Posted on April 15th, 2019by Dr. Matthew Ledermanin Infertility Conditions

What is Secondary Infertility?

Secondary infertility is the inability to conceive or carry a full-term pregnancy after having at least one child. Individuals or couples experiencing secondary infertility may be less likely to be diagnosed or seek treatment because of the perception that if they were able to successfully bear children before, they should be able to do so again.

What Causes Secondary Infertility?
The causes of secondary infertility are similar to those of primary infertility and often have a lot to do with age. In young, healthy women, the average monthly pregnancy rate is approximately 20%. As women get older, this rate starts to decline, especially after 35 when both the number of eggs and the quality of eggs commonly decline.

Other causes can include abnormalities in sperm quality and quantity, damaged fallopian tubes, endometriosis, ovulation disorders, uterine disorders, and one’s general overall health, such as weight, chronic medical conditions and smoking.

Treating Secondary Infertility
It is recommended that individuals seek the help of a fertility specialist after unsuccessfully trying to conceive for 6 - 12 months. For individuals over age 35 or who have known medical conditions, it is generally recommended they see a specialist after 4-6 months.

Treating secondary infertility, like primary infertility, will depend on the causes or underlying condition. To determine the cause(s) of infertility a fertility check is performed which can include a blood test to check hormone levels, an ultrasound, hysterosalpingogram (HSG), and a semen analysis. After evaluating the results, a reproductive endocrinologist will create an individualized treatment plan to address each diagnosis.

Primary treatment strategies usually revolve around increasing the number of available follicles or eggs in a cycle, which increases the chances of fertilization. This is done via oral medications such as clomid or letrozole. These treatment cycles are often combined with intrauterine insemination (IUI). Ultimately, a couple may use in vitro fertilization (IVF) to conceive. IVF involves retrieving eggs, fertilizing them, and analyzing the embryos. A chromosomally normal male or female embryo is then transferred back into the uterus.

With a variety of treatment options available, a diagnosis of secondary infertility does not limit a couple’s ability to grow their family. Together with a reproductive endocrinologist, individuals or couples can determine a treatment plan that is realistic and appropriate for their family building goals.

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