Secondary infertility is defined as the inability to conceive or carry a pregnancy to term after you have already successfully given birth to one or more children. Many couples experience secondary infertility even after easily conceiving and carrying an earlier pregnancy to term. Though this type of infertility is given the name "secondary," this doesn’t mean that it is any less painful than primary infertility; it can cause just as intense emotions and feelings.
How Common Is Secondary Infertility
Secondary infertility can affect any couple, no matter what their age or cultural background. In fact, this type of infertility affects almost 20% of all American couples. Unfortunately, many health care providers and researchers pay less attention to secondary infertility than to primary infertility. However, recent studies suggest that secondary infertility actually accounts for the majority of all infertility cases.
The Emotions of Secondary Infertility
Secondary infertility is a highly emotional journey for couples to have to take. Many couples find it hard to believe that they can’t get pregnant, especially after getting pregnant so easily the first time around. It is common to experience feelings of anger and frustration towards those who are so easily able to expand their families.
Couples experiencing secondary infertility often feel particularly alone too – not only do family and friends seem unable to understand, but those experiencing primary infertility are often less than supportive. These intense emotions can really make dealing with infertility difficult.
What Causes Secondary Infertility?
Many of the causes of secondary infertility are similar to those associated with primary infertility. Most couples find that their secondary infertility is the result of a combination of these factors.
As women age, the number of eggs available for fertilization begins to decline. Ovulation becomes more sporadic, making pregnancy less likely during each menstrual cycle. Most women find that their fertility peaks between the age of 25 and 35. After 35, fertility begins to decline steadily and by age 45, the chance of pregnancy is less than 6% per cycle. Additionally, as women age, existing eggs become degraded, increasing the chances of early miscarriage.
Male fertility also declines with age. Though men continue to produce sperm throughout their life, the motility and morphology of their sperm begins to decline. This makes fertilization of an egg less likely.
Reproductive problems can develop after an initial pregnancy. In fact, previous pregnancies sometimes cause reproductive issues that actually lead to secondary infertility. For instance, many women experience pelvic infections after a delivery or a cesarean section, which can lead to scarring and tubal blockage. Additional reproductive problems can include:
- irregular ovulation
- pituitary disorders
- erectile dysfunction
- sperm duct blockage
A change in lifestyle factors can also impact upon your ability to get pregnant for a second or third time. Women who put on excessive weight during pregnancy often develop ovulatory disorders. This is because excess weight can actually increase the amount of estrogen in the body, influencing your ability to become pregnant. Men who exercise excessively may also increase their body temperature, affecting the development of their sperm. Cigarette smoking, alcohol, and recreation drug use can also impact upon female and male fertility.
Dealing with Secondary Infertility
When it comes to secondary infertility, many couples are simply at a loss for what to do. You may wonder when you should seek help from a specialist or if you should pursue certain fertility treatments. Here are some options to consider.
When to Seek Help
Many couples facing secondary infertility wonder when they should seek help from a specialist. You may be inclined to wait it out on your own, especially if you got pregnant easily the first time around. But secondary infertility will only get worse with time.
Generally, it is recommended that couples see an infertility specialist for a checkup if they haven’t gotten pregnant after one year of unprotected, timed intercourse. If you are a woman over the age of 35, you may want to seek help after six months of timed intercourse. Though you may feel most comfortable talking with your obstetrician/gynecologist, a reproductive endocrinologist will probably be able to offer you a more in-depth examination.
Treatments for Secondary Infertility
The treatments for secondary infertility are the same as for primary infertility. Depending upon the cause of your secondary infertility, you may consider any one of the following fertility treatments:
- ovulation induction (using medications like Clomid)
- surgery to remove pelvic adhesions or scarring
- hormones to treat reproductive conditions, like PCOS or endometriosis
- treatments using donor sperm or eggs
Getting Support for Secondary Infertility
Secondary infertility can be a very difficult diagnosis to deal with. It is important to look for specialized support to help you deal with your feelings and emotions. Great sources of support can include:
- family and friends
- support groups for secondary infertility
- clinical social workers or psychologists