Secondary Infertility: Causes, Diagnosis, Treatment & Tips

• What is Secondary Infertility?
• What Are The Causes of Secondary Infertility?
• Diagnosis of Secondary Infertility
• Treatment Options For Secondary Infertility
• Emotional Impact of Secondary Infertility
• FAQ’s

What is Secondary Infertility?

Secondary Infertility is a condition where couples find it difficult to conceive for the second time for more than six months to one year. They might have a successful first pregnancy, but the second pregnancy would not happen. Or they might not complete the entire term of pregnancy. An example of secondary infertility is continuous pregnancy loss, where the couple can conceive but not carry them for the whole pregnancy term. The problem may happen in any of the following stages.

• Ovulation – when the egg is released
• Fertilization – egg fertilizes with the sperm when the fertilized egg travels to the uterus
• Implantation – When the egg reaches the uterus and implants itself on the surface of the uterus

The critical factor to classify infertility as secondary is that the first or previous pregnancy might have happened without the help of any fertility treatments or medications like IVF. Secondary Infertility is very common to primary infertility.

What Are The Causes of Secondary Infertility?

Secondary infertility can be related to either men or women, and both take equal chances of having secondary infertility. Several factors could cause secondary infertility and let us discuss each of them.

1. Age

Age is one of the most important causes of secondary infertility. Interestingly, science says that age plays a vital role in fertility. Biologically speaking, the fertile age for women is around 20 years. It starts declining around 30 and decreases significantly by 40.

This does not mean pregnancy is not possible in later stages, and it is just tricky.

2. Quantity And Quality of Eggs

Women are born with a fixed number of eggs. As they grow up and age, the quantity and quality of the eggs decrease. By the age of 40, the number of eggs decreases. Additionally, the chances of chromosomal malfunctions are higher for the remaining eggs.

If age is not a factor, and still the woman cannot conceive, the eggs’ quality might be good enough to fertilize.

3. Infections in Fallopian Tube

The Fallopian Tubes carry eggs to the uterus from the ovaries. The chances of pregnancy reduce if the fallopian tube is blocked because of pelvic infections like Chlamydia or gonorrhoea.

4. Issues in The Uterus

Any minor problem in the Uterus can result in secondary Infertility. Any of the following uterus problems could be the cause.

• Dilation and Curettage (D&C)
• C-section delivery might create adhesions in the uterus
• Fibroids
• Polyps
• Retained Placenta
• Endometriosis

Endometriosis is a condition wherein the tissue grows inside the uterus grows in any other place in the body, either the ovary or bowel surface. This condition is prevalent. But not all endometriosis cause infertility

5. Polycystic Ovary Syndrome

Polycystic Ovary Syndrome is a hormonal disorder where women experience irregular menstrual cycles or abnormal periods. Women suffering from Polycystic Ovary Syndrome have more male hormones. So, the ovaries do not release the eggs regularly. All these factors make conception difficult

6. Breastfeeding

Exclusively breastfeeding mothers may find it difficult to conceive again. This is because their body stops releasing eggs regularly or delays ovulation.

7. Weight Gain And Lifestyle Changes

Some women might face ovary dysfunction due to weight gain. Sometimes, diet might affect fertility.

8. Unexplained Infertility

Unexplained Infertility is a situation that none of the women wants to be in. Sometimes, all the test results would return normal. But still, you would find it difficult to conceive, and doctors might not be able to diagnose the reason. Remember that our body keeps changing. With continuous support from the doctors, you can increase the chances of conceiving again.

Infertility might also affect men. The following are the causes of infertility in men.

• Reduced testosterone level
• Testicular Varicocele
• Poor-quality Semen
• Prostate enlargement
• Prostate Removal
• Late-Onset hypogonadism

Diagnosis of Secondary Infertility

Secondary Infertility can be diagnosed when couples face certain signs and symptoms. The primary symptom is when a couple aged less than 35 years is trying to get pregnant for more than 6 months and is failing continuously. This applies to women over 30 years suffering from pelvic inflammatory disease, painful periods, or miscarriages.

Early evaluation is critical to start early treatment. If you suspect secondary infertility, visit your doctor at the earliest. The doctor might check your medical history and the changes since your previous or first pregnancy.

• For women, the doctor could check for the regularity of the menstrual cycle. Doctors will also do a study of the reproductive system with blood tests and scans to understand the underlying problem.
• The evaluation would relate to thyroid disease, sperm count, age-related conditions, or cancer for men.
• The doctor might also suggest an X-ray of the Uterus, also known as a Hysterosalpingogram or HSG, which would reveal abnormalities. The doctor might also suggest semen analysis.

Treatment Options For Secondary Infertility

The treatment for secondary infertility is similar to the treatment offered for primary infertility.

Secondary Infertility Treatment Options For Women

• Medications that can induce ovulation in women who suffer from ovulatory disorder.
• Intrauterine (IUI), where the sperm is placed inside a woman`s uterus to allow it to fertilize. In IUI, sperm donors might be considered.
• In Vitro Fertilization (IVF) where injections are given daily to induce ovulation and stimulate the ovaries. Surgical procedure is done to collect the eggs, fertilise them with the sperm and allow them to fertilize in the lab. Once the eggs fertilize and the embryos form, the fertilized eggs are transferred to the uterus.
• For issues with the uterus,, doctors can perform surgery to repair the structural problems. The surgery might include removing the scar tissue, polyps, and fibroids outgrown in the uterus.

Secondary Infertility Treatment Options For Men

• The doctors might perform the surgery to repair the testicular varicocele in men.
• Drug treatment, antioxidants, and anti-ageing supplements can also increase fertility in men.

Emotional Impact of Secondary Infertility

Infertility can take an emotional toll on couples. When the treatments fail, they might undergo a bunch of emotions, including sadness, anger, loneliness, and guilt. They seek empathy from family, friends, and the doctor.

Such couples who suffer from secondary infertility might take the support of extended mental health professionals to cope with the impact.

While it is true that secondary infertility is unexpected in most cases, treatment options are also available, which means that with proper care and guidance the couple will be able to conceive after testing, diagnosis, and the right treatment options. It is important to not lose hope and approach the right medical experts and experienced doctors to help them through this phase

FAQ’s

1. Can You Get Pregnant With Secondary Infertility?

No. You cannot get pregnant if you have secondary infertility. However, as guided by the doctor, early diagnosis and appropriate treatment might bring back your fertility, and you can conceive again.

2. How is Secondary Infertility Diagnosed?

Secondary Infertility can be diagnosed by various tests and scans as suggested by the doctors. The main symptom is when couples with age more than 35 years have tried to get pregnant for more than six months to one year and are still unable to conceive after having their first baby.

3. Is Secondary Infertility Permanent?

No. Secondary Infertility is not permanent, and it is treatable; women with secondary infertility have taken proper treatment and had successful second pregnancies.

4. Can a C-section Cause Secondary Infertility?

Sometimes Yes. Research studies suggest that around 20 per cent of the women who underwent the first delivery through C-section have found it difficult to conceive again. C-sections might cause scars and inflammation, making it difficult to become pregnant.