Second time around

Damage to the fallopian tubes. Surgery may be needed, or In-Vitro Fertilisation. See IVF: what you need to know. The woman is given hormones to stimulate the ovaries to produce a large number of follicles. The follicles are emptied and the eggs collected with ultrasound guidance. The eggs can then be fertilised with the partner’s sperm and the resulting embryos are transferred into the uterus two to three days later where, with luck, they will implant. A maximum of two to three embryos are transferred during a ‘fresh’ embryo transfer cycle, but any surplus embryos of good quality may be frozen for a subsequent attempt.

Sperm problems. Intrauterine Insemination (IUI) can help conception. A sperm sample is taken and prepared so that good quality sperm are retrieved. The insemination is carried out at the optimum time in the partner’s ovulation cycle. This treatment can be made more effective by gently stimulating the ovaries with hormones to ensure the woman releases two or three eggs with each ovulation.

If the sperm count is very low or if only a few eggs can be retrieved at IVF, then the technique of Intra-cytoplasmic Sperm Injection (ICSI) can be used. With this treatment the woman will undergo a conventional IVF cycle but once the eggs have been collected, one sperm is injected directly into each egg to fertilise it.

Even after a vasectomy or failed reversal, when a man will obviously not be able to ejaculate sperm because the vas deferens has been blocked, it is still possible to collect the sperm. This can be done surgically, either by taking them from the epididymis, or directly from the testes. The sperm can then be used with ICSI in an IVF cycle.

Overall, the chances of conceiving for a couple with secondary infertility are quite good. The key thing is to consider assisted conception techniques sooner rather than later. Don’t hang around hoping and waiting.