Secondary Infertility
March 20, 2025- When the first baby comes in, it seems easy to conceive the second one. That's not always true and many people have trouble conceiving their second child. Secondary infertility is defined as difficulty in achieving pregnancy or carrying a pregnancy to live birth after having conceived and delivered a child. The National Center for Health Statistics indicates that it affects millions of families.
- Even if you have one child, dealing with secondary infertility can be difficult. For women, one of the most common reasons for secondary infertility is polycystic ovary syndrome (PCOS), but other issues like endometriosis and genital infections can also cause problems.
Here we will look at the number of factors leading to secondary infertility, available treatments, and more.
What is Secondary Infertility?
Infertility refers to a condition where a couple is unable to conceive after attempting for a year without any form of contraception. Infertility can be classified as primary or secondary.
Primary infertility is defined as the inability of a couple to conceive after at least one year of trying. The second type is secondary infertility, which is the infertility of a couple after they have conceived and delivered at least one child.
Why Does it Occur?
Secondary infertility may be associated with problems related to fertility in either the male or female partner. Approximately one-third of the cases are attributed to the female, another third is associated with the male. In the rest of the cases, which account for 30%, secondary infertility may be due to both partners, or the main causes remain unknown. Factors contributing to secondary infertility in females include:
- Advanced age (35 years or older)
- Endometriosis
- Obstructed fallopian tubes
- Polycystic ovary syndrome (PCOS)
- Significant weight gain
Major causes that contribute to secondary infertility in men are:
- Older age (40 years and older)
- Reduced testosterone levels
- Enlarged prostate
- Surgical removal of the prostate
- Late-onset hypogonadism
- Excessive weight gain
Sometimes, the causes of secondary infertility cannot be identified. This is referred to as unexplained secondary infertility and impacts about twenty per cent of couples. It is a good idea to consult your doctor if you've been attempting to conceive for a year without achieving pregnancy.
Effective Treatments for Secondary Infertility
If you're struggling to conceive again, there are various solutions available to assist you. Treatments for secondary infertility include medicine, surgery, artificial insemination, assisted reproductive technology (ART), and using surrogacy. The treatment plan you follow will be influenced by the particular cause of your infertility.
Here are some treatments your doctor or fertility expert may suggest:
Medications
Medication can assist in ovulation formation, which is critical to conception. The medications can be categorized into two main classes, namely clomifene, trademarked as Clomid, and letrozole. A doctor can prescribe a medication called metformin if diagnosed with PCOS. While the drug does not primarily focus on improving fertility, it enables hormone control and regularizes ovulation by treating insulin resistance.
Ovulation-stimulating medications are not indicated in women with idiopathic infertility because these women may be ovulating normally, outside the normal reference range for those doses, hence making any such medications ineffective.
Surgery
Surgical procedures can treat certain issues affecting your ability to conceive, like obstructions or scars in your reproductive organs. Surgery is also capable of addressing uterine scarring or excising significant fibroids in the uterus, which are benign tumors that may hinder a fertilized egg's ability to implant in the uterus lining.
If you suffer from endometriosis, your physician may suggest a laparoscopy, a minimally invasive surgery aimed at eliminating lesions caused by endometriosis.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) could be an appropriate treatment method for those facing difficulties with infertility. The process involves isolating healthy sperm from less viable ones and placing them into the uterus at the time of ovulation.
IUI can take place in a natural ovulatory cycle or can be enhanced with hormonal treatment to boost egg development.
In vitro Fertilisation (IVF)
If you are considering growing your family, you may have come across a method of assisted reproductive technology known as in vitro fertilization (IVF).
In the process of IVF, doctors prescribe medications that help the ovaries produce more eggs than they normally produce. After that, the eggs are extracted and combined with sperm in a laboratory setting. The embryos that are formed are then placed back into the uterus to continue their growth and development.
Intracytoplasmic Sperm Injection (ICSI)
If a couple has trouble getting pregnant because of low sperm count or poor-quality sperm, there is a treatment called intracytoplasmic sperm injection (ICSI) that can help. ICSI is a part of in vitro fertilization (IVF), but rather than simply combining the sperm with the egg, a single sperm cell is injected directly into each egg that has been collected. This technique enhances the likelihood of pregnancy since the sperm does not enter the egg on its own.
Egg and Sperm Donation
People who have trouble getting pregnant can use donor eggs, sperm, or embryos. Choosing to use a donor is an important choice and may not be right for everyone, but it can be great for:
- Unmarried individuals
- Same-sex couples
- Those who are unable to generate sperm or eggs
- People at an elevated risk of transmitting a hereditary or genetic condition
- Individuals who have not found success with other fertility options
In cases where intended parents are unable to carry a baby themselves, such as same-sex male couples, single men, transgender individuals, or women who have undergone a hysterectomy, they may consider the option of employing a surrogate or gestational carrier.
Wrapping Up!
Secondary infertility can sometimes be undesired and too much to handle. If you find this unbearable, you should reach out to your partner, family, or friends for help. It might be good to talk to your doctor about this earlier, especially if any risk factors may hinder your fertility. These factors can involve having infrequent menstrual cycles or suffering from endometriosis.
Our expert doctors at Apollo Fertility can assist you in determining if you should receive specialized treatment or services. They will diagnose the primary cause and customize your treatment. Contact our experts today or book an appointment.
