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Everything You Need to Know About Secondary Infertility
Article from medical experts from our clinic
2022-06-29

Everything You Need to Know About Secondary Infertility

It can be confusing, or difficult, to learn that you are experiencing secondary infertility. Not many people are familiar with it, as it is not a subject that is commonly discussed among friends and family members due to the stigma that often comes with the diagnosis. But we believe it is important it be discussed and known about, and that it is nothing to be ashamed of.

That is why we have created this guide on everything you need to know about secondary infertility, from answering basic questions like “What is it?” to suggesting causes, explaining how a diagnosis can be made, and showing you what treatments are available if you want to have a baby. Read on to learn more, or contact us now if you would like to set up a consultation with a discreet and understanding fertility specialist.

What is Secondary Infertility?

Secondary infertility is the term given to infertility that happens after you have already had a child or children. It means that even if you are trying to conceive naturally again, you are having trouble doing so.

What is the Difference Between Primary and Secondary Infertility?

Primary infertility is the term given to infertility that happens before a person or a couple has had children, meaning that they are having difficulties conceiving without ever having had a baby before. Secondary infertility differs because it means that the people involved have already had at least one child.

There are several similarities between the two types of infertility, which can often make people think of them as being the same. For instance, neither one is more common, and both primary and secondary infertility will normally be diagnosed after a year or more of trying without success. This time frame then falls to 6 months if the female partner is over the age of 35.

Primary and secondary infertility also share many of the same root causes, as these are often tied to health, lifestyle, and environmental factors. These factors might have changed between you having your child or children and trying to conceive again.

Common Causes of Secondary Infertility

It is important to note that either partner may be experiencing fertility problems, as the most common causes of secondary infertility are based on equally common factors that affect both men and women. In some cases, it may be that both partners are experiencing fertility issues at the same time.

Causes that may have an impact on both male and female fertility include:

  • Ageing (fertility declines with age, though the impact is more significant in women)
  • Alcohol use
  • Anxiety, depression, or stress
  • Drug use (including the use of tobacco)
  • Prescribed medications
  • Significant weight gain

Common Causes of Secondary Infertility in Men

The most common causes of secondary infertility in men, as well as nonbinary or transgender people who were male at birth, include:

Drugs That Affect Sperm Count and Quality

Certain antibiotics and medications, including those that treat high blood pressure, may play a role in male infertility. Sperm count and quality can also be affected by treatments for:

  • Arthritis
  • Certain cancers, including prostate cancer
  • Enlarged prostate
  • Fungal infections
  • Gout
  • Pain
  • Schizophrenia
  • Seizures
  • Stomach acid
  • Ulcerative colitis
  • Urinary tract infections (UTIs)

Having a Reduced Testosterone Level

Testosterone has a major role to play in sperm production, and it may become reduced in a male body due to ageing, injuries, or certain medical conditions. These conditions include:

  • Anaesthesia
  • Benign tumours
  • Blood diseases 
  • Burns
  • Coma
  • Congestive heart failure
  • Diabetes
  • Emotional stress
  • Genital infections
  • Mumps
  • Myocardial infarction (previous heart attacks)
  • Respiratory failure
  • Sepsis
  • Smallpox
  • Stroke
  • Surgery in the genital tract
  • The presence of mycoplasma (a type of bacteria)
  • Thyroid diseases
  • Tuberculosis

Excessive Weight Gain

Gaining a significant amount of weight can cause increased levels of oestrogen in the male body, while reducing the amount of testosterone.

Exposure to Chemicals and Radiation

Exposure to chemicals such as pesticides, heavy metals such as lead, and excessive amounts of heat can all impact on male fertility.

Late Onset Hypogonadism

This condition causes a reduction of hormone secretion.

Prostate Enlargement

Having an enlarged prostate can hinder normal ejaculation and cause a lower sperm count.

Prostate Removal

Having your prostate removed can sometimes cause retrograde ejaculation to take place. This is a condition where semen flows backwards into the bladder instead of out through the penis during orgasm, meaning you might ejaculate little to no semen when having sex.

Testicular Varicocele

This is an enlargement of the veins of the scrotum – the sack of the skin containing the testicles. It’s a common cause of low sperm production, as it increases the temperature inside the scrotal sac.

Use of Certain Sexual Lubricants

Certain sexual lubricants are actually toxic to sperm. Using natural lubricants should help you to avoid this.

Common Causes of Secondary Infertility in Women

The most common causes of infertility in women, or in nonbinary or transgender people who were female at birth, include:

Breastfeeding

If you currently have a baby under 6 months old and are feeding them only by breastfeeding (meaning you are not giving them formula, other foods, or pumping), you are unlikely to ovulate. Because of this, some people will choose to use it as a form of birth control. This birth control method is known as the lactational amenorrhea method, or LAM. 

Endometriosis

This is a condition where uterine tissues that would normally only grow in the uterus start to grow elsewhere, including places like the ovaries or the fallopian tubes. 

Issues with Your Fallopian Tubes

If you have blocked fallopian tubes, perhaps as a result of previous surgeries or an infection, eggs cannot travel from the ovaries to meet sperm cells or to become implanted in the uterine lining.

Low Quality or a Low Quantity of Eggs

People who are born female will be born with all the eggs they will ever have or need in their lifetime. The amount of eggs that they have decreases as they age, and the ones that remain will also decline in quality. There is also a higher chance that the remaining eggs will develop chromosomal issues.

