When Conceiving Baby #2 Isn’t as Easy as Expected: Secondary Infertility and What You Need to Know

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This post is presented by VIOS Fertility Institute whose philosophy is to bring the science of medicine and the art of care to each patient in a customized, welcoming and reassuring atmosphere. Everyone’s fertility journey is different. At VIOS, their team approach focuses on helping you navigate the journey and make your dreams of parenthood a reality. Today’s featured author is Dr. Ellen C. Hayes, a board certified Reproductive Endocrinologist. 

April 21-27, 2019 is National Infertility Awareness Week (NIAW) and this year’s theme is #InfertilityUncovered. Infertility does not discriminate, and anyone can be affected. This week especially and every day throughout the year, we look to educate on fertility health and help remove the stigma of infertility.

Secondary Infertility :: Why Does it Happen?

As a Reproductive Endocrinologist at Vios Fertility Institute, I speak with these couples every day who are having difficulty getting pregnant. Some of the most frustrated patients I see are those that have had a successful pregnancy in the past but are now unable to conceive. This is referred to as secondary infertility (versus primary infertility where no successful pregnancy has occurred before). It is estimated that approximately 3 million women in the United States may be affected by secondary infertility making it much more common than most people realize.

Age Can Be a Factor in Secondary Infertility

There can be very good reasons why someone who easily conceived before may have more trouble the second time around. Certain problems may arise or become worse over time that can have a significant impact on female or male fertility. The most common reason for secondary infertility is age. Men and women can both experience changes in their fertility as they get older, resulting in problems with sperm or egg quality and quantity. As women reach their mid to late 30s, they often start to experience a decline in their supply of eggs. The quality of their remaining eggs can also become an issue making it more difficult to get pregnant naturally. Men typically won’t see significant changes in their sperm quality until they reach their mid to late 40s or beyond.

Life Happens, and so Does Secondary Infertility

Secondary infertility can be caused by changes in lifestyle, such as weight gain or stress, which can affect ovulation. Problems with the female reproductive organs resulting from previous surgery, a pelvic infection, development of uterine fibroids or polyps are also a factor. Women diagnosed with endometriosis can also have a harder time conceiving a second time at an older age due to worsening symptoms that can lead to scar tissue affecting the uterus, ovaries, and fallopian tubes. In addition to changes in sperm quality, as men get older, they more frequently experience problems with erectile dysfunction and ejaculation that can make it difficult to have intercourse with their partner.

What to Do about Secondary Infertility

Secondary infertility is a very stressful and emotional problem. When compared to those with primary infertility, individuals with secondary infertility often wait longer to seek medical help or never see a doctor at all. Many of them wait because they assume that conceiving easily in the past means that they will have a similar experience when they try for pregnancy again. Unfortunately, it is very common for those with secondary infertility to feel ashamed or even feel ungrateful for the child they already have, and this can also lead to a delay in seeking help from a doctor. It is very important to remember that wanting to have another child does not mean that you do not love and appreciate the child or children that you already have. It simply means that you have your own idea about what a complete family means for you.

For the most part, secondary infertility is evaluated and treated just like primary infertility. It is appropriate for a woman who is <35 years old to try for pregnancy for one year before seeking help from her doctor, while women age 35 or older should be seen for an evaluation after 6 months of attempting pregnancy. If you have been trying for longer than the recommended 6-12 months, a fertility specialist will recommend routine testing for both the female and male partner. These tests will check the ovarian reserve (egg quality and supply), the sperm count and quality, as well as the anatomy of the woman’s reproductive organs with an ultrasound or other imaging tests. It is usually possible to have testing as well as a follow up visit with your fertility physician to discuss your test results all completed within one month (or menstrual cycle) allowing you to have your questions answered and an individualized treatment plan in place very quickly.

Finally, it is important to understand that whether it’s primary or secondary infertility, having difficulty getting pregnant can place a great deal of emotional stress and strain on a couple or individual so remember that you are not alone in this process. Don’t be afraid to seek out support from friends, family, support groups, or a therapist. At Vios Fertility Institute, we recognize how difficult this process can be and we can help you find the answers and support you need. Every member of our Vios team is here to help guide you through this journey to help you realize your dream and complete your family.

As a board certified Reproductive Endocrinologist with Vios Fertility Institute, Dr. Ellen C. Hayes is dedicated to assisting patients experiencing infertility issues. For over 15 years, she has been providing compassionate, individualized care to her patients with access to the most advanced, state-of-the-art treatment options available.


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