Secondary infertility is when a couple is having trouble getting pregnant after successfully having a child (or children) in the past. Many women who don't experience any problems getting pregnant with their first child may notice it more hard to get significant the second fourth dimension around.

Reproductive Endocrinologists, Dr. Scott Morin and Dr. Jonathan Kort explain exactly why this happens and how to take a successful pregnancy if yous are experiencing difficulties achieving pregnancy after your first kid.

What is Secondary Infertility?

A adult female's fertility declines with age, sometimes information technology can exist harder to get pregnant with a second kid than information technology was with the first. When a woman has problem getting pregnant on her own after a previously successful natural conception and birth, fertility doctors refer to this as secondary infertility. Secondary fertility can often exist treated with fertility treatment.

What is the difference betwixt Primary Infertility and Secondary Infertility?

Primary infertility is more than commonly referred to as simply, infertility. Main infertility is diagnosed when a couple fails to become pregnant later six-12 months of trying. Secondary infertility is when a couple fails to become pregnant afterward successfully giving nascency in the past.

The causes of primary and secondary infertility are nigh identical, but the emotional bear upon can be very different from each other. Fortunately, fertility treatments for primary and secondary infertility are the same and both have high success rates.

How mutual is secondary infertility?

Secondary infertility is every bit common as primary infertility. Infertility affects ane in eight couples trying to excogitate or about 12.5 percent.

Out of all infertility causes, secondary infertility makes up about fifty per centum of all cases.

Causes of Secondary Infertility

Secondary infertility can be caused by issues with the female or male partner.

  • Almost 33% of all infertility cases stem from issues with the female partner.
  • Another 33% of cases stem from the male partner.
  • The remaining 33% are a combination of issues from both the male and female partner

Causes of secondary infertility in women

  • Egg quality or quantity: A woman is born with all the eggs she'll ever take, and that supply slowly decreases as she releases eggs every month during her menstrual bicycle. So as a woman ages, she has fewer eggs, and fewer good quality eggs – both factors that reduce her chances of getting pregnant naturally.By and large, a adult female is virtually fertile in her mid-to-belatedly-20s, afterward which bespeak her fertility begins to decline slowly until age 35 when the decline accelerates. That said, every woman is different, and that decline can brainstorm earlier or later. Because fertility declines with age, it'southward possible – and even common – for women who had no trouble getting pregnant with their first child to struggle to conceive the second time around, when they are older and less fertile.
  • Damaged or blocked fallopian tubes: Issues with the fallopian tubes can hinder the egg from traveling to the ovaries successfully.
  • Issues with the uterus: Scaring from a C-section or fibroids may also cause infertility.
  • Endometriosis: Endometriosis is a very common cause of infertility. It is a status where tissue that typically grows inside the uterus grows in places like the ovaries.
  • Polycystic Ovary Syndrome (PCOS): A hormonal disorder that causes women to have exceptional or prolonged periods. PCOS patients may too accept excess androgen levels (male hormones). Patients with PCOS often develop small collections of fluid around their ovaries which inhibit eggs from releasing.
  • Lifestyle: An increase in BMI and/or certain medications may also lead to ovary dysfunction and bear on your fertility.

Causes of secondary infertility in men

Male person infertility is mainly caused by problems with their sperm, hormonal imbalances, or problems related to their reproductive anatomy.

  • Low sperm count: Low testosterone levels, a blocked duct, and even certain medications can cause low sperm count.
  • Sperm abnormalities: Sperm may be abnormal in shape or may not be able to swim to the egg well enough for fertilization to occur.
  • Azoospermia: Azoospermia is when a man has no viable sperm. This means that his body produces aberrant sperm.
  • Varicocele: Call back of a varicocele as a varicose vein in the scrotum. This may enhance the temperature in the testes to higher-than-normal levels which tin alter sperm product.
  • Anti-sperm antibodies: Some men and women have anti-sperm antibodies that make it difficult for them to achieve a pregnancy.

Tin a C-Section crusade secondary infertility?

