Nothing can cause a more emotive response from a parent than something related to their children. The inability to have children can be heartbreaking, even if you already have one child. The pain that you can experience from not being able to have a second one is just as powerful. Secondary infertility is the name given to this scenario. It is where you are unable to conceive or carry a baby to term for a second time after, i.e., after having a previous successful pregnancy. This form of infertility is very similar to other types of infertility and can be due to either the man or the woman. The good news is that there are treatments available to help you have that second baby.     

What are the Causes of Secondary Infertility

Secondary infertility is a problem that is attributed to either partner or both. Approximately a third of these cases stem from women and another third from the man. The final third is an issue that is due to a combination of factors. Many things can affect the fertility of men and women after already conceiving a child. Here are a few of them:

• Age – Women over 35 years old may have issues with the quality and quantity of their eggs. Women are born with a finite supply of eggs. So the older you are, the fewer eggs you have left.
• The fallopian tubes, which carry the egg from the ovary to the uterus, can become damaged.
• Endometriosis – a condition where the lining of