As mamas, we all have different ideas about what the perfect family looks like: for some of us it’s just one chick in the nest and for others it’s a whole brood!
But what about when the nest doesn’t seem to be filling up like you’d hoped? If you’ve been trying for a second baby for a while and things aren’t working out, it could be that you’re experiencing secondary infertility.
We know that struggling to conceive can be a really tough and isolating experience, and it can seem all the more confusing when you’ve already had one or more children before. That’s why we’ve put together the key facts about secondary infertility here, to help you navigate this difficult time. We’re here for you, always.
Primary vs secondary infertility
Secondary infertility means that you’re unable to conceive or carry a baby to full-term (the point when they’re fully grown and ready to be born), despite the fact that you’ve had at least one little peanut in the past. Usually, you’ll have been trying for a baby for a year – six months if you’re over 35 years old – before secondary infertility is diagnosed.
In contrast, primary infertility is where you haven’t been able to conceive or carry a full-term baby at all, after trying for at least 6 months.
Both primary and secondary infertility are painful experiences to go through for many women and their partners. However, it can be especially hard to get support when you’re experiencing secondary infertility and the condition is often misunderstood. Unsympathetic responses like “But you already have a child…” just aren’t helpful.
How common is secondary infertility?
A lot of the data on infertility doesn’t have separate primary and secondary infertility statistics. For example, the CDC reports that 12% of women in the US struggle to conceive or carry a pregnancy to term. It’s also estimated that at least 50 million couples across the world go through infertility.
However, a 2010 study that took into account multiple national health surveys from different countries suggests that secondary infertility is actually more common than primary infertility. The researchers found that, globally, 10.5% of women experienced secondary infertility while only 2% experienced primary infertility.
What causes secondary infertility?
Secondary infertility shares many of the same causes as primary infertility. Conception – the process of the egg and the sperm meeting in just the right way to make a baby – has different stages, and a problem at any of those stages can result in infertility.
So, what are some of the causes of infertility in women and men?
Causes of infertility in women
Infertility in women is often linked to a problem in one of three key areas: ovulation (release of an egg from the ovaries), the fertilized egg’s journey down one of the fallopian tubes, and the attachment of the fertilized egg to the wall of the uterus.
- Ovulation: One of the most common reasons behind women’s infertility is PCOS (polycystic ovary syndrome), where the body produces too many hormones and this gets in the way of the ovaries releasing their eggs. Other conditions that can cause ovulation problems include POI (primary ovarian insufficiency), thyroid disorders, and reduced ovulation related to age.
- Fallopian tubes: For conception to be successful, the egg has to meet the sperm in one of the fallopian tubes, get fertilized, and then travel down to the uterus. If the tubes become blocked (for example, with scar tissue following pelvic inflammatory disease or severe endometriosis) then the egg may not be fertilized or may not be able to reach the uterus.
- Uterus: Sometimes the shape of the uterus or the state of the tissue that lines it can make it more difficult for an embryo to implant and grow into a baby. Scarring from a previous C-section (also called isthmocele) can also cause problems.
Causes of infertility in men
For men, infertility can be linked to:
- Issues with sperm: If a man isn’t producing enough semen with a high enough sperm count, or there’s a problem with the sperm’s shape or movement, this can reduce the chances of a healthy sperm cell meeting the egg to fertilize it.
- Medical conditions: Conditions such as varicocele (swollen veins around the testicles) or low testosterone production can impact a man’s fertility.
- Medical treatments or drugs: For example, chemotherapy as a cancer treatment, calcium channel blockers for high blood pressure, or recreational drugs.
For both women and men, lifestyle factors can sometimes play a part in infertility: for example, not getting the right nutrients in your diet, and regularly smoking or drinking alcohol. The good news is that getting the support for lifestyle changes could improve the chances of conceiving.
Secondary infertility treatment: What are your options?
If you think you’re experiencing secondary infertility, the next step is to visit your doctor. They’ll be able to test you and your partner, and find out where the issue lies.
For you, this could involve blood tests, a pelvic exam, ovulation tests, and an X-ray of your fallopian tubes. Once the problem has been spotted, your doctor will then be able to discuss possible treatments. These could include:
- Medication: For example, PCOS can be effectively treated with medication to bring about ovulation (sometimes in combination with lifestyle changes), which allows up to 70% of women with the condition to have successful pregnancies.
- Surgery: Surgical procedures may be used to treat scarring in the uterus (for example, from a previous C-section) or to remove large uterine fibroids (non-cancerous growths that can, in rare cases, stop a fertilized egg attaching to the wall of the uterus).
- ART (Advanced reproductive technology): Fertility treatments that can boost your chances of conceiving include IUI and IVF. With IUI, the sperm are inserted directly into your uterus around the time that you’re ovulating. With IVF, your eggs and your partner’s/a donor’s sperm are collected and used to make embryos in a lab, which are then implanted in your uterus.
An estimated 15–30% of couples are diagnosed with “unexplained infertility” (where the doctors just can’t figure out what’s wrong), but many do still go on to conceive eventually, without treatment.
Staying positive during this time
There’s no denying that the experience of secondary infertility is challenging: conflicting emotions, tiring doctor’s appointments, and (sometimes) intrusive treatment.
But the key, if possible, is to stay hopeful and be kind to yourself. You could even seek out secondary infertility success stories on Peanut for a little inspiration.
If you’re sharing your fertility journey with a partner, remember to connect with them and make sure you listen to each other on the road. On the other hand, if you’re going it alone, look for support from family, friends, and other women.