If you’re already a parent, it’s natural to assume that growing your family will be a familiar fertility journey, just like with your previous child(ren).
But that’s not always the case. Secondary infertility is more common than most people realize, yet it doesn’t get nearly as much attention. As a result, it can catch families off guard, leaving them confused and overwhelmed.
In this article, we’ll cover everything you need to know about secondary infertility, how to prepare for expanding your family, and what to do if you suspect it might be part of your story.
What is Secondary Infertility?
Secondary infertility occurs when you’re having difficulty conceiving or carrying another pregnancy to term, even though you’ve successfully had a child before.
At TRIO, we understand how challenging this can be, and we’re here to offer compassionate support and guide you through every step of your journey. There is hope, and we’re with you all the way.
How Common is Secondary Infertility?
Secondary infertility is almost as common as primary infertility — about one-third of all IVF cycles are thought to address secondary infertility.
If you’re facing secondary infertility, remember that you’re not alone. Treatment options are available, and it is possible to have a successful pregnancy again.
Causes of Secondary Infertility
Learn about the factors that affect reproductive health and can lead to secondary infertility below.
Causes of Secondary Infertility in Assigned Females
Multiple factors contribute to secondary infertility in AFAB (Assigned Female at Birth) individuals, including:
- Reduced Egg Quality or Quantity: Both egg quantity and quality naturally decline with age. This process may speed up due to autoimmune conditions or genetic factors. Previous surgeries, radiation treatment, and lifestyle choices can also impact egg health.
- Fallopian Tube Issues: Blocked tubes prevent eggs and sperm from meeting. This can result from infections like chlamydia or gonorrhea. Surgery, radiation, or conditions like endometriosis may also cause blockages.
- Uterine Problems: Changes in uterine health can affect embryo implantation. Common issues include endometriosis and fibroids or polyps in the uterine wall. Scarring from previous C-sections or retained placenta can also create problems.
- Hormonal Disorders: Conditions like PCOS can disrupt ovulation. They cause hormonal imbalances and may lead to ovarian cysts.
Causes of Secondary Infertility in Assigned Males
Secondary infertility causes in AMAB (Assigned Male at Birth) individuals may involve:
- Reduced Testosterone: This hormone is essential for sperm production. Aging, genital injuries, or medical conditions can affect testosterone levels. Thyroid disease, diabetes, and emotional stress may also play a role.
- Testicular Varicocele: Enlarged veins in the scrotum can affect sperm production and quality. This often results from valve dysfunction in these veins.
- Reduced Sperm Quality or Count: Sperm count and quality naturally decline after age 40. Certain medications can further impact sperm parameters. These include treatments for prostate cancer, seizures, or arthritis.
- Prostate Problems: An enlarged prostate can interfere with ejaculation and fertility. Treatments for prostate conditions may also affect reproductive function.
Lifestyle and Health Factors
Lifestyle changes can also contribute to secondary infertility, such as:
- Weight Changes: Weight gain or loss since your previous pregnancy can affect hormonal balance. This may disrupt reproductive function.
- Stress: Chronic stress interferes with hormones needed for reproduction. Managing stress is essential for fertility.
- Environmental Factors: Exposure to chemicals, radiation, or pollutants can impact fertility. Minimize these exposures when possible.
- Medications: Side effects of some medications may impact fertility. Discuss all medications with your fertility specialist.
- Age: Fertility declines with age for everyone. This becomes more apparent when trying for a second or third child. For instance, secondary infertility at 40 is more common than at 30 years of age.
Diagnosing Secondary Infertility
At TRIO, we take a comprehensive approach to diagnosing secondary infertility. The first step in diagnosis and developing a treatment plan is to meet with your specialist to discuss your history and order bloodwork to investigate your fertility status.
Blood Test for Fertility
Your initial fertility assessment blood tests will measure reproductive hormones like FSH, LH, estrogen, and progesterone. Your medical team will also test your thyroid function and investigate your AMH levels to assess ovarian reserve.
