Hatch Fertility Blog

What Is Secondary Infertility: Signs, Causes and Treatment Options

Hatch Fertility
Written by Hatch Fertility

After conceiving and giving birth to your first child, you might think having a successful second pregnancy will be easy. However, this is not always the case for some families.

Many people can experience what is called secondary infertility after having their first child. While the reason for secondary infertility can be attributed to any number of causes for both sexes, there are an array of options to help address many of them. Continue reading to better understand what secondary infertility is, what may cause it, and what can be done to treat it.

What Is Secondary Infertility?

Secondary infertility is defined as the inability to conceive or carry a baby to term after previously conceived naturally and given birth. It can be caused by increased age, complications from a prior pregnancy or surgery, and many other factors.

The Signs of Secondary Infertility

Secondary infertility shows similar signs to other types of infertility. For a man and woman under age 35 who have had unprotected sexual intercourse with the intent of conception for 6-12 months without getting pregnant, they should suspect the possibility of secondary infertility. This is particularly so for women who have experienced pelvic inflammatory disease, irregular menstrual cycles, or miscarriages, and for men with low sperm count.

What Causes Secondary Infertility?

Sometimes the cause of secondary infertility is simply unknown. Diagnosed causes of secondary infertility may include:

Advanced Maternal Age (Age 35 and Older)

A woman's fertility starts to decline after age 30. Many studies demonstrate a significant drop in pregnancy rates as women get into their late thirties. Studies have shown that the chance of a 20-year-old woman conceiving after one month of exposure is at 30%. While, at 30 years this rate drops to 20% per month, and at 40 it’s 10% per month. At 45, there is less than a 2 - 3% chance of a woman conceiving on her own after trying for one cycle. 

The reason behind this phenomenon lies in the fact that egg quality deteriorates with time, which in turn translates to lower pregnancy rates. Unlike men’s sperm supply, women are born with a set number of eggs which they use up over the lifespan of their reproductive years. With time, the number of eggs dormant in the ovaries will deteriorate, hence the lower fecundity rate. A direct correlation to this is the increased risk of chromosomal anomalies in infants born from older women. 

Problems With the Uterus

Conditions related to the uterus can cause secondary infertility. For example, Endometriosis is a condition in which cells similar to those that make up the endometrium lining grow outside the uterus. Dilation and curettage (D&C) or Cesarean delivery can cause scarring inside the uterus that interferes with future pregnancies. Fibroids or polyps grow inside the uterus which can affect pregnancy.

Damaged Fallopian Tubes

The internal lining of the fallopian tube contains delicate hair-like projections that are instrumental in facilitating the transportation of the sperm, egg, and embryo through the inside of the tube. If a tube or tubes are damaged or blocked, the sperm and the egg are not able to meet and fertilization cannot occur in the body. If fertilization does occur but the tube is damaged, it may not be able to transport the embryo to the uterus. 

Additional causes of tubal damage are: 

  • Sexually transmitted diseases such as Gonorrhea and or Chlamydia. If these infections remain undetected and are left untreated, they can permanently damage the tube’s delicate lining and cause scar tissue, which can lead to tubal blockage. 
  • History of surgery in the pelvis, such as removing ovarian cysts or surgery for appendicitis. 
  • Endometriosis can cause scarring, tubal damage, and blockage. 

Polycystic Ovary Syndrome (PCOS)

The diagnosis of polycystic ovary syndrome (PCOS) requires three of the following symptoms: menstrual irregularities, androgen excess, and the appearance of polycystic ovaries on an ultrasound. This condition affects 5 - 8% of reproductive-aged women. 

Abnormal BMI

An individual’s body fat percentage plays an important role in the regulation of their menstrual cycle. If you experience a significant decline in body fat, you may experience the total absence of normal periods or irregular periods. This is why many underweight athletes, such as marathon runners or ballet dancers, suffer from infertility. Studies have also demonstrated that overweight women have a higher chance of having anovulatory infertility especially when their BMI is greater than 27 kg/m2.

Lifestyle Factors

For both sexes, smoking, excessive alcohol use, and emotional stress can also affect fertility. Avoid damaging environmental factors, such as smoking, heavy exercise, toxicants, certain drugs, or excessive alcohol. Reduce stress levels, and maintain a healthy body weight by exercising and eating a healthy diet.

Poor Sperm Quality

Poor semen quality can cause secondary infertility. After age 40, the quality of semen typically starts to decline. According to the World Health Organization (WHO)the most common causes of male infertility are problems related to the ejection of semen, motility (movement) of the sperm, morphology (abnormal shape), and low level or absence of sperm. 

Is Secondary Infertility Treatable?

Yes! Secondary Infertility is treatable. Nowadays with advancements in Assisted Reproductive Technology (ART), there are several treatment options available for the condition including the following:

Intrauterine Insemination (IUI)

IUI is a procedure where sperm is placed inside the uterus to ensure healthy sperm gets closer to the egg and increases the chances of successful fertilization.

The sperm is placed in the uterus during ovulation. The hope for the outcome of the procedure is for the sperm to swim to the fallopian tube and fertilize the egg, resulting in pregnancy.

In Vitro Fertilization (IVF)

IVF treatment involves ovary stimulation using daily hormonal injections. A patient will undergo a surgical procedure to retrieve the eggs, the retrieved eggs will be fertilized in a lab to become embryos, embryos will be cultured for about a week, then an embryo or embryos will be transferred into the uterus. 

An egg donor, sperm donor, and gestational surrogate can be used in IVF treatment depending on each case. For women without a partner or who desire future fertility, egg freezing can be done before fertilization so that the eggs can be stored for future use.

Additional Treatment Options for Secondary Infertility

Egg Donation

If you are experiencing secondary infertility issues such as age-related infertility, unexplained repeated IVF failure, or removal of ovaries, an egg donor may be needed for your IVF treatment.

Many cases that use an egg donor for their IVF cycle yield a higher rate of success. By finding a healthy donor with good egg quality, we frequently see better results for birth rates. Finding the right egg donor takes time and careful consideration. Hatch is the most experienced egg donation agency which was established in 1991. We have set the standard for best and ethical practices.

Egg donors who work with Hatch need to meet various medical, psychological, and demographic screening requirements to ensure they are a healthy reproductive match for your family. Our experienced staff has full confidence that we can help you choose the perfect egg donor and guide you through the whole egg donation process.

Learn More About Egg Donation ➜

Gestational Surrogacy

There are many reasons why a couple or an individual needs to find a gestational surrogate. The reasons include the removal of the uterus due to medical problems or the inability to carry full-term.

If you are medically unable to carry a pregnancy again due to previous pregnancy complications, using a surrogate will help you achieve the goal of having more than one child.  

Our office is close to top fertility clinics in the Los Angeles area, and we work closely with IVF physicians. Here at Hatch, we are an all-inclusive agency providing a top fertility specialist, fertility clinic, surrogacy agency, and donor egg bank. We support you through your journey to parenthood, from assisting you in choosing your egg donor and surrogate, to embryo implantation and pregnancy, to the birth of your baby.

Finding the right Surrogate can be lengthy, and it is better to start the search as soon as possible. We recommend booking your initial consultation with one of our specialists. We will give you an overview of our programs, matching process, surrogacy costs, insurance, legal process, and much more.

Learn More About Surrogacy ➜

We Are Here To Help

Even if you already have a child, secondary infertility can still be painful and challenging for a family. Secondary infertility can come as an unwelcome surprise for couples who have previously managed to conceive naturally and give birth without fertility issues. It’s always important to speak to your doctor if you are experiencing difficulty conceiving again.

It also may be comforting to know that these types of issues aren’t uncommon and that there are even support groups for families struggling with fertility complications. Understanding and talking about these issues in a safe environment is often helpful to families. For more information on secondary infertility and how Hatch can help overcome these hurdles, you can reach out to our support staff, and they can schedule some time to discuss your situation.

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