What is Secondary Infertility

Sep 22, 2022 | Fertility, IVF, Male Infertility

fter having your first child naturally, you might think that becoming pregnant the second time will be easy. However, that is not always the case. If you are struggling to become pregnant for the second time, you’re not alone. Secondary infertility is as common as primary infertility, more than 6 million women between 15 and 44 struggle to become or stay pregnant and of those, one-third are estimated to have secondary infertility.


What is secondary infertility?

Secondary infertility is the inability to conceive a child or carry a pregnancy to full term after previously giving birth. And it is typically diagnosed after trying unsuccessfully to conceive for six months to a year. Secondary infertility can happen to either partner, one-third of cases are in women and another third in men. The remaining third can be linked to both partners or to unknown causes.


What can cause secondary infertility?

Secondary infertility causes can differ for women and men, here are some of the most common causes of secondary infertility in women: 

  • Ovulation disorders: Problems with ovulation can be a sign of PCOS, decreased egg production related to aging, thyroid disorder, or some lifestyle factors. 
  • Problems with the uterus or fallopian tubes: Endometriosis, uterine scarring, uterine fibroid, or blocked fallopian tubes can be some of the problems affecting your fertility.
  • C-section scarring: If you had a c-section with a previous pregnancy, you might have developed some scarring in the uterus, called isthmocele. An isthmocele can lead to inflammation in the uterus that affects implantation.
  • Excessive weight gain: Weight gain can lead to ovarian dysfunction in some women.
  • Breastfeeding: If you are mainly breastfeeding, your body might stop ovulating or releasing eggs for potential fertilization.

Causes of secondary infertility in men include:

  • Poor quality sperm: Semen is the fluid that carries sperm. After age 40, the quality of semen tends to decline.
  • Prostate removal: Removal of the prostate can cause semen to flow backward.
  • Testicular varicocele: Enlargement of veins in the scrotum, or the sack of skin encasing the testicles, affecting 30% of infertile men.
  • Reduced testosterone levels: Testosterone plays a key role in sperm production, its reduction can be caused by genital infections, thyroid diseases, diabetes, mumps, and emotional stress, among others.


What are treatment options for secondary infertility?

Primary and secondary infertility have very similar treatments, and the treatment that your doctor might suggest depends on the cause and your age. 


Fertility treatment falls into two main categories: 

  • Helps fertility through medications or surgery
  • Assisted reproductive technologies. 


Treatment options for women include:

  • Clomid – An oral medication that stimulates hormones that produce eggs in women with ovulation problems.
  • Uterine surgery that clears unwanted growths in the uterus like scar tissue, polyps, and fibroids that impact fertility.
  • In vitro fertilization (IVF) – A procedure in which eggs are surgically retrieved from the uterus, fertilized in a lab with sperm, with the resulting embryos transferred back into the uterus.

Treatment options for men include:


  • Intrauterine insemination (IUI) – A procedure in which sperm is inserted directly into a woman’s uterus, often used when men have low sperm count or poor sperm quality.
  • Testicular surgery can repair testicular varicocele, a condition that can affect sperm quality and count.
  • Supplements like antioxidants and anti-aging supplements can increase fertility in men.


How to cope with secondary infertility

Experiencing secondary infertility can be emotionally challenging for both partners.

Here are some coping strategies that can help you during the process of trying to conceive:


  • Give your spouse permission to feel differently
  • Give yourself permission to cry or grieve
  • Join a support group
  • Consider counseling with your partner
  • Take care of yourself



Secondary infertility refers to a couple who cannot conceive or carry to term after having at least one successful birth in the past.  

Primary and secondary infertility have very similar treatments, and the treatment that your doctor might suggest depends on the cause and your age. 

Infertility can take a toll on emotions, but coping strategies, such as joining a support group, may help.

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