You’ve already had a baby (or multiple!) and now you’re ready for another. Just because having a baby was easy before doesn’t necessarily mean you’ll have the same experience again. Secondary infertility, as it’s called, is actually the most common form of infertility. Here we’ll break down what it means and what treatment options are available.
What is secondary infertility?
In general, infertility is the inability to have a baby after a year of trying (or six months if you’re over age 35). Secondary infertility is when infertility occurs after you’ve already had a child and without using fertility treatments in your prior pregnancy, such as fertility medications or in vitro fertilization. You may have difficulty getting pregnant or carrying a pregnancy to term.
Secondary infertility looks similar to—and is as common as—primary infertility. About 12 percent of people of childbearing age in the United States deal with some kind of infertility.
Reasons why you may experience secondary infertility
The causes of secondary infertility are generally the same as those of primary infertility. These include:
- Age: Fertility starts to decline by your mid-30s. By the time you’re 45, getting pregnant on your own probably isn’t likely.
- Ovulation concerns: If your ovaries aren’t releasing an egg every month, it can be harder to conceive. Polycystic ovary syndrome (PCOS) is a condition that affects your hormone levels and can cause irregular periods.
- Endometriosis: This is a condition where uterine tissue grows outside of your uterus, where it shouldn’t. It can cause inflammation and scarring, which can affect your ability to conceive.
- Autoimmune disorders such as lupus.
- Infections, such as pelvic inflammatory disease (PID).
- Scar tissue from a cesarean section.
- A lower than average amount of eggs, known as diminished ovarian reserve.
- Fibroids, scarring, or polyps in your uterus.
- Blocked fallopian tubes.
- Unexplained: No cause to your infertility can be found.
Infertility doesn’t just affect women. In fact, when it comes to problems conceiving, 30 percent of problems are due to fertility issues in the male partner, 30 percent to the female partner, and another 30 percent are a mix.
How is secondary infertility diagnosed?
If you’ve been actively trying to get pregnant for at least a year—or are over age 35 or have a medical condition that can affect fertility—it may be time to talk with your healthcare provider. They’ll ask you questions about your medical and family history, how your prior pregnancies went, and any concerns with your periods such as irregular cycles.
You might be referred to a specialist such as a reproductive endocrinologist, a doctor with advanced training in treating people with infertility. You’ll have a physical exam and testing to look at your overall fertility status.
This might include an ultrasound of your uterus, ovaries, and fallopian tubes and an X-ray called a hysterosalpingogram to make sure your uterus and fallopian tubes are healthy. The workup will probably also include blood work to check your hormone levels and your ovaries’ functioning. Your male partner will probably be tested as well with a semen analysis.
Treating secondary infertility
Even though a secondary infertility diagnosis can be difficult to cope with, there are treatments available so you can still have a baby—and it doesn’t always mean you need to do IVF (or spend a fortune).
Fertility medications
Medications can help correct hormone imbalances and can help you ovulate. These can include oral medications, suppositories, and injections. Clomiphene, or Clomid, is a commonly prescribed fertility medication that stimulates ovulation. Another group of medications called gonadotropins are given by injection early in your cycle and can help you ovulate.
Surgery
You might have surgery to fix any blockages in your fallopian tubes or remove any polyps, scarring, or fibroids. Most of these surgeries are done laparoscopically where medical instruments are inserted through small cuts in your abdomen to make these repairs.
Intrauterine insemination
This is a procedure where a thin flexible tube called a catheter is used to deposit washed sperm directly into your uterus at the time you’re ovulating in order to maximize your chances of fertilization.
In vitro fertilization
VF is an involved process where you give yourself injections daily in order to stimulate your ovaries to grow lots of eggs. Your doctor removes these eggs in a procedure known as an egg retrieval. The eggs are then fertilized with your partner’s or donor’s sperm in a lab. One or more of the developing embryos are placed into your uterus through a catheter. Any remaining embryos or unfertilized eggs can be frozen and stored for use later. You can use an egg donor, sperm donor, or gestational surrogate as well.
Secondary infertility can be an emotional process and reaching out to others who may be experiencing secondary infertility themselves can make you feel less alone. But there are treatment options available that can help, so don’t hesitate to let your healthcare provider know what’s going on.