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Secondary Infertility

What is Secondary Infertility?

July 15th, 2021 | 6 min. read

By Virginia Hamilton Furnari

When you experience difficulty conceiving Baby #2 after having a relatively easy time getting pregnant with Baby #1, it can be shocking, confusing, and heartbreaking. There might even be a lingering sense of guilt: "Well, I already have a child, so I should just be happy."

This is known in our world as secondary infertility, and it can be deeply upsetting. We typically associate the term “infertility” with those who are unable to have their first child, but secondary infertility is very real, and much more common than you might think. 

The good news is that you’re not alone and secondary infertility is treatable in most cases. Yes, this time around may look different, but there are people, places, and groups out there to help you. 

So try to drop that guilt, mama. The desire to have another child should never be dismissed or downplayed. Just because you have a child (or children) and still want more doesn’t make this any less important. You deserve support and answers, so read on to better understand secondary infertility. We're here to help you feel empowered on your family-building journey.

What Does Secondary Infertility Mean?

Secondary infertility is the inability to become pregnant or to carry a baby to term within one year (or six months if you’re over the age of 35) after previously giving birth to a baby (or babies). 

While you might not hear about this as much as women who are unable to conceive at all, secondary infertility is actually the most common form of female infertility, affecting around 1 in 10 women. 

Why Am I Having Trouble Conceiving Again?

Now, for the big question that is likely hanging over your head...why? 

Secondary infertility shares many of the same causes of primary infertility. While some fertility challenges show up earlier on, some complications don’t arise until after one, or multiple, successful pregnancies. 

To better understand what might be going on, let’s break down some of the most common causes of secondary infertility.

Age

We know that fertility declines with age. Since egg quality declines as we age, women in their mid-to-late 30’s and older are more likely to experience fertility issues.

Male Infertility

Men may experience issues leading to infertility, such as impaired sperm production, problems with sperm count, shape, or motility. 

Worsening of Underlying Fertility Issue

It’s possible that you had an underlying condition like endometriosis or PCOS all along, but you had no idea. Other issues may include abnormal cervical mucus or ovulation problems. 

Prior Pregnancy Complications

You could have scar tissue, fibroids, adhesions, or blocked tubes as a result of a prior pregnancy or surgery. 

Lifestyle Changes

Since your last pregnancy, you or your partner may now have increased risk factors, such as weight, age, smoking, or taking certain medications. 

Recurrent Miscarriage

Also known as recurrent pregnancy loss, this is when a woman has three or more consecutive, spontaneous miscarriages.

Unexplained Issues

This option is not ideal, I know. While we can work to understand what is causing secondary infertility, there are occasions where it is unexplainable. However, unexplained DOESN’T mean unsolvable! There are still solutions that could be right for you. 

When Should I Call A Doctor About My Fertility?

If you’ve been trying to conceive for one year or longer (or six months for women 35 years or older) with no luck, consider reaching out to a reproductive endocrinology and infertility specialist

In my experience, women who are facing secondary infertility are more likely to put off seeking support. Maybe your friends and family members are downplaying your struggles because you have successfully had a child or maybe you’re feeling guilty for wanting to further expand your family.

Or, hey, you’re a mom – maybe it’s difficult for you to find the time and emotional energy to seek help when you’re already caring for a young child. 

There’s no shame in this game. The truth is that coping with secondary infertility can cause anxiety and grief and you deserve support while trying to achieve the family you desire. 


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How Do You Treat Secondary Infertility?

The short answer? Testing and treatment for secondary infertility are typically the same as that of primary infertility. 

Let’s dig into more details…in order to begin treatment, both you and your partner need to be evaluated, and your provider will run tests to determine the cause. These can include a hysterosalpingogram (or HSG) and a saline sonogram for her, and a semen analysis for him.

Curious about what to expect from a semen analysis? Check it out here. From there, your Reproductive Endocrinologist will design a unique game plan to solve your secondary infertility.

While individual treatment plans vary, there are four commonly-used options. Let's talk about them! 

Treatment Options for Secondary Infertility

  • Ovulation assistance: This involves taking drugs to make you ovulate or "superovulate," timing your ovulation with the introduction of sperm.
  • Intrauterine insemination (IUI): A fertility treatment that involves placing sperm inside a woman’s uterus with timed ovulation (induced with medication).
  • In vitro fertilization (IVF): This is the process of fertilization by extracting eggs, retrieving a sperm sample, and then manually combining an egg and sperm in a laboratory dish. The embryo(s) is then transferred to the uterus. 
  • Donor egg or donor sperm: This involves using donated eggs or sperm from someone you know or from an anonymous donor. Learn more about moving forward with donor eggs here

Remember: You're Not Alone

Secondary infertility should not be taken lightly - it can come with a great deal of stress and overwhelm. You may be encountering less than supportive friends and family members who wonder why you’re “trying so hard" when "You already have a kid!”

But as mentioned before, your family-building goals are your own, and every one of them is valid and supported by us here at RMA of Connecticut.

The truth is, your need for support and treatment is the same as any person struggling with infertility. You should never feel ashamed about facing infertility just because you “already have kids.” When you long to have a child and are unable to conceive, the subsequent emotions can be heartbreaking. 

Please don’t feel like you need to cope alone. Advocate for yourself, seek out support, and talk to your health care provider. We see women every day who are struggling with secondary infertility, so while this may feel like a devastating and isolating event, please know that you are not alone, and there are solutions available.

We understand how difficult secondary infertility truly is, and we’re here to help.


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Virginia Hamilton Furnari

Virginia Hamilton Furnari is Illume Fertility's former Brand Specialist. In addition to helping mold the Illume Fertility brand through blogs, videos, and events, she was also a patient at Illume. Given her professional and personal involvement in the fertility community, she has immersed her mind, body, and soul in family-building education.