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What is Secondary Infertility?


Secondary infertility is defined as the inability to become pregnant or carry a pregnancy after previously having a successful birth. Secondary infertility can occur in both males and females due to changes that happen after a successful birth which affect a woman’s ability to conceive. The condition is diagnosed after a woman is having difficulties conceiving after trying for one year, or after 6 months if the woman is 35 or older.

People experiencing secondary infertility are less likely to seek out treatment due to their previously successful experience in having a child. Although secondary infertility may come as a shock, you’re not alone — 11 percent of couples in the United States who have already had a child experience secondary infertility, amounting to 4 million couples, or almost half of all infertility cases.  

The good news is that in general, having already had a successful delivery increases one’s chances of a successful second pregnancy, and there are many treatment and support options for individuals experiencing secondary infertility.

Causes of Secondary Infertility in Women

A common cause of secondary infertility in women is age. As women get older after their first pregnancy, their chances of successfully having a baby naturally decrease as the number of eggs stored in her body begin to diminish over time. This factor is especially important for women entering their late 30s and early 40s. 

Another cause can be weight — studies have shown that women who are overweight or obese have decreased fertility, which might be caused by disruptions in menstrual cycles or ovulation because of hormonal changes. However, in these women, lifestyle changes and weight loss have been shown to increase the likelihood of conception.

Scarring or adhesions of the female reproductive tract can arise from a previous infection or surgery, and can also lead to secondary infertility. Adhesions or scarring can disrupt the menstrual cycle, prevent the successful implantation of an embryo, or block entry of the sperm into the fallopian tubes, therefore preventing pregnancy. 

Other health issues that cause primary infertility can also cause secondary infertility, such as endometriosis, polycystic ovary syndrome, uterine fibroids, or thyroid conditions


Causes of Secondary Infertility in Men

One-third of secondary infertility cases are actually related to male factors. For men, one of the most common issues causing secondary infertility is a low sperm count. In 80% of men with secondary infertility, this low sperm count is a result of varicocele, which is an enlargement of veins in the scrotum that can hurt sperm production by increasing heat and pressure in the testes. 

Causes of secondary infertility in men are very similar to causes of primary infertility as well, such as lowered sperm quality due to age, infection, environmental toxins, drugs, and lifestyle factors. Age can also amplify infertility issues caused by health problems, such as in the case of diabetes-related reproductive problems. Another health problem causing secondary infertility could be senile prostatic enlargement (SPE), which can compromise normal ejaculation and therefore prevent fertilization. 

Treatment Options

There are many treatment options for both men and women experiencing secondary infertility. Scarring and adhesions in women can be surgically removed, which can often be enough to significantly increase chances of pregnancy. In-vitro fertilization can also be an option in this case, as implanting a fertilized egg into the uterus can bypass any blockages caused by scar tissue. Treatment of the underlying health issues that are related to secondary infertility can also increase the chance of pregnancy. For men, varicocele can be treated with surgery, and IVF can also bypass issues of low sperm count.

In any case, treatment for secondary infertility is possible and highly individualized. Speak with a mate doctor at one of our clinics to decide which path is right for you.

Gabriel Bogner
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