What is Secondary Infertility?

Secondary Infertility FAQs: Answered by Dr Gayete-Lafuente 

Q: I became pregnant naturally before. Why am I having difficulty now?

A: This is a really common question I hear from infertile patients with kids. When someone has conceived in the past but is now having difficulty becoming pregnant, we call this secondary infertility.

A previous pregnancy is reassuring, but unfortunately, it does not guarantee that fertility will remain unchanged. Our reproductive health can evolve over time, and several factors may be different now.

Q: What can cause secondary infertility?

A: Of course, one important factor is age, especially the more years pass between pregnancies; but other possible causes include changes in ovulation, diminished ovarian reserve, uterine fibroids / polyps or scar tissue after a previous pregnancy (from delivery or from D&C), or blocked fallopian tubes. In fact, lregnancy, delivery, pelvic surgery, or infections related to obstetric processes may also itself occasionally affect the reproductive tract and ability to conceive next.

Q: Could the problem be related to my partner?

A: Yes, of course. Fertility is never only a female issue.

Sperm count, movement, or quality can change over time, even if the male partner previously conceived without difficulty. This is why we recommend evaluating both partners from the beginning.

Q: When should I see a fertility specialist?

A: If you are younger than 35, an evaluation is generally recommended after 12 months of trying without success.

If you are 35 or older, we recommend seeking help after six months. 

And if you are in your 40s, or if you have irregular periods, endometriosis, prior pelvic surgery, recurrent pregnancy loss, or another known fertility concern, it is reasonable to seek advice sooner.

YES! Even if you have a previous child!

Q: Does secondary infertility always mean that I will need IVF?

A: No. Treatment depends on the cause, your age, how long you have been trying, and your family-building goals... with a plan that should always be individualized.

Q: Why does secondary infertility feel so emotionally difficult?

A: Many patients feel confused, guilty, or isolated. Others feel that they should not be upset because they already have a child. Friends and family may also unintentionally minimize the experience when infertility affects couples that are already parents.

But secondary infertility is a real medical condition, and your emotions are completely valid. Your struggle does not matter less because you have conceived before. 

If pregnancy is taking longer than expected, speak with your OB-GYN or a fertility specialist. We may be able to help! 

If you're interested in learning more, listen to The Egg Factor episode with Dr. Gayete-Lafuente here.