Secondary infertility, more common than primary infertility can be successfully treated.

Although most people think of infertility as a condition that affects couples who have never had children, in fact, even if you’ve successfully conceived before, you might have fertility issues later in life. Secondary infertility (the inability to conceive or carry a pregnancy to term after the birth of one or more children) is even more common statistically than primary infertility. According to the National Survey of Family Growth, more than 1 million couples struggle with secondary infertility.

Secondary infertility is often a “hidden” issue, as couples experiencing secondary infertility often find it difficult to gain understanding or sympathy from family, friends and relatives. Since they already have one child, most people assume that the couple will have no problem having another. Patients with primary infertility may resent couples who have a baby and believe their own pain would disappear if only they too could bear one child. Couples who are victims of secondary infertility are caught between two worlds, fertile and infertile — and can be excluded from both!

Causes of secondary infertility

Common scenarios for secondary infertility can include new relationships in which one partner experienced no problems with fertility previously or cases in which one or both members of the couple have developed fertility problems since the birth of their last child.
For women, this can include

• disorders of ovulation
• progression of endometriosis
• growths in the uterus
• or most commonly, an increase in age

Men can also experience a decline in fertility with age, although it is typically much milder than in women.

There can be many emotions involved in the diagnosis of secondary infertility. Some couples are shocked to find that they are unable to conceive a second child, especially if the first conception was very easy. Those couples who have had problems with infertility may feel significant anxiety and pressure initiating fertility treatments. Other couples may feel guilty about not being able to provide a sibling for their child or fear that they have waited until it’s ‘too late’.

Though couples who have had a previous pregnancy often think of themselves as ‘fertile’, this isn’t always the case. It is important to initiate a workup as soon as a couple is experiencing difficulty conceiving.

The workup for secondary infertility is the same as for primary infertility. A thorough history and physical examination, and evaluation of the uterine, ovarian, fallopian tube, and sperm status are critical. Your doctor can help you to make the right choice regarding further steps. As with primary infertility, treatments for secondary infertility are successful in most cases.