Secondary Infertility 101

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Secondary infertility can be a stressful diagnosis as it occurs in individuals who have previously been able to conceive. Secondary infertility refers to the difficulty in conceiving after a prior successful pregnancy. 

We spoke with Dr. Christine Hur, MD at IVF1, with the goal of helping individuals better understand secondary infertility, a complex subject that is often less discussed than primary infertility but is equally as important.

Understanding Secondary Infertility

Secondary infertility shares many of the same causes as primary infertility. The causes of secondary infertility include but are not limited to:

  • Age-related factors
  • Changes in weight
  • Sperm quality issues
  • Issues with ovulation
  • Fallopian tube damage
  • Concerns with the uterus 
  • Complications related to prior pregnancies
  • Underlying medical conditions that may have developed since the last pregnancy

An important thing to consider is the impact of a woman’s age on fertility.  Unlike men who produce new sperm every three months, women are born with all of the eggs that they will have. Because of this, as women age, both their egg quantity and quality decline. This can often contribute to secondary infertility. For men, while sperm quality can also decrease with age, it typically happens later in life compared to women.

Overall changes in health that have occurred since the prior pregnancy can also play a role. Changes in weight, exposure to alcohol or smoke, and underlying medical conditions can all impact the ability to successfully conceive.

Medical Conditions and Secondary Infertility

Medical conditions (i.e. hypertension, diabetes, obesity, endometriosis, polycystic ovary syndrome (PCOS), adenomyosis and uterine fibroids) may appear or worsen after a previous pregnancy and lead to secondary infertility. For males, a decline in testosterone or issues with other reproductive hormones can affect sperm production and quality.

Additionally, complications from a previous pregnancy or birth, such as scar tissue from prior procedures or infections, could potentially harm the uterus or the fallopian tubes and their function.

Testing and Diagnosis

Similarly to primary fertility, the approach to diagnosing secondary infertility involves a thorough medical history and physical examination. This should be followed by a series of tests to assess ovulation, the uterus and fallopian tubes, and the quality and quantity of sperm. This evaluation should be done with a fertility specialist.

Treatment Options for Secondary Infertility

Treatment for secondary infertility should be individualized and depend on the underlying cause. Options may include medications to ovulation induction, intrauterine insemination (IUI), assisted reproductive technologies such as in vitro fertilization (IVF), and surgery to correct anatomical issues. 

Secondary Infertility’s Emotional Impact

The emotional impact of secondary infertility is complex. Individuals and couples often experience a range of emotions from confusion to frustration, guilt, and grief. It is important to acknowledge these feelings and seek support from healthcare providers, counselors, support groups, or loved ones. 

Many struggling with secondary infertility are often also met with misconceptions from others who assume that having one child means they can easily have another. This lack of understanding can lead to isolation and minimized feelings. 

Building a Supportive Environment

When struggling with secondary infertility, creating a supportive environment is crucial. This can be done by educating family and friends about the realities of secondary infertility to foster a more understanding support system or by seeking out external groups and forums with others struggling to share support. Many benefit from professional support services including fertility counselors or therapists who specialize in reproductive challenges. 

Grow Your Family

Secondary infertility is a complex issue, and through comprehensive care, tailored treatments, and emotional support, many individuals and couples can overcome secondary infertility and grow their families. 

Remember, if you are struggling with secondary infertility, you are not alone. It is a medical condition that affects approximately one in ten couples, many who are able to later find success with the right care and support.

Related Content

  • Fertility advocate and model Iskra Lawrence shares her experience with secondary infertility on The TODAY Show as Progyny’s 2024 ambassador for National Infertility Awareness Week (NIAW). Watch her interview here.