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Secondary Infertility

Secondary infertility is when a couple are having difficulty getting pregnant, after having had a child through natural conception in the past.It’s natural to presume that, because you’ve had a child before, conception will be just as easy, if not easier, the second or third time around. It may surprise you to know that secondary infertility is just as common as primary infertility, so you are not alone.Secondary infertility can affect both men and women and there are a variety of possible causes. As with primary infertility, there are options that can help, so it’s advisable to contact your doctor.

What are the common causes of secondary infertility in women?

• Fertility declines significantly with age, so a woman who had no difficulty conceiving the first or second time around, in her 20s or early 30s, may have trouble conceiving again later, especially after the age of 35. This is due to having less eggs and fewer good quality eggs.

• If a woman’s fallopian tubes have been blocked or damaged since her previous pregnancy, the eggs may be unable to travel to the ovaries successfully.

• A woman’s lifestyle may have changed since her previous pregnancy – weight gain, medication or an increase in alcohol or tobacco may cause secondary infertility.

• Scar tissue build up from having had a C-section with a previous birth may cause difficulty conceiving

• The onset or worsening of conditions such as endometriosis or Polycystic Ovary Syndrome

There may be a combination of different factors causing the secondary infertility.

What are the common causes of secondary infertility in men?

• A low or lower sperm count, which can be caused by taking certain prescribed medications

• Lifestyle changes – including an increased intake of alcohol or tobacco or the taking of drugs

• Abnormal sperm – issues with the shape or motility of sperm

• A varicocele, quite common in men, can alter the production of sperm, as it raises the temperature in the testes.

How will I know if I have secondary infertility?

If you are a woman over the age of 35 and have been trying to conceive for 6 months, you should consult a doctor. If you are under 35, you should consult a doctor after 12 months of trying. If, however, you have developed symptoms since your last pregnancy that you think may also be causing infertility, you may decide to seek advice earlier, for example, if you are having heavier or more painful periods.

Visiting the doctor as a couple will allow the doctor to quickly assess any immediate indicators and also to advise you on the best course of action moving forwards.

The doctor may then do fertility tests to establish egg count, sperm count and the shape and motility of the sperm.

What treatment is available for secondary infertility?

Secondary infertility is treatable and couples often go on to have a successful pregnancy afterwards.

The treatment is very much dependant on any diagnosis, but even with unexplained secondary infertility, you have options as a couple to choose ART  (Assisted Reproductive Techniques).

ART treatments include:

• Intrauterine Insemination (IUI) When the female partner is around ovulation time, the male partner will be asked to produce a sperm sample, which the doctor places into the female partner’s uterus.

• In Vitro Fertilisation (IVF) The woman’s ovaries are stimulated with drugs via daily injection, so that more eggs can be collected. The sperm and eggs are then joined together in petri dishes in a lab. After 3-5 days of growth, any viable embryos are put back into the uterus.

• Intracytoplasmic Sperm Injection (ICSI) This is used to assist when the male partner has very poor semen quality or untreatable testicular failure, as sperm can be removed from the testicle or epididymis by surgery. A single sperm is injected into the egg, then the egg is put in the female partner’s uterus.  

As with primary infertility, these ART methods have varying success rates, but they do result in many couples being able to become parents, even with fertility issues. Our subsequent blog will explore further the causes and treatment of male infertility.

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