Roughly 20% of women who gave birth via cesarean section reported difficulties getting significant with a second kid.

A C-section causes scarring and sometimes this scarring tin cause inflammation or obstructions that can make becoming meaning more hard.

Scar tissue can also grow and form large masses and cause endometriosis.

Secondary Infertility, Dr. Lange | RMA of Philadelphia, Fertility Dispensary

When should I see a doctor for secondary fertility?

The guidelines on when you should encounter a fertility dr. for secondary infertility are exactly the aforementioned every bit for whatsoever woman trying to get pregnant.

You lot should seek the assistance of a reproductive endocrinologist if you are under 35 years old and trying to conceive for 12 months.

It is recommended that y'all seek help after only vi months of trying if yous are 35 years erstwhile or older.

Can you get meaning with secondary infertility?

The curt answer is yes, you can become pregnant with secondary infertility, but you may demand to seek out the assistance of a fertility doctor, and here's why.

While women over the age of 35 nonetheless have eggs left, information technology becomes more hard to go pregnant because the eggs are of lower quality.

Enquiry performed by doctors at RMA showed that a woman's historic period impacts the viability of the embryos created from her eggs.

Namely, the older a woman, the more likely it is that her eggs have a chromosomal error which will, in turn, consequence in embryos existence aneuploid, or chromosomally abnormal.

For instance, in her mid-to-late 20s, the charge per unit of aneuploidy in a woman'due south eggs is a little more than xx percent, rises to the mid-30s past historic period 35, is about 50 percent by age 40, and is nearly 90 percent past age 42 and 43.

This means that while most 20 percent of the embryos a adult female creates may be abnormal in her tardily 20s, well-nigh ninety percent could be abnormal by her early on 40s. That is a significant change in a piffling over a decade.

What does aneuploidy have to do with a successful pregnancy?

A lot. The opposite of aneuploid is euploid, which ways an embryo is chromosomally normal, or that it has the normal amount of chromosomes and has a good take chances of implanting inside the uterus and leading to a successful pregnancy.

Aneuploid embryos, on the other mitt, have as well few or too many chromosomes, and often fail to implant within the uterus.

In the chance they do implant, they often lead to miscarriage or an affected child.

So the older the woman, the college her chances of producing aneuploid embryos that fail to implant, leading to infertility.

Aneuploidy embryo chart

How can I tell if I have secondary infertility?

If y'all were able to get pregnant naturally and gave birth without effect in the past merely are having trouble conceiving on your ain for the 2nd or third time, you may have secondary infertility.

However, it is also possible that there is another cause for your infertility, and doing the necessary fertility testing will assist you determine the cause so yous can move forward with the advisable treatment.

All patients at RMA undergo diagnostic testing to become a complete picture of their fertility before moving onto treatment; this includes fertility bloodwork to learn more about a patient's egg count, which tin can help determine whether or not she is experiencing secondary infertility.

What type of handling is available for women with secondary infertility?

Secondary infertility is treatable, and many women diagnosed with it proceed to have successful subsequent pregnancies.

At that place are various handling options based on the woman's specific fertility profile, including Intrauterine Insemination (IUI), where sperm is inserted into a woman'southward uterus at the time of ovulation.

In Vitro Fertilization (IVF) is another option, where sperm and egg are fertilized outside the adult female'southward body and a resulting embryo is transferred back into the woman'southward uterus in hopes of implantation.

IVF infographic

No matter which treatment path you pursue, yous should accept hope that we are here for you lot and you can overcome secondary infertility with merely a little flake of help.

Is IVF more successful in secondary fertility?

IVF is not necessarily more successful for patients with secondary infertility, only it is often the merely or nearly successful fertility treatment option.

Secondary Infertility Support Groups

Struggling with infertility tin can be very hard to deal with alone. It is important to know that in that location are support groups out in that location defended specifically to men and women dealing with infertility. Resolve: The National Infertility Association offers support groups all across the US. Use their helpful Infertility Support Group Finder to notice a meeting closest to you.