Secondary Infertility: Causes, Tests and Treatment

Secondary Infertility

Conceiving a first child may seem quite a simple and straightforward matter for most couples. When you decide to add a new member to the family, and you find it difficult to conceive, it can come as a shock. It may leave you confused, and you could start having doubts about your capability to give a brother or sister to your child.

What is Secondary Infertility

The couple’s failure to conceive a baby, in spite of being parents of a healthy child, refers to secondary infertility. The first child may be their own or with a different partner. The fact that they have been able to give birth to a child successfully can give rise to many physical and emotional upheavals. It is also because you may not know how common secondary infertility is. The realisation can be pretty disheartening, especially if all your friends have managed to complete their families with a second child.

At such a low time, it is important to know that secondary infertility in women is common. In fact, secondary infertility is more common than being unable to conceive for the first time. About one in seven couples face this problem. As you would have guessed, older women face this problem because of age and fertility issues.

How Long Does it Take to Conceive after Your First Child’s Birth

The amount of time it takes you to conceive after delivering your first baby depends on whether you are breastfeeding yet or not? Ovulation can suppress since breastfeeding and the hormones needed for producing milk possess these qualities. If a woman isn’t breastfeeding her baby, it may take at least six weeks for the ovulation to begin. However, mothers should ideally maintain a gap of a year to 18 months between pregnancies. An earlier attempt to get pregnant can result in premature delivery and low birth weight for the baby.

Causes of Secondary Infertility

There could be many causes of secondary infertility which is why conceiving the second time could be difficult. You may be having a previous complication that may have metamorphosed into a larger one. There is a probability of developing a new infection or a surgical procedure which could have affected your capability to sire children.

A few other issues which could interfere with your fertility are:

Tests for Secondary Infertility

Tests for female infertility are helpful in determining if your reproductive tract allows the egg to pass into the fallopian tube and fuse with the sperm. These tests also check if the ovaries are releasing the healthy eggs. Apart from the general gynaecological examinations, you will have to undergo other tests for unexplained secondary infertility. These include:

  • Hysterosalpingography: This test is carried out to understand the condition of the fallopian tubes and uterus. It also checks for blockages if any. This test is done by injecting X-ray contrast into the uterus, and an X-ray is taken to know if the cavities are filled properly.
  • Ovulation testing: This is a blood test that determines your hormone levels to know if you are ovulating correctly.
  • Hormone testing: These tests check the levels of pituitary hormones and ovulatory hormones which are responsible for reproductive processes.
  • Ovarian Reserve testing: This testing is carried out to check the quantity and quality of eggs needed for ovulation.
  • Imaging Tests: These tests include a pelvic ultrasound which analyses fallopian or uterine diseases and infections.
  • Genetic testing: This test is conducted to know if there are any genetic defects which are responsible for infertility.
  • Laparoscopy: This is a small surgery that helps in identifying any irregularities in fallopian tubes, problems related to the ovaries or uterus, endometriosis and scarring blockages. A small incision is made just below the navel, and an ultra-thin viewing device is inserted to examine the uterus, ovaries and fallopian tubes.
  • Hysteroscopy: In a hysteroscopy, a tiny lighted device is passed through the cervix to reach the uterus. It is helpful in viewing any abnormalities and can detect uterine diseases.


The following are the conventional methods of medications used to address problems related to secondary fertility:

  1. Intrauterine Insemination (IUI)

During this procedure, healthy sperm is inserted directly into the uterus. This is done at the time when the ovary releases the eggs for fertilisation. The IUI timing is usually matched with the regular ovulation cycle and to suit fertility medicines.


2. Fertility Drugs

Women who are infertile due to ovulation disorders are treated with fertility drugs. These drugs helping in inducing and regulating ovulation. You can speak to your specialist about the various types of drugs available and understand the benefits and risks each one carries.

3. Hysteroscopic Surgery

This surgery can successfully treat uterine issues like uterine septum, intrauterine scars and endometrial polyps.

Can Changing Diet and Lifestyle Help

Yes indeed. Your current lifestyle, eating habits, the diet you follow and your sleep patterns can be equally responsible for your secondary infertility. If you have put on weight or lost weight since the time of your first delivery, it may become harder for you to become pregnant. If you and your partner follow a fast lifestyle that includes smoking, drinking and late nights, it is best to curtail them. A healthy lifestyle could make a major difference in your capacity to conceive a baby.

How Can You Deal with Secondary Infertility?

If you are dealing with secondary infertility, there are certain ways of coping with it successfully:

1. Understand the physical and emotional changes since your firstborn

Your body goes through several changes as you age and your egg quality and fertility declines. Medications, weight gain, stress etc can also contribute to the inability to conceive.

2. Create a plan

Plan with your partner about your next steps. You can consider what approach you would prefer, IVF, egg donor or fertility treatments and check if you have the budget for it.

3. Seek medical attention proactively

Visit a fertility specialist if you are concerned about your fertility. Your fertility will keep declining as you age and hence, seeing a doctor can be beneficial to plan remedial measures.

4. Learn about the tests you will undergo

Stay informed about the tests that you may have including ultrasounds, blood tests, X-rays etc to determine the cause of infertility. Your partner may also have a semen analysis which checks the quality and count of the sperm.

5. Plan your logistics if you are planning to undergo treatment

Fertility treatment can require frequent tests and visits to the doctor. During this time, ensure that you have planned ahead to tend to your other commitments, including kids and work.

6. Accept your feelings

It is okay to be angry, sad or frustrated about this. But ensure that you seek help from a professional or join support groups to help you through this.

7. Get ready to answer some tough questions and prepare some stock answers

Prepare your answers for family and friends who ask about when you’d be having another baby.

8. Focus on the moment and enjoy time with your child who is with you now

Don’t let the worry of tomorrow rob you from the pleasures celebrating your little one who’s with you now.


When Should You Visit Your Doctor

You will need to meet up with your doctor if you have been having normal sexual relations with your partner without contraception for a year and you are still not pregnant. Your partner should join you for this visit since it is a joint responsibility. It is also important to treat secondary fertility when you are at a slightly advanced age or are suffering from a condition that could affect fertility. In such cases, you should make a trip to the doctor earlier than you anticipate.

What Are the Chances of Success

More than often, it is the age of the female that is responsible for the likelihood of success. If the female is below the age of 36 then the chances are bright. However, females of age 38 and above may not have similar success. Not giving up after a couple of months of treatment is the key to improving your chances of success. Remember the first time when you were trying to conceive? You didn’t give up after the first few months, did you?

Most of the times a few years have passed since your first child. It is well-known that the older you get, the more difficult it is to conceive. You may have put on weight, had surgeries or your partner’s sperm quality and quantity has deteriorated too. If your sex life is good and yet you are unable to conceive, it is time to meet a good doctor. It is best to sit down together and create a time frame for all that will happen in the next few months. Know how much money you need and what options you will consider.

Also Read: Unexplained Infertility

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