Diagnosis and treatment of second-born infertility

The article was consulted professionally by Specialist Ii Huynh Thi Hien – Obstetrician and Gynecologist – Obstetrics and Gynecology Department – Share99 Nha Trang International Health Hub.

Second infertility is a condition where a couple has been pregnant but after a period of time, wanting to continue giving birth can no longer conceive. Second-born infertility accounts for 30% of cases of infertility and is caused by various causes.

If i birth infertility is a condition in which couples regularly have sex, do not apply the method of contraception but after at least a year still can not get pregnant; second infertility is a case where a husband and wife have been pregnant or giving birth, but cannot continue conceiving after a period of "planning".

Causes of second-line infertility in men:

• Genital infections: Inflammation in the genitals facilitates bacteria to reach the testicles according to the conduction system, causing inflammation of the testicles, in some cases necrosis is forced to remove the testicles.
• Obstruction of the ductology: Obstruction of the urethral canal can be caused by genital inflammation, urethritis … caused. It is one of the leading causes of second-line infertility in men.
• Varicose veins: Increasing levels of varicose veins damage sperm.
• Other reasons: Men work in toxic environments, many chemicals, radiation rays … affects the quality of sperm, disorders of the functioning of the genitals.

Causes of second-line infertility in females:

• Abortion and misuse of contraceptive pills: Abortion, miscarriage or abuse of the emergency contraceptive pill can alter the structure of a woman's uterus and ovary ducts.
• Inflammation of the ovulation: Inflammation of the ovulation of the ovulation that completely clos or completely blocks the ovulation process.
• Inflammation of the uterus: The damaged inner lining of the uterus interferes with the movement of the embryo when nesting.
• Ovarian inflammation: The ovaries can become infected causing ovarian cysts, obstruction of the ovary ducts … interferes with ovulation and fertilization.

To diagnose second-degree infertility, the doctor will conduct a clinical examination and conduct tests including:

• In females: Uterus imaging; Check the reserve capacity of the ovaries; Hormone tests; Pelvic ultrasound; Check ovulation…
• In men: Semen test; Hormone tests; Ultrasound of the scrotum; Genetic testing; Testicle bios…

Depending on the cause of second-degree infertility, the doctor will have a suitable treatment plan for couples who wish to have children. For example, second-degree infertility due to pathology will receive medical or surgical treatment for intervention; Infertility due to lifestyle will be consulted to change healthy lifestyle, nutrition; When applying fruitless treatments, couples will be consulted to apply assisted reproduction methods.

Some methods of treatment for second-party infertility include:

Medical treatment:Depending on the condition of the spouse, the doctor will use the appropriate medications. In case of second-degree infertility due to bacterial infections, western medicine will be prescribed by the doctor to eliminate the pathogen. In addition, patients can use additional drugs to support inflammation, increase resistance, improve physical condition to improve reproduction health.

Surgical treatment : Surgeryapplies to severe inflammatory cases such as: testicular torsion, proboscis obstruction, obstruction of the erm ducts; polycystic ovaries; uterine fibroids…

Methods of assisted reproduction: Some common methods of assisted reproduction that are applied to couples with second-generation infertility include: Pumping sperm into the uterus (IUI); IVF in vism in vism fertilization; Injection of sperm into oocysts (ICSI)cells; Membrane drainage (AH) support;…

Lifestyle and nutrition changes: To increase fertility, you should improve your sexual health by adopting a healthy lifestyle and adopting a varied diet such as: Regular exercise; Keep a BMI of 19 – 25; Limit alcohol and stimulants; Quit smoking…

Second-born infertility is increasingly common, for the prevention of the disease, couples need to apply some of the following methods of prevention of second-class infertility:

• Pregnancy before the age of 35.
• The gap between pregnancies and childbirth is from 3-5 years.
• Gynecologic examination every 6 months.
• Limit abortion, abuse of emergency contraceptives. In case of compulsory abortion, it is necessary to choose a reputable medical facility.
• Clean the enclosure properly.
• When there are signs of inflammation of the closed area, it is necessary to go to the doctor and treat it definitively.
• Safe sex. Use contraceptives without the intention of getting pregnant.
• Improve health by practicing physical exercise; healthy eating; do not smoke; limiting alcohol and stimulants; limiting exposure to toxic pollutants….