Your specialist may also look for infections that affect fertility and offer genetic tests for inherited factors.
For AMAB individuals, we further conduct semen analysis. This evaluates sperm count, motility, and morphology. Depending on the situation, patients may benefit from specialized tests like DNA fragmentation analysis — your medical team will let you know if additional testing is advised.
When to Get Tested
You may want to consider testing if:
- You’re under 35 and have tried to conceive for 12 months without success.
- You’re 35 or older and have tried for 6 months.
- You have risk factors like irregular cycles or a history of pelvic surgery.
- You’ve experienced previous fertility issues.
Treatment for Secondary Infertility
Based on diagnostic criteria, our team will create a plan suited to you and your needs. This plan will address your specific fertility challenges. It may include:
Ovulation Induction and Hormonal Therapies
For ovulation disorders, treatment will depend on your specific medical profile.
Fertility medications like Ovidrel can help trigger ovulation and regulate egg release. We may also suggest progesterone or other hormones to support reproduction. During treatment, we track progress with ultrasounds and blood tests. This helps find the best time to try for pregnancy.
Intrauterine Insemination (IUI) and IVF
Advanced reproductive technologies offer effective solutions for secondary infertility, such as:
- Intrauterine Insemination (IUI): This option places prepared sperm directly into the uterus.
- In Vitro Fertilization (IVF): IVF offers the highest success rates when other treatments fail. We stimulate your ovaries to produce multiple eggs, which are retrieved and fertilized in our laboratory. The resulting embryos are then transferred to the uterus.
We also offer genetic testing for embryos before transfer to help those with genetic concerns or who have experienced repeated pregnancy loss.
Surgical Options and Other Medical Interventions
Some causes of secondary infertility require surgery. This option may be used for:
- Removal of uterine growths (such as fibroids, polyps, or scar tissue that interfere with implantation)
- Fallopian tube repair
- Treatment of varicocele
Emotional and Psychological Support
Experiencing secondary infertility can bring up feelings of guilt for wanting another child, and it can be hard when others don’t fully understand your desire to grow your family. These emotions can feel isolating and overwhelming, but you don’t have to face them alone. We’re here to provide the support you need during this challenging time.
At TRIO, we have a team of counsellors who specialize in fertility and understand the emotional challenges you may face. We also offer a range of virtual support groups, including one specifically for patients struggling with secondary infertility. Accessing the proper support is a vital part of your journey, and we’re here to help you through it.
If you’re searching for “infertility treatment near me,” TRIO is here to help. Book a time to talk with one of our Care Navigators today.
Frequently Asked Questions
How Does Secondary Infertility Differ from Primary Infertility?
Secondary infertility means you’ve previously conceived without fertility treatment. The diagnostic and treatment approaches remain similar to primary infertility. Oftentimes, factors may have changed since your previous pregnancy. These could include age-related fertility decline or new health conditions.
What Lifestyle Changes Can Improve Fertility?
Many lifestyle changes may improve fertility, such as:
- Maintaining a healthy weight
- Eating a healthy and balanced whole foods diet
- Reducing stress
- Avoiding or limiting alcoholic drinks
- Decreasing caffeine intake
- Exercising regularly
When Should I Seek Medical Advice for Secondary Infertility?
If you’re under 35, we recommend getting medical advice after one year of trying without success. If you’re 35 or older, consult after six months of trying.
If you have reproductive conditions or have had past pelvic surgery, fertility help may also be an essential part of your journey. Early intervention often leads to better outcomes.
How Does Age Affect Secondary Infertility?
- Even if getting pregnant was easy before, everyone’s general health and fertility naturally decline over time. After the age of 35, egg quality and quantity decline, and the risk of miscarriage also increases. Sperm quality is also known to decrease with age.
While it’s essential to understand the risks and variables, the most important thing to know is that a healthy pregnancy is possible, and you’re never alone — the TRIO team is here to help.
