On the road to growing a family, there are many factors that can impact the ability to conceive. For some couples who are looking to add baby number two, one frustrating factor can be, what is known as secondary infertility.
While primary infertility is the inability to carry a child to term or conceive without ever experiencing a successful pregnancy, secondary infertility is the inability to conceive or carry a baby to term after you have successfully had a previous clinical pregnancy without difficulty or assisted reproductive technology.
Though it can be alarming and disheartening to experience, medical experts believe that secondary infertility, likely occurs at the same rate as primary infertility, and affects about 10 percent of couples. Similar to those causes of primary infertility, there are a number of potential causes related to secondary infertility.
Causes of Secondary Infertility
When it comes to secondary infertility, there are a number of factors that can contribute, some are as simple as lifestyle changes and medical assistance, while other may be a greater underlying condition that requires more professional assistance to treat.
What serves as the most common fertility issues during primary infertility, still play a big part the second time around. Unhealthy weight, poor diet and exercise, certain medication use, toxin exposure, as well as unhealthy lifestyle choices such as smoking, vaping, alcohol consumption and drug use are factors that can affect both men and women’s ability to conceive by causing interruptions in the ovulation process and decreases in sperm health.
As with primary fertility complications, egg quality and quantity decreases, due to women’s age can play a part of secondary infertility and these decreased egg supplies can make it more difficult to conceive the second time around.
Sperm count, motility and quality decreases, impaired sperm production, or delivery, or testicular damage that may have occurred since prior pregnancy can factor in with secondary infertility issues.
Reproductive complications can include a number of previous underlying issues such as endometriosis, polycystic ovarian syndrome (PCOS), ovarian cysts, abnormalities with fallopian tubes, ovulation disorders or irregular cycles, pelvic adhesions, thyroid or other endocrine disorders that affect hormone production, and intrauterine adhesions.
Infections, including sexually transmitted infections, can impair your fertility or lead to further complications such as changes in cervical mucus, decreased fertility or more severe issues such as pelvic inflammatory disease and scarring or blockage of the fallopian tubes. Non-reproductive diseases can have an impact as well. Autoimmune disorders that cause the body to attack healthy tissues, for example, can also have a negative impact on fertility the second time around. The good news is that the sooner the infection or underlying disease is treated, the less your fertility will be affected.
Scar tissue build up or uterine damage caused from previous surgeries, or uterine scaring from a previous C-section delivery, known as isthmocele, can lead to inflammation in the uterus that affects implantation.
Much like primary infertility, it is possible that there is no discernible reason for secondary infertility, when no reason or specific factor can be identified for the inability to conceive, it is known as unexplained infertility, or idiopathic infertility. Almost 30 percent of all infertility cases seen by doctors are considered unexplained causes.
Treating Secondary Infertility
There’s no doubt that dealing with secondary infertility can be a stressful journey, but it doesn’t necessarily mean that your family is maxed out with only one child. There are a number of approaches for overcoming secondary infertility and successfully growing your biological family that are very similar to those options available for primary infertility.
Like any TTC approach, improving your health and practicing fertility-friendly lifestyle choices can help improve your chances of conception. Nutrient rich diet, proper exercise, prenatal supplements and proper sleep can have a big impact on overall fertility health.
Treatment for secondary infertility first starts with identifying the primary cause, so don’t be surprised if your doctor recommends some tests such as blood tests to identify hormone levels, ovulation tests, pelvic exams, sonohysterogram, hysterosalpingography, or other tests to view your uterus and cervix. If your tests come back without any red flags, your doctor may further suggest looking into tests for male infertility such as a semen analysis.
Medications may be used to stimulate the ovaries, balance hormone levels and even trigger the release of more eggs. Depending on your age and timeframe for getting pregnant a second time, your doctor may choose to follow a more vigorous approach to achieve a successful pregnancy with a faster approach.
When pursuing more advanced medical assistance to overcome secondary infertility, one option is through IUI. With this approach, a semen sample from the partner or a donor is placed directly into a woman’s uterus during ovulation. This places the sperm as close as possible to the fallopian tubes, with the hopes of fertilization and conception.
The most notable fertility treatment approach, IVF is comprised of combining an egg with the sperm to create an embryo outside of the uterus. This embryo is then directly implanted into the uterus and can be done using the couple’s eggs and sperm or using donor eggs or sperm.
Coping with Secondary Infertility
If you previously conceived easily, this new journey may feel very scary, unfamiliar and frustratingly complicated, and coping with secondary infertility can be tough. There are many things within your control to improve your fertility and one of them is self-care.
To help you navigate this new struggle, remember to be kind to yourself, focus on the factors you can control, and include open conversation with your partner and doctors to help you physically and mentally navigate secondary infertility in a healthy manner.