Unexplained secondary infertility

[cndnveggie]

We've been trying to get PG with baby #2 for 1.5 years now. My cycles have been regular the whole time, and there have been no miscarriages that I'm aware of. I was tested a few months ago, and all appears normal with me - blood tests on day 3 and day 23 showed all the hormone levels were good, and confirmed that I ovulated (which corresponded to my charting). I've charted off and on, have observed ovulation every time, and know that we are timing things correctly. DH has also been tested, his sperm analysis was normal.

We got PG with DS on the first try, so this infertility is unexpected, and a bit baffling - of course if I wasn't ovulating, or DH had sperm issues, it would make sense - but there's nothing we can even do except keep trying.

The only thing (and I know it might be a big thing) is that I'm still nursing DS, who is almost 3. It hasn't affect my cycles in terms of ovulating or regularity, so I don't know if it's contributing to the infertility, but it's really the only difference between when we got PG with DS and trying now. I'm planning to let him wean when he's ready, so I guess that means I have to be prepared for a much bigger age gap between kids than I had anticipated. And I don't even know if we'll get PG once he weans.

For the most part, I'm not too upset about it - it's mostly just frustrating, and we're kind of getting burnt out on the TTCing thing (which of course makes it harder). But I'm also glad we didn't get PG right away, because I do think DS needed this extra time with us.

Anyways, kind of just wanted to vent (especially since on most other forums, people just think I'm strange for not weaning my 3yo), and also see if anyone else has gone through/is going through something similar. Thanks for reading

[Tear78]

Hi! I'm sorry it's taking longer than you wanted. My sister actually went through something similar while nursing her 3 yo and she's pregnant now. She didn't ever find a medical reason why it took longer, but she was told by some medical people that she should stop nursing before they would treat her for fertility help. She never stopped, and got pregnant naturally. The only other thing I can suggest is to get your thyroid checked if you haven't. I think for more extensive infertility treatment you may be asked to stop nursing first, and honestly you may not want to go ahead with them before trying that (ie laparoscopy and drug therapy). I hope that helps, and I hope you get pregnant naturally soon!

[gen24]

Is it possible you have a short LP? It's very common when nursing

[cndnveggie]

Originally Posted by gen24

Is it possible you have a short LP? It's very common when nursing

Yes, I do think I have a short(ish) LP - probably 10-11 days on average. However, I had a short LP when I got PG with DS (it was 11-12 days then), so I'm not sure if that is causing the problem. As well, I have tested a few cycles when I really thought I might be PG, and have never ever gotten a positive PG test, which I'm assuming I might have if a short LP is the problem... I got a positive PG test with DS when I was 9dpo, so I know I can get an early positive.

Anyways, that could definitely be a problem, but I'm not sure if that's it. I really feel like we're just not getting PG at all (no egg fertilized), because I don't even get symptoms of anything having happened...

[gen24]

Some say you need a LP of at least 10 days for implantation but some say 12 days. You might have already tried but I have heard that vitamin B6 can increase your LP length if that is the problem.
When I realized that I had problems conceiving while bfing, I took B6 and Vitex and I guess it worked because I got pregnant right away.
Good luck to you!

[cndnveggie]

I did take Vitex and Vit B6 for awhile (maybe a year?), but I've kind of slacked off because I didn't see much improvement in the length of my LP. I was hoping that was all it would take to help us get PG, but unfortunately it didn't work. I've considered acupuncture, but not sure I'm ready to spend that much money... Not sure what other things I can try, or if we should just wait and let it happen.

[lesliesara63]

You know we had a similar situation. Got pregnant for dd1 after 2 or 3 months. We started ttc right around the time she weaned at 2.5yrs. It took 23 cycles to get pregnant again (doing clomid/iui). No explanation. After dd2 was born, my cycles went right back to normal starting when she was 9 weeks old. We started ttc again when she was about 16mths and its been 13 mths and 16 cycles in that time and we haven't conceived. I did encourage her to wean after Christmas and she has been done nursing since about Feb(she was 2yrs 3mths). I feel bad that she is not nursing, but I also made my goal of two yrs. If I had actually conceived when she was 1.5 and the milk dried up I would have felt really bad. She needed to nurse a lot more at 1.5 than she did at just over 2 yrs. If it makes you feel any better my girls are almost 5 yrs apart and the age difference has been great. It was just the journey and not knowing if there would be another child that was so hard.

