What Is Secondary Infertility?

Many parents want to grow their families and have siblings for their children. However, some families are susceptible to secondary infertility. In fact, more than 3 million people of childbearing age in the U.S. who have one biological child have difficulty getting pregnant or carrying another to term.

Secondary infertility affects both males and females and results in difficulty in becoming pregnant or carrying a pregnancy full-term. Unfortunately, treatment for secondary infertility is less sought after than primary infertility. One reason is the perception that is previously having children indicates the family should be able to do it again. If you suspect or know your family is experiencing secondary infertility, continue reading to learn more about it!

A brief overview of secondary infertility

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As mentioned, secondary infertility is the ability to become pregnant or carry a pregnancy full-term after having successfully given birth at least once. Issues regarding secondary infertility can be explainable or, unfortunately, unexplainable. Common culprits of secondary infertility are issues of ovulation, fertilization, fertilized egg movement, and implantation.

The underlying “source” of secondary infertility does not always affect just one person in the relationship. In fact, 35% of couples experiencing secondary infertility have female and male factors correlating to fertility struggles. In 8% of cases, the male factor alone contributes to fertility issues. Diseases and conditions can also play a role. 

Couples experiencing secondary fertility should be weary of falling into hurtful behaviors of:

• Blaming their partner for the issue of infertility
• Dwelling on negative thoughts rather than success stories
• Disconnecting with their partner rather than supporting one another
• Focusing on things outside of their control
• Ignoring the need to find support

What causes it?

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Approximately one-third of secondary infertility cases are linked to the female partner, leaving the other third to the male partner, and 30% of cases have unknown causes. Therefore, about 70% of secondary infertility cases have identifiable causes. What are they? The reason varies depending on the male or female link.

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Reasons for secondary infertility in females include:

• Maturity: Infertility issues can appear around age 35 or older because female fertility declines after age 30.
• Excess weight: Some women experience ovarian dysfunction because of excessive weight gain.
• Polycystic Ovary Syndrome (PCOS): A hormonal disorder causing increased levels of male sex hormones, which prevent regular ovulation and menstruation cycles.
• Blocked fallopian tubes: Pelvic infections can block the tube responsible for carrying eggs from the ovaries to the uterus.
• Endometriosis: A condition where tissues resembling the uterus lining grow outside of the womb and create challenges to becoming or staying pregnant.
• Ovulation disorders: Approximately 40% of female infertility results from the inability to consistently ovulate because of disorders like primary ovarian insufficiency (POI) (reference 2).
• C-section scarring: The uterus can become scarred from cesarean deliveries.
• Autoimmune disorders: Some autoimmune disorders, such as lupus and rheumatoid arthritis, can cause inflammation in the uterus and placenta.

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Reasons for secondary infertility in males include:

• Maturity: Semen quality in males declines after age 40.
• Enlarged prostate: Sperm count can be reduced, and ejaculation can be restricted by enlarged prostrates.
• Excess Weight: Excessive weight gain can increase the risk of male infertility by 10% for every 20lbs of additional weight gain (reference 3).
• Low testosterone levels: Age and genital injuries can decrease the testosterone needed for sperm production.
• Prostate removal: Prostate removal causes sperm to flow in reverse.
• Late-onset hypogonadism: A condition causing reduced male hormone secretion.
• Testicular varicocele: A condition that enlarges the scrotum veins, which causes low sperm count (affecting about 30% of male infertility).

Secondary infertility can be caused by other injuries, conditions, illnesses, and medications not previously listed.

Common signs and symptoms

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Secondary infertility is not a “thief in the night” where fertility is there one day and gone the next. Often, there are signs and symptoms apart from the most obvious of the inability to become pregnant or successfully have a live delivery (usually resulting in miscarriage). Commonly, the signs and symptoms correlate with the results of the causes mentioned above.

For example: 

• Inconsistent ovulation
• Low sperm count
• Age
• Decreased ejaculation
• Hormone imbalance
• Sex organ scarring, injury, or inflammation
• Sexually transmitted diseases (STIs)
• Excess weight gain
• Prostate absence or abnormality

Of course, signs and symptoms can also be associated with the typical signs and symptoms connected to diseases, conditions, and medications that directly affect secondary infertility. It is recommended to seek diagnosis when couples of 35 or younger have unprotected sex for 12 months (6 months if older than 35) without pregnancy and successful delivery. Women over 30 should also seek diagnosis if experiencing pelvic inflammatory disease or irregular menstrual cycles.

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When should you see a specialist?

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Often, healthcare providers downplay the possibility of secondary infertility in their previously fertile patients. Many are encouraged to keep trying.

When you should consult a fertility specialist:

• If you have been actively trying to conceive for over a year (or for over six months over the age of 35
• If you are over 30 and have a history of pelvic inflammatory disease, painful periods, miscarriage, irregular cycles
• If your partner has a known low sperm count, do not wait one year

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What are the treatment options?

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Thankfully, secondary infertility treatment options exist to help couples conceive and give birth again. The type of treatment will depend on the causes and sex of the person receiving treatment. 

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Some treatment options for females include:

• Clomid: Oral medication to stimulate egg-producing hormones.
• In Vitro Fertilization (IVF): Surgical removal of eggs that are fertilized in a lab and transferred back to the uterus when becoming embryos
• Uterine Surgery: A procedure that clears unwanted growth and disturbances (such as scar tissue) that negatively impact fertility.

Possible male treatments include:

• Testicular surgery: A procedure that treats testicular varicocele.
• Supplements: Antioxidant supplements increase fertility, and drug treatment can enhance semen quality.
• Intrauterine insemination (IUI): Implanting semen into a female’s womb.

Start your pregnancy journey with Anja Health

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Starting or continuing your pregnancy journey is exciting but can sometimes be difficult. Families need to consider the challenges before, during, and after pregnancy. Contact us today and see how cord blood banking can help your family! At Anja Health, we are ready to help you prepare for your family’s future.