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Addressing Secondary Infertility: Causes, Diagnosis, and Treatment

The choice to have another child can be exciting for many couples who have already joyfully become parents. But for others, the road to grow their family could be beset by unforeseen difficulties—a condition known as secondary infertility. While sometimes disregarded, secondary infertility can be just as physically and emotionally taxing as main infertility. To equip you to handle this journey, we will examine the reasons, diagnosis, and available treatments for secondary infertility in this post based on our experience.

What Is Secondary Infertility?

Having previously given birth to at least one child, secondary infertility is the inability to conceive or carry a pregnancy to term. Secondary infertility is more widespread than many people know; it is thought to affect 10-15% of couples during their lifetimes.

Unlike primary infertility, in which a couple has never been able to conceive, secondary infertility can be especially difficult emotionally since the couple may feel bewildered or frustrated after having previously conceived and already carried out a pregnancy.

What Are the Main Causes of Secondary Infertility?

Many things could lead to secondary infertility, some of which might be connected to the prior pregnancy or delivery experience. The most often occurring reasons are as follows:

Age-Related Fertility Reduction

It gets harder to conceive as women age because their ovarian reserve—the quantity of viable eggs left—decreases. For women above 35, this is particularly true.

Uterine Factors

An embryo’s ability to implant properly can be hampered by conditions like endometriosis, uterine fibroids (see diagram), or scarring from prior procedures or births. Uterine fibroids, or leiomyoma, are benign tumors of the uterus that may cause severe pain, bleeding, and infertility.

Accessed from: Medline Academics website, Uterine Factors In Infertility – Myomas (a common benign (non-cancerous) tumor that arises in the smooth muscles of the uterus

Hormonal Imbalances

Ovulation and fertility can be interfered with by hormonal changes during childbirth or by disorders like polycystic ovarian syndrome (PCOS).

Fallopian Tube Blockages

Fertilization can be hampered by partial or total obstructions in the fallopian tubes brought on by infections, scarring from prior procedures, or ectopic pregnancies. 

Accessed from: Reproductive Science Center website

Male Factor Infertility

From time to time, problems with sperm motility, quality, or production can lead to secondary infertility.

How Can Secondary Infertility Be Overcome?

Many times, a mix of emotional support, medical procedures, and lifestyle modifications is required to overcome secondary infertility. These actions might be helpful:

Seek Professional Support

Speaking with a fertility specialist is necessary if you have been trying to conceive for longer than a year (six months if the woman is over 35). They can carry out essential investigations and assessments to determine the underlying reason of your secondary infertility.

Address Underlying Medical Conditions

Assisted reproductive technologies like in vitro fertilization (IVF) or hormone therapy may be suggested by your doctor depending on the underlying cause of the secondary infertility.

Make the Most of Your Lifestyle

Fertility can suffer from things like smoking, drinking too much alcohol, stress, and poor diet. Reproductive health can be enhanced generally by adopting good lifestyle habits like frequent exercise, a balanced diet, and stress-reduction measures.

Consider Fertility Treatment

Depending on the particular reason of your secondary infertility, fertility drugs or intrauterine insemination (IUI) may be advised as assisted reproductive technologies.

Get Emotional Support

There might be a big emotional cost to secondary infertility. To help you deal with the difficulties and stress of this journey, think about going to counseling or joining a support group.

Accessed from: ResearchGate website

Is It Harder to Conceive the Second Time?

Though there is a widespread belief that second-time conception is easier, secondary infertility can be just as difficult as primary infertility. Actually, some research indicates that compared to their first experience with conception, couples may be more susceptible to secondary infertility.

The possible challenges in becoming pregnant a second time can be attributed to age, underlying medical problems, and the combined effects of lifestyle choices. Further complicating the difficulties can be the emotional strain and stress linked to secondary infertility.

How Long Should You Wait to Get Pregnant with a Second Child?

When to begin trying for a second child is not set in stone because situations and circumstances can differ. But before trying again, most doctors advise waiting between 18 months and two years following the birth of your first kid.

The body of the mother has time to heal from the physical strains of pregnancy and delivery and to restock vital nutrients. It also gives couples the chance to get back into the mental and physical shape for another pregnancy and to adapt to the rigors of becoming parents.

Given that fertility falls more quickly as one ages, it could be wise to think about trying for a second child sooner if you are over 35. Talk to your fertility doctor about the best time for your particular circumstances.

Managing Secondary Infertility Requires a Multidisciplinary Approach

Overcoming secondary infertility often requires a comprehensive and multidisciplinary approach involving various healthcare professionals, such as:

Reproductive Endocrinologists

These medical professionals can assess and handle hormonal abnormalities, ovulation problems, and other underlying reasons of infertility.

Specialists in Urology

A urologist may be involved in the diagnosis and management of problems with sperm production or quality in cases involving male factor infertility.

Gynecologic Surgeons

A gynecological surgeon may advise surgical procedures if structural problems like fibroids or scar tissue are causing secondary infertility.

Mental Health Professionals

Secondary infertility may take a heavy emotional toll, and support groups or counseling can be quite helpful in helping one deal with the difficulties.

Overcoming Secondary Infertility

Recognize that treating secondary infertility is a process requiring a group of medical specialists and maybe several stages. Many couples are able to conquer secondary infertility and realize their desire of growing their family with time, persistence, and the appropriate help. Get in touch with our fertility specialists if you have any questions at all.


What is secondary infertility?

Secondary infertility is the inability to conceive after previously giving birth. It affects 10-15% of couples and can be emotionally challenging.

What are the main causes of secondary infertility?

Age-related decline in eggs (women over 35), uterine issues, hormonal imbalances, blocked fallopian tubes, and male factor infertility can all contribute.

How is secondary infertility diagnosed?

A fertility specialist will typically perform tests like blood tests, ultrasounds, and semen analysis to determine the underlying cause.

How long should we try to conceive before seeking help?

Couples under 35 can try for a year, while those over 35 may want to consult a specialist after 6 months of trying unsuccessfully.

Can lifestyle changes improve my chances of conception?

Yes. Maintaining a healthy weight, eating a balanced diet, exercising regularly, and managing stress can all contribute to hormonal balance and fertility.

  • Published on : Thursday June 20, 2024
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About the author

Michelle Tan is an IVF Consultant with 12 years of experience in fertility consulting. Having personally undergone IVF and surrogacy, she brings firsthand insight and empathy to her work. Based in Singapore, Michelle frequently travels to clinics in Bangkok, Phnom Penh, and Bishkek, sharing her expertise and supporting patients on their fertility journeys.