[xtara2003x]

I had to respond after reading this.

Your story sounds very very very similar to mine.

DH and I have been TTC #2 since June 2009. My cycles are normal....my average number of CD's is 29! I ovulate around the 14-16th day of my cycle. I have EWCM. My temp clearly shows I ovulate.

DD is still nursing. She just turned 3. She's only nursing about 1 x per day now....but it's in the morning and sometimes she nurses for like an entire hour due to me falling back asleep and her falling back asleep as well.

I conceived at the end of Jan. 2010..and I had a miscarriage in March. I continued to nurse DD when I found out I was pregnant. Then I spotted at 5 weeks, and stopped nursing her for an entire week. Then I thought I was okay. I nursed her 1 time around 6 weeks, the next day I spotted. I stopped nursing her for 2 weeks. Then I had a US and they told me the baby had died. The day after I started my m/c.

I will always wonder if bfing DD played a part..but most people insist that something was wrong with the baby from the beginning. I am now starting to wonder though, if my body can simply NOT nurse (even though I have no milk left) and sustain a pregnancy at the same time. I think I may wean DD soon. It wasn't very hard the first time, so I don't think it'd be hard to do it now...I think she'd be able to handle it just fine (if I didn't think that I wouldn't be able to wean her I don't think).

Anyway, I just wanted to comment on how similar our stories are. I had my progesterone tested during my last pregnancy. It was a 5. Very very low. It makes me wonder if I have a progesterone problem....or if it was bfing related, or if there really was something just wrong with the baby. I'm not sure I'll ever know.

I haven't done any further testing. I may..I'm undecided at this point. I guess I'll have to see after a few more months?

Good luck to you! I know how frustrating this can be!

[soso-lynn]

Did you have a hysterosonography to check if your tubes are blocked? It can happen during or after a normal pregnancy so it's worth checking.

Also, did you do an antral follicle count (day3 ultrasound) or any other ultrasounds to rule out cysts and other such things?

How old are you? A few years can make a huge difference in fertility, so getting pregnant easily 4 years ago means nothing if you are in your late thirties.

Another obvious thing is THS and prolactine. The levels should be back to normal after 3 years of nursing, but you never know.

Otherwise, it could be that nothing is rong and that you will get pregnant soon. You say you've been trying for a year and a half. It could be that when you first started trying, things were not yet back to normal from nursing and that they are now. It could be that the first 6 months to a year of trying were really too soon.

[briome]

You didn't mention how you gave birth----a c-section CAN cause secondary infertility (did for me).

The cycle info the pp wrote about seems likely, look into that, maybe get some acupucture.

[cndnveggie]

Thank you for all the replies! To answer some of the recent questions: no, I didn't have a hysterosonography (the dr said that since I've already been pregnant, it's unlikely that my tubes are blocked - so it's good to know that I should still consider it a possible issue) or antral follicle count. I'll be 33 in a few months, so definitely older but not late thirties. I do believe my THS levels were tested and were normal, but I focused more on the hormone levels when I was receiving the results, so I honestly can't remember. And, I did have a c-section (unplanned) - it's interesting that you brought this us, briome, because I've often wondered if it could be contributing. But of course, I know so many women who've had c-sections, and they had no problem getting PG again (just like I know so many women who don't have any problem getting PG while breastfeeding).

Anyways, it sounds like there still could be several issues left to explore, but probably the most obvious thing would be to wean DS (or wait until he's done nursing). I'm not sure how weaning would go - he still nurses to sleep almost all the time, so I worry that trying to get him to sleep would be a challenge... And he still asks for it at times, so denying him would be difficult. He doesn't nurse too often - upon waking, before nap (occasionally after), and then before bed. But it's the nursing to sleep that makes me especially reluctant.

