What is Secondary Infertility? How to Overcome it?

What is Secondary Infertility?

Secondary infertility occurs when a couple is unable to conceive or carry a pregnancy to term after giving birth for the first time. To consider secondary infertility different from primary infertility, doctors usually take into account the fact that the previous pregnancy happened without using fertility medications or treatments, such as IVF or IUI.

What Causes Secondary Infertility?

Secondary infertility can be a confusing and frustrating experience. While the exact causes for the condition are not yet known, there are certain factors that are known to cause secondary infertility in females and males.

Some of the known factors contributing to secondary infertility in females are -

• Decline in Egg Quality: As a woman ages, the quantity and quality of her eggs decline.
• Underlying Health Conditions: Conditions like PCOS can disrupt ovulation, whereas endometriosis can damage the fallopian tubes.
• Previous Pregnancy Issues: This can happen due to a C-section, normal childbirth, or fibroid development. They can cause scarring or blockage in the reproductive system. This might prevent a woman from conceiving.
• Lifestyle Factors: Smoking, alcohol consumption, and weight gain can also affect fertility in women.
• Hormonal Imbalances: Disruptions in hormones, such as hypothyroidism or hyperthyroidism, can cause the body not to ovulate during a cycle.
• Other Conditions: STIs may also increase the risk of secondary infertility.

Causes of secondary infertility might be -

• Low Sperm Count: This is a factor in male infertility, in which sperm count, motility, or quality is low. This, in result, can cause secondary infertility.
• Reduced Testosterone Level: Testosterone helps in sperm production, and a decline in the level of testosterone in the male body can hinder the production.
• Testicular Varicocele: This condition causes the veins in the scrotum to enlarge, which causes low sperm production and infertility in men.
• Prostate Enlargement and Removal: An enlarged prostate can lower the sperm count, which may cause abnormal ejaculation.
• Drugs and Surgery: Prostate cancer surgery, gout, ulcerative colitis, and fungal infection can also affect sperm count and quality.

Note: There are certain cases where the partners appear healthy, but they are unable to conceive after the first child.

Secondary Infertility Symptoms

The major sign of secondary infertility is being unable to get pregnant after having one natural conception. If a person is below the age of 35, and even after trying to conceive for at least 12 months, the doctor may suspect secondary infertility. However, for people above 35 who are trying to conceive for at least 6 months, it is regarded as secondary infertility.

Can Secondary Infertility be Overcome?

Yes. Secondary infertility can be overcome in several cases through targeted treatments, such as ovulation induction, making changes in lifestyle, etc. Some common ways to overcome secondary infertility -

• Lifestyle Modification: Doctors advise addressing issues such as weight management, stress reduction, and diet improvement.
• Assisted Reproduction Techniques: Infertility treatment, such as IVF and IUI, can help in conceiving.
• Surgical Options: Surgery can help correct structural issues, such as blocked fallopian tubes, uterine fibroids, or scarring. It also involves treating varicocele in men.

Note: Doctors may also recommend considering yoga as a means to improve fertility in women and men. Also, before recommending any treatment method, they diagnose the condition causing infertility.

How Do Doctors Diagnose Secondary Infertility?

To determine what’s causing secondary infertility, the doctors usually diagnose both partners together from the start. Here’s an overview of what the process may entail -

• Medical History:

  The doctors may ask the patient about their previous pregnancy, cycle patterns, how many times they’ve tried, lifestyle, medications (if any), etc.

• Ovulation Assessment:

  They also conduct an ovulation assessment to check whether ovulation is occurring regularly. In addition, they check if the hormones that drive ovulation are functioning properly.

• Imaging:

  It involves a transvaginal ultrasound and hysterosalpingogram to check the health of the uterus and fallopian tubes.

• Semen Analysis

  This is done to check for male infertility. In this test, the doctors assess the count, motility, and morphology.

How to Get Pregnant With Secondary Infertility?

With the advancement in technology, there are several ways one can get pregnant. Some of them are -

• Hormonal Therapy:

  When the test results reveal a hormonal imbalance, doctors use targeted medication to restore the hormone levels. This usually helps bring the ovulation back on track.

• Treating Underlying Conditions:

  Thyroid disorders, infections, and endometriosis can prevent a person from getting pregnant. Treating the exact condition, rather than working around it, offers a better chance. Intrauterine Insemination (IUI):IUI involves injecting sperm directly into the uterus. The sperm is either extracted from the male partner or, sometimes, the doctors may use donor sperm (only if the partner does not have healthy sperm).

• In Vitro Fertilisation (IVF):

  During IVF, the egg is harvested from the female and fertilised in the lab with sperm. After a few days, when the embryo is formed, it is transferred to the uterus.

• Intracytoplasmic Sperm Injection (ICSI):

  In this, a single sperm is injected into the egg, and is mostly helpful when the sperm count of quality is extremely low.

Conclusion

Secondary infertility can come as a surprise, and this is mostly true if the first pregnancy was smooth and easy. But that does not mean the end of a dream. This is because, to overcome the situation, there are certain means to help one start a new family.

No matter if the cause is hormonal or physical, fertility specialists can help with the right diagnosis and treatment. From IVF to IUI and ICSI, in addition to surgery and lifestyle changes, there are several options available to help you experience motherhood again.