Some studies suggest that secondary infertility may be even more common than primary infertility.

Most of the time people think of infertility as the inability to conceive at all. However, couples who have previously had children can have trouble with conception too. Secondary infertility is the inability to get pregnant when conception has been successful in the past.

Dealing with secondary infertility is difficult.

Getting pregnant in the past may have been very easy, so it is difficult to understand and come to terms with the fact that it’s not happening this time around. Furthermore, couples may feel guilty for wanting more children when they probably have many friends or family members who are struggling with primary infertility. Couples also often feel pressured or guilty about not being able to provide a sibling for their current child.

Secondary infertility typically is usually caused by advancing maternal age or a new medical problem that has developed since the last pregnancy. Sometimes, one partner has had children before while the other partner has not. While this may suggest a problem in the partner who has never conceived, this is not always the case. This explains why both partners should always be evaluated.

For women, secondary infertility can stem from

• new problems with ovulation
• worsening of endometriosis leading to new scar tissue or blocked fallopian tubes
• new polyps or fibroids in the uterus
• most commonly, the problem is simply that time has passed and it becomes more difficult to conceive with age

For men, secondary infertility can result from

• development or progression of a varicocele (dilated blood vessels in the scrotum)
• pituitary issues resulting in a lack of FSH production; usually accompanied by a low testosterone level
• testicular failure (a rare finding)
• new medical problems like high blood pressure, diabetes or weight gain

Getting an evaluation for secondary infertility is just as important as for primary infertility. Continuing to try to conceive without an evaluation after 6-12 months could be wasting valuable time. The evaluation for secondary infertility is the same as the evaluation for primary. We need to evaluate the uterus, hormone levels, fallopian tubes and semen analysis. Treatment of secondary infertility is successful in most cases!

If you have any questions, please contact our San Antonio fertility center.