Certain circumstances can also mean that younger people experience a lower number of good quality eggs. These include:

  • Autoimmune disorders
  • Genetic conditions
  • Having a low or diminished ovarian reserve (having fewer eggs than is expected of someone your age)
  • Prior surgeries
  • The side effects of radiation therapy or chemotherapy

Polycystic Ovary Syndrome (PCOS)

This condition is particularly common, and can cause irregular periods by preventing ovulation.

Uterine Issues

Several conditions and issues related to the uterus can be the cause of secondary female infertility. For instance, scars from surgeries (including Caesarean deliveries) may cause adhesions (bands of scar tissue) that could potentially interfere with future pregnancies. It is also possible to develop polyps (benign growths) in your uterus as you get older, which may have an impact on your ability to get pregnant.

Having a retained placenta (placenta that stays inside your body for longer than it should) may also cause infection or scarring that may impede your ability to get pregnant again.

Weight Gain

Significant weight gain can often lead to dysfunction in the ovaries, and certain diets can have an impact on a person’s fertility.

Secondary Infertility After Miscarriage

There is a common misconception that experiencing a miscarriage can make you infertile. This is simply not the case. It is actually more likely that a person who is having difficulty conceiving after a miscarriage has other, underlying issues related to their fertility. The miscarriage itself may therefore be a symptom of the problem, rather than the cause. 

The chances of experiencing a miscarriage after a miscarriage also increase, but this doesn’t mean that you will never be able to carry to term. Many people who experience this loss will go on to try again and have a child or children as a result. If you would like to do this, you will be able to as well; just remember to allow yourself time to grieve, and never feel pressured into trying again before you’re ready.

Secondary Infertility and When to Stop Trying

Ultimately, the only person who can tell you when to stop trying to have another baby is you. This decision will include your partner if you have one. But if you should decide that the process of trying has been too stressful and emotionally draining on everyone involved, or too expensive, or physically demanding to go through again, then no one should pressure you into doing more than you already have. 

Emotional Support for Secondary Infertility

We understand how overwhelming and hopeless going through secondary infertility can feel, and how lonely it can be if others around you are continuing to get pregnant. It can be especially devastating if friends and family members are not supportive, either because they feel you should be “grateful” for the child or children you already have, or simply don’t understand why you are not having more children. 

But it is important to remember that you are not alone. Many couples regularly experience trouble getting pregnant, and many are willing to talk and share their experiences with others. A range of support groups are available online and many therapists and counsellors specialise in this type of discussion. Each of these can be recommended by your doctor or a fertility specialist.

If you are going through this with a partner, communicating with them and seeking their support is also key. Remember that they are likely to be grieving as well, and will need your support as much as you need theirs. Sharing your fears and worries with them, and letting them share theirs with you, is a vital step in the process. If you feel it is necessary, you may think of attending couples’ counselling or therapy together, to address these.

Diagnosing Secondary Infertility

If you have been trying to conceive naturally for over a year (or 6 months if you are 35 years of age or older) without success, consider speaking to your doctor or healthcare provider, or getting advice from a fertility specialist. This may open up a range of options for tests, investigations, and professional treatments that may help you to take the next step on the way toward expanding your family.

Your doctor should be able to help you spot any changes that have happened since your previous pregnancy, and may decide to carry out examinations or conduct tests that may determine the cause of any fertility issues. For female patients, this may mean undergoing blood tests or ultrasound scans to determine ovarian reserve, while male patients may be asked to undergo a semen analysis.

These assessments are also available as Male and Female Fertility Assessments at GENNET City Fertility. In both of these expertly performed, straightforward tests, you will be offered the diagnoses and reassurance that you need – as well as the advice on how to move forward that you have been looking for. If you have a partner and would like to make the assessments more affordable before you start your fertility journey, you can also have them combined into a Couples’ Initial Consultation Package.

Treatment Options for Secondary Infertility

If a diagnosis has been made which suggests that lifestyle changes will not work to improve your fertility (e.g. switching to a healthier diet, getting regular exercise, etc.), then a doctor or specialist may instead recommend a range of different fertility treatments. Each of these treatment options may help you to manage, cure, or circumvent the causes of secondary infertility that are preventing you from having a baby:

  • Antibiotics and other treatments for infections
  • Assisted reproductive technologies (ART); these treatments include in-vitro fertilisation (IVF) and intrauterine insemination (IUI)
  • Hormone treatments and medications; these are often used to help induce ovulation in those with ovulatory disorders
  • Surgery; this may help to correct or manage scar tissue, polyps, or fibroids in female patients and testicular varicocele in male patients

How We Can Help at GENNET City Fertility

We can offer a variety of different treatment options that may help cases of secondary infertility. Once you have been through an initial assessment and consultation with us, we will be glad to talk you through the kinds of care we can provide, so you can start to consider the treatments you would like to try and feel comfortable undergoing. Everything you decide on will then help to form a bespoke treatment plan that’s suited to you.

The fertility treatment options you can decide on at our private clinic in London include:

Book a Consultation

If you have been hoping to bring another child into your family but feel as though you may need some help doing so, please do not hesitate to get in touch. Our friendly team will be ready and waiting to book you in for a free, 30-minute mini consultation with one of our fertility specialists. This will help us to learn more about what we can do to help you overcome or circumvent secondary infertility.

After your initial assessment and a discussion about your medical and fertility history, our specialist will be able to present you with a range of options for further tests, assessments, and treatments that are likely to be beneficial in your circumstances. Any of these that you would like to try will then go to form part of a treatment plan that’s tailored to you so that you will always receive the care that suits you and your needs best.

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Article from medical experts from our clinic