Secondary infertility is when you’re unable to get pregnant or carry a pregnancy to term after previously
giving birth. Fertility specialists typically diagnose secondary infertility after a couple tries to conceive for
six months to a year.
What are the signs of Secondary Infertility ?
The main sign of secondary infertility is being unable to get pregnant after having one or more biological
children. If you’re younger than 35, specialist may suspect secondary infertility after one year (12
months) of having regular, unprotected sex. If you’re older than 35, doctor may classify it as secondary
infertility after six months of regular, unprotected sex.
What are the common causes of Secondary Infertility ?
Secondary infertility can affect one or both partners and can be due to multiple factors. In fact, the cause
of secondary infertility is equally split between assigned sexes and unknown causes.
Most common causes are :
- Poor quality and quantity sperms and eggs.
- Age.
- Complications from a previous pregnancy.
- Complications from a previous surgery.
- An increase in body weight or BMI (body mass index).
- Medications or other medical conditions.
- Sexually transmitted infections (STIs).
- Lifestyle factors like excessive weight gain, drinking alcohol and smoking cigarettes, drug abuse,
tobacco use.
Female Factors
Problems in the quantity or quality of eggs.
Women are born with a limited supply of eggs and can’t create new eggs. As you approach your 40s, the
number of eggs left in your ovaries decreases, and the remaining eggs have a higher chance of having
chromosomal problems.
Autoimmune or genetic conditions and prior surgery or radiation are other reasons a person may have a
low number of good-quality eggs.
Structural issues (like scars or blockages)
Infections and surgery can cause damage to parts of your fallopian tubes or uterus. Your fallopian tube
carries an egg to your uterus. Complications from infections like chlamydia, gonorrhea and pelvic
inflammatory disease (PID) can block your fallopian tubes.
Similarly, certain conditions can affect your uterus and cause secondary infertility. Scarring from certain
procedures can interfere with pregnancy. These procedures include dilation and curettage (D&C) or Csection delivery. Uterine fibroids or polyps can also block portions of your uterus, impairing a pregnancy
Polycystic ovary syndrome (PCOS)
PCOS is a hormonal condition that causes irregular and infrequent menstrual periods. Most people with
PCOS don’t ovulate regularly, which can affect their ability to conceive.
Endometriosis
Endometriosis is a condition where tissue that normally grows inside your uterus grows in your ovaries
or other body parts. While endometriosis is common, not all endometriosis causes infertility
Weight gain or other lifestyle changes
Weight gain can lead to ovarian dysfunction in some people. Medications or treatments for certain
conditions can also contribute to infertility. Things like smoking cigarettes or drinking alcohol can also
impact ovulation and conception.
Male Factors :
Causes of secondary infertility in men often include issues with hormone levels, certain medical
conditions and lifestyle factors.
Reduced testosterone level
Testosterone plays a key role in sperm production. Testosterone levels can decline due to aging, injury to
your testicles or certain medical conditions. These conditions include Genital infections, Thyroid
diseases, Diabetes, Tuberculosis, Mumps, Smallpox, Blood diseases, Benign tumors, Emotional stress,
Myocardial infarction (heart attack), Coma, Stroke, Respiratory failure, Congestive heart failure, Burns,
Sepsis.
Hypogonadism affects 2% of all men which means low and is more common once you’re over 40 years
old.
Testicular varicocele
Testicular varicocele is an enlargement of veins in your scrotum, or the sack of skin encasing your
testicles. This condition is a common cause of low sperm production and infertility in men and people
AMAB — about 30%.
Poor-quality semen
Semen is the fluid that carries sperm. After age 40, the quality of semen tends to decline.
Low sperm count
Healthcare providers consider less than 15 million sperm per milliliter of semen to be a low sperm count.
You may hear them call this condition oligospermia.
Prostate enlargement or removal
An enlarged prostate can lower sperm count and cause abnormal ejaculation. If your provider removes
your prostate due to cancer or other conditions, it can cause semen to flow backward.
Certain drugs affect sperm count and quality
These drugs include some antibiotics and medications that treat high blood pressure. Treatments for the
following conditions can affect sperm quality:
Prostate cancer, Fungal infections, Urinary tract infections, Ulcerative colitis, Arthritis, Gout, Pain,
Cancers, Seizures, Schizophrenia, Lifestyle factors or chemicals
Certain lifestyle factors, including exposure to chemicals that damage sperm, can cause infertility. Some
of these include:
Using natural lubricants that are toxic to sperm. This includes certain oils and petroleum jelly.
Being exposed to pesticides, lead, industrial chemicals and excessive heat can all impact fertility.
Gaining a large amount of body weight. This can decrease testosterone levels and increase estrogen
levels.
What next to be done ?
If you suspect secondary infertility, schedule an exam with your FERTILITY SPECIALIST. Early evaluation is
critical to ensure the widest variety of treatment options. They will :
- Review your medical history to determine if anything has changed since your previous
pregnancy. - Discuss your menstrual cycles to determine if you’re ovulating and producing eggs.
- Evaluate if certain diseases are affecting sperm count or sperm quality.
Diagnostic modalities for Secondary Infertility ?
- A semen analysis.
- Blood tests to look at hormone levels.
- A transvaginal ultrasound.
- A hysterosalpingogram, a type of X-ray that allows to see your uterus and fallopian tubes
Available treatment options
- LABLE TREATMENT OPTIONS –
- Ovulation induction (OI)-
- Medications to induce ovulation in people who aren’t ovulating regularly.
- Intrauterine insemination (IUI), which involves placing sperm inside your uterus to increase the
chance of fertilization. - In vitro fertilization (IVF), a process that involves retrieving eggs from ovaries and manually
combining them with sperm in a lab for fertilization. - Surgery to repair uterine-related complications such as removing scar tissue, polyps and fibroids.
- Surgery to repair testicular varicocele. This is the most surgically correctible cause of male
infertility.
Can secondary infertility be corrected ?
Yes, there are many treatment options for secondary infertility. Your fertility specialist can work with you
on a treatment plan that works for you based on your diagnosis and goals.
you can get pregnant with secondary infertility. It’s a common condition that usually results in pregnancy
with treatment.