Anyways, thanks again for sharing your stories and also for pointing out other questions that I can explore/address. I really appreciate the input!

[allfrog68]

I was just lurking. Use to hang on this board a lot. I went through secondary infertility and it was really frustrating. This board and then a Yahoo TTC Group helped me a lot. Think it gave me a ton of information. Helped me get testing done w/ the Docs super efficiently. In my case I was prescribed Metformin (normally helps w/ Type II diabetes) and I got pregnant the first month. I am on the chunky side. I do feel that for me if I had lost some weight, probably 15-20 lbs, this would have happened naturally. Had I known it would have taken me quite a while to get pregnant, 18 months, I probably would have lost the weight early on. It was hard to focus on such a task w/ all the focus on getting pregnant. Good luck. The age gap is kind of nice though, there are pros and cons.

[briome]

I think the secondary infertility after a section (or any abdominal surgery) is how our bodies have healed afterward and of course the skillfullness of the surgeon!

This is just a random site I found that explained it.
http://www.clearpassage.com/infertil...nfertility.php

I did end up conceiveing about 4 months after I weaned my son totally (he was just over 2 when I did) but he had already been night weaned for a year and only nursed occasionaly during the day at this point. We had been trying for a year and 6months when we eventually conceived. The reason I suspect the section is that the next time I got pregnant (after the VBAC) my nursling was only 10m or so old and I was still nursing him around the clock. That pregnancy did not stay (molar maybe?) but I did get pregnant again a couple months later and this pregnancy is fine and nearing the end...and I am still nursing my second who is almost 2 1/2.

I have had a few friends debate the weaning, conceiving another child and I know it is hard. I doubt I would of weaned my first when I did if he was more distressed with the idea. I encourage you to look at some alternative methods like Mayan Abdominal Massage and Acupucture to possibly align your lady energy!

Thinking of you!

[soso-lynn]

Originally Posted by cndnveggie

Anyways, it sounds like there still could be several issues left to explore, but probably the most obvious thing would be to wean DS (or wait until he's done nursing). I'm not sure how weaning would go - he still nurses to sleep almost all the time, so I worry that trying to get him to sleep would be a challenge... And he still asks for it at times, so denying him would be difficult. He doesn't nurse too often - upon waking, before nap (occasionally after), and then before bed. But it's the nursing to sleep that makes me especially reluctant.

Weaning should only be necessary if you need to take meds that are not compatible (even then it is possible to just not nurse for a few days depensing on what you are taking). If your prolactin is back to normal, there really is no real link between nursing a 3yo and infertility (as opposed to nursing an infant or whatnot). Many doctors will tell you you need to wean, but they really have zero experience with full-term nursing. When questionned a bit more, they usually agree that it is not a problem.

I would really advise you get a hysterosonography or hysteroscopy, especially with having had a c-section, there can be scar tissue that is making it more difficult or even Asherman's could develop from that (http://en.wikipedia.org/wiki/Asherman%27s_syndrome).

Scar tissue from a c-section can be more than the actual incision as the removal of the placenta is usually far from natural as well.

[cndnveggie]

Thanks for the reply - I will discuss the hysterosonography at my next appt, the nurse-midwife has brought it up before but said they don't usually do it for someone who has had a successful pregnancy already.

As for weaning, I also agree that it shouldn't be preventing me from getting PG since my hormone levels are all fine - but I have just heard several people say that they tried for a long time to get PG, and weren't able to conceive until they weaned. I think maybe some women just can't support a pregnancy while nursing. I don't know - it's definitely not common, as I know many, many people who have conceived easily while still breastfeeding. Who knows!

[happysmileylady]

DH and I went though six years of unexplained secondary IF, and were able to conceive DD2 only with IVF.

