Common Causes & Treatments for Secondary Infertility

What is secondary infertility?

This kind of infertility happens when couples who already have a child struggle to get pregnant again. Primary infertility is when couples struggle to get pregnant for the first time. A recent research study shows that about 11% of people and 1 in 6 couples struggle with infertility.

Causes of secondary infertility?

There are various causes of secondary infertility. First, fertility often changes with age for both women and men. Besides age, developing and pre-existing medical conditions and other environmental factors can contribute to secondary infertility.

For men,  sperm production and function can sometimes decrease with age. A man can also develop medical conditions that influence his sperm.  This means that a man who once fathered a child can have problems fathering more children.

In most societies, women often receive the blame for secondary infertility, but statistics show that male infertility is just as common as female infertility. Couples need to seek medical intervention together from their fertility doctors. In detail, factors that cause infertility include:

• Age: The quality and quantity of a women’s eggs decrease as she grows older. With age, the risk of miscarriage increases, and her chance of conceiving decreases. At 35 years of age, a woman has only a 15% chance to get pregnant each month. This chance decreases further as the woman ages. For men, fertility falls beyond the age of 45 years. According to scientific studies, older men have a high chance of having genetic sperm defects. These genetic defects can predispose a woman to miscarriage, or cause genetic conditions in children. Some complex traits such as autism or schizophrenia are more common in children of older fathers.
• Previous Deliveries: Complications occurring from previous pregnancies and deliveries can negatively affect future pregnancies.
• These complications include scar tissue development in the fallopian tubes and uterus.
• Lifestyle Changes: Other lifestyle changes can lead to a decrease in sperm and egg quality. These changes include weight gain, alcohol misuse, and also cigarette smoking.
• Medical conditions such as diabetes
• Endometriosis
• Fibroids
• Other hormonal issues
• Uterine tubal factors

When should couples seek advice for secondary infertility?

Most couples who suffer from secondary infertility are older than those seeking a diagnosis for primary infertility. Time may be of the essence to find solutions for secondary infertility.

In women who are 35 years and above, the oocytes face fatigue-related metabolic issues. Older oocytes often have problems forming healthy embryos. When aging oocytes and other fertility barriers are combined, couples facing secondary infertility find it more challenging as technology commonly used to assist them like IVF is less well suited to address these concerns.

IVF does allow a woman with poor egg quality to produce more eggs each cycle, improving her chance of finding healthy eggs. IVF success rates vary meaningfully with a woman’s age. You should consider having a thorough checkup for you and your partner earlier than later if you are over 35 years old and suffering from secondary infertility.

If you are a young couple, you should consider medical intervention after 12 months of trying to conceive. To get rid of the anxiety and worries that come with secondary infertility, people should consider getting a full medical evaluation from a fertility expert.

Treatment options for secondary infertility

Treatment for secondary infertility goes hand-in-hand with those for primary infertility. After you visit a fertility expert and get a medical evaluation, your doctor will give an insight into the best treatment options for you. In-vitro fertilization (IVF), is a reasonable treatment option for couples who are 35 years or older, or for those couples who have had three or more consecutive miscarriages.

In IVF, pre-implantation genetic testing of embryos (PGT-A) can be of great assistance in finding and selecting out embryos that have the best chance of making a healthy baby.  This process for genetic testing is known as comprehensive chromosome screening (CCS). The chromosome screening helps identify embryos with the wrong DNA manual.

This helps rule out embryos that could cause a miscarriage or a baby affected by a genetic syndrome. Embryos are tested after they are 5 or 6 days old and reach a stage of development known as a blastocyst. Using PGT-A and CCS, your doctor will be able to hand-pick chromosomally healthy embryos. This lowers the risks of miscarriages leading to successful pregnancies over a shorter period of time.

Most whole chromosome problems in embryos come from early egg cell divisions known as meiosis. By only transferring embryos that have the right chromosomes (DNA instruction set) with a good chance of making a normal baby, the costs of IVF overall are reduced and the time to achieve a successful pregnancy leading to the birth of a healthy baby is minimized.

Problems encountered by couples facing secondary infertility

As a couple, you often have the chance to decide the number of children you want in your family. Most people do not realize the distress, anger, and frustration that is brought about by secondary infertility.

There are also instances of guilt when a couple is unable to give their child or children other siblings. Your friends or family members might have the assumption that you do not want to have other children.

They may start probing on when you plan on having another baby. This unwanted questioning from your friends and family can be hurtful and unhelpful. When you want to expand your family and you cannot, you may suffer from instances of depression.

What is IVF?

IVF is a kind of assisted reproduction technique that involves the use of advanced laboratory technology. The egg and sperm are fertilized outside the female body, also known as in-vitro technology.

The doctor and their team of scientists assess and compare the embryos formed in the IVF laboratory. The doctor then picks the best and most reliable of a couple’s embryos and then replaces them through the natural opening of her cervical canal, into her uterus, or womb.

If other healthy embryos are suitable these can be frozen, and genetically tested. Frozen embryos can be warmed and transferred back at a future time to make a baby. With the help of IVF, many couples suffering from both primary and secondary infertility can grow healthy families.

Who benefits from IVF?

IVF is beneficial to many couples who are struggling with infertility issues. These fertility issues might be as a result of:

• Fallopian tube blockage or absence of fallopian tubes due to surgical procedures after ectopic pregnancy
• Women facing sub-fertility problems such as endometriosis
• Women of age 35 years and above struggling with secondary infertility
• Men having problems with sperm production or function
• Men with problems having sex
• Men who have had a vasectomy or failed vasectomy reversal procedure

Besides IVF, other treatments for secondary infertility include ovulation induction and intrauterine insemination (IUI). This procedure involves evaluating, washing, optimizing, and inserting a man’s sperm directly into the womb of a woman during ovulation.

Myths surrounding secondary infertility

• The man cannot be the problem: Both men and women are equally at risk of having secondary infertility problems
• Age is not a big issue; this is undoubtedly a big myth. Many women who are 35 years or older struggle to conceive
• Being overweight does not affect infertility: This is also a huge myth. Weight problems bring about fertility problems for both men and women
• The fact that you have had children earlier does not qualify you to have secondary infertility problems. Secondary infertility can occur in anyone at any time. Although many couples have completed their families by the time this happens, secondary infertility affects every couple with the eventual passage of time.

If you would like to learn more about secondary infertility, check out our Women’s Health Melbourne Podcast Knocked Up, or reach out to contact a fertility expert at our  Women’s Health Melbourne clinic.

About The Author:

I am Alessia Martin and I have a passion for writing interesting and informative pieces. I write content for a wide range of topics and I just want to share my knowledge with the online community and learn more.