many different fertility treatments. Just don't wait longer than six months of trying before you see a doctor who may have the right treatment for you.

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