After dd2 was born, I was only able to bf for about 5 months. Three months later, I went on antidepressants. One of the side effects of the AD that I was on was that it increased levels of prolactin in the blood, so I got to experience lots of bf'ing "side effects" but not bf. This included messed up cycles. I went off of them in December and hadn't had an AF for about 6 weeks at that point. I wasn't sure when to expect it, because I wasn't sure when and if I was ovulating, which is unusual for me because after 6 years of ttc, I could usually pinpoint ovulation to the HOUR. I finally took a pg test in mid January and it was positive. We apparently got pg on our own the first time I ovulated after going off the meds. I am convinced that prolactin levels had to do with both our infertility and fertility.

[busybumblebee]

also dealing here with secondary infertility, we have been trying for 18 months now, I stopped nursing my 3.5 year old 6 months ago and there was no change in a cycle pattern etc, have several friends who conceived while nursing, I am happy that I did not stop nursing in order to conceive as it would be very disappointing, with DD we conceived first month, then
had a c-section and another abdominal surgery after my DD was born, I have decided not to go via medical help to conceive again as the meical help clearly impacted my fertility it's very hard to think about not having any more babies

[kalamos23]

You mentioned that your LP was 10-11 days - how much b6 were you taking? Also, are you possibly anemic? Anemia can cause low oxygenated blood flow to the uterine lining which doesn't promote implantation. Also, caffeinated drinks can cause low iron absorption.

So my story I have been BFing a LOT, my DD nurses like a newborn - got pregnant with an LP of 8 or 9 days when DD was 11mo, lost the baby due to LPD. Got pregnant 6 months later the month my LP was 12 days after going off of caffeinated drinks, and taking b6, 50 mg in teh morning and 50 at night. Lost the baby (I'm thinking this was probably chromosomal as the baby passed at 8w5d). My LPs after the m/c were 8, 10, 12 and this cycle we got a BFP at 11dpo. The only thing different we did this cycle was to take iron pills/prenatal/yellowdock (for iron absorption)/100 mg B6/sublingual b complex. I tend to run anemic anyway, and I'm wondering if my iron levels were low enough to prevent implantation while also needing an LP of closer to 12 days.

That being said, if you think you might be running anemic (which is not uncommon as BFing and birth along with closer cycles that I'm guessing you are having with a shorter LP can cause anemia), you could try taking iron or floradix (which I recommend - I didn't have any I could buy here, so I took iron+yellowdock instead) and also up your dosage of b6 (but not more than 200mg/day) and see if that helps your LP any.

Alternatively, you could take Maca or Vitex and see if that helps egg quality so that you have a longer LP naturally - this was my next step. Good luck, and I hope you have a BFP soon!

[Kristin0105]

Just a few things to throw out there that occurred to me as I read your post. If your LP is around 10 days that may be too short. MY TCM provider thought it was too short for me. I use an over the counter progesterone cream and Vitex tincture from 3 days after ovulation until I am certain AF has started. It lengthened my LP from 10 or 11 days to a full 14-15.

I doubt nursing a 3 year old would effect your prolactin level enough to effect your fertility. If you have not checked your prolactin level have it checked so that you can put that concern to rest. When my daughter was 2+ my doctor blamed my secondary infertility on her nursing. However, my prolactin level turned out to be so low it was clearly not the cause of my 2ndary infertility issues.

Good luck and good for you for letting your LO nurse as long as they need to.

[hergrace]

Secondary infertility is so frustrating. I had recurrent miscarriages after my eldest. I had a complete infertility work up. The only thing that showed up was mild subclinical hypothyroidism. It was so mild, my gp wouldn't have treated it except for the miscarriages. 6 months after starting the thyroid meds, I conceived spontaneous triplets and carried them to term. When I was doing my research, I saw a lot of material suggesting that some mds use a range of normal for thyroid activity that is too wide and includes a substantial number of folks who are functionally hypothyroid. I don't have the research at hand now. I would check the thyroid numbers with my doctor if I were unsure of them.