Secondary infertility is when a man and woman do not conceive after one year of trying, despite having conceived children in the past without any problems. While primary infertility gets the most media attention, secondary infertility is as common as primary infertility.
According to statistics collected by the Center for Disease Control, 11% of couples who already have a child go on to experience secondary infertility. That's approximately 4 million families, or about half of all infertility cases.
Unfortunately, because couples experiencing secondary infertility already have a child, their struggle is often downplayed or even ignored by friends, family, couples experiencing primary infertility, and even doctors.
Assuming that infertility "can't happen" to them, a couple experiencing secondary infertility may delay seeking help for their problems getting pregnant, and wait longer than the recommended 6 months for women over 35, or longer than a year for women younger than 35.
But delaying testing and treatment may mean a lower treatment success rate, as some causes of infertility worsen with time.
Secondary Infertility Causes
Secondary infertility is caused by the same problems that lead to primary infertility. Those causes include:
- Male infertility due to low or absent sperm count, problems with sperm shape (also known as sperm morphology), or problems with sperm movement (also known as sperm motility).
- Problems with ovulation, whether irregular ovulation or anovulation.
- Blocked fallopian tubes.
- Recurrent miscarriage.
About one-third of infertility cases are related to male infertility, another third are related to female infertility, and another third are related to problems in both the man and woman, or remain unexplained.
You may be wondering why you're having trouble this time, when you didn't have trouble in the past. It's a good question, but one that unfortunately may not have an answer.
Age may be a factor, especially if you were a lot younger when you had your first child, or you had a late start to your family building. Some causes of infertility may worsen over time, like endometriosis or growing fibroids. If you've gained significant weight since your first child, that can also lead to problems conceiving.
But just as often, there are no obvious reasons why you can't conceive this time as compared to last time.
Testing for Secondary Infertility
Testing for secondary infertility is the same as testing for primary infertility. Both the man and woman need to be checked.
Secondary Infertility Treatments
Treatments for secondary infertility are the same as for primary infertility. Treatments may include:
- Fertility drugs, often starting with the most commonly prescribed fertility drug Clomid
- IVF, sometimes in combination with other assisted reproductive options.
- Surgery, usually laparoscopic surgery, to repair blocked fallopian tubes, or to remove fibroids or endometriosis deposits
Sometimes when you're experiencing secondary infertility and need fertility treatment, friends or family may wonder why you are "going to extremes" and insist that since you've had a child in the past, you must be able to have one naturally now. If only you "stopped trying", "relaxed", "let it happen", etc.
Be assured that your need for treatment is the same as someone with primary infertility. It is not an "extreme measure" to use medical treatments that may help you have the child you desire.
Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J. Fertility, family planning, and reproductive health of U.S. women: Data from the 2002 National Survey of Family Growth. National Center for Health Statistics. Vital Health Stat 23(25). 2005. http://www.cdc.gov/nchs/data/series/sr_23/sr23_025.pdf
Secondary Infertility. RESOLVE: The National Infertility Association. http://www.resolve.org/diagnosis-management/infertility-diagnosis/secondary-infertility.html Accessed July 29, 2010.