The Everywoman Cliniq

Secondary Infertility

Secondary infertility is defined as the inability to become pregnant, or to carry a pregnancy to term, following the birth of one or more biological children. The birth of the first child does not involve any assisted reproductive technologies or fertility medications.

Unfortunately, because couples experiencing secondary infertility already have a child, their struggle is often downplayed or even ignored by friends, family, couples experiencing primary infertility, and even doctors.

Assuming that infertility "can't happen" to them, a couple experiencing secondary infertility may delay seeking help for their problems getting pregnant, and wait longer than the recommended 6 months for women over 35, or longer than a year for women younger than 35

Secondary Infertility

But delaying testing and treatment may mean a lower treatment success rate, as some causes of infertility worsen with time.

Secondary Infertility Causes

Secondary infertility is caused by the same problems that lead to primary infertility. Those causes include:

Male infertility due to low or absent sperm count, problems with sperm shape (also known as sperm morphology), or problems with sperm movement (also known as sperm motility).

  • Problems with ovulation, whether irregular ovulation or anovulation.
  • Blocked fallopian tubes.
  • Endometriosis.
  • Fibroids.
  • Recurrent miscarriage.

About one-third of infertility cases are related to male infertility, another third are related to female infertility, and another third are related to problems in both the man and woman, or remain unexplained.

You may be wondering why you're having trouble this time, when you didn't have trouble in the past. It's a good question, but one that unfortunately may not have an answer.

Age may be a factor, especially if you were a lot younger when you had your first child, or you had a late start to your family building. Some causes of infertility may worsen over time, like endometriosis or growing fibroids. If you've gained significant weight since your first child, that can also lead to problems conceiving.

But just as often, there are no obvious reasons why you can't conceive this time as compared to last time.

The emotional side of secondary infertility

Physicians, too, may downplay the possibility of secondary infertility in their previously fertile patients and encourage the couple to "keep on trying." The emotional experience of secondary infertility often is a compilation of the distressing feelings of anger, grief, depression, isolation, guilt, jealousy, self-blame, and being out of control. You may feel guilty for experiencing normal grief and worry about how your current emotional state will affect your existing child. The powerlessness to produce a sibling for the existing child often produces feelings of sorrow, as does the inability to perpetuate the parenting role. You may feel distant from friends as those who were a great source of support when parenting the first child are now linked to sensations of pain and jealously.

Sadly, couples with secondary infertility tend to receive less social support from others than couples who have primary infertility because the infertility is unacknowledged, the pain associated with infertility is invisible as the couple has a child, and there is no concrete loss in the family. In addition, couples experiencing secondary infertility may be recipients of criticism by others who think they should be grateful for one child and that it is foolish to go to extremes to increase family size. Of course, a couple can be extraordinarily thankful for their existing child and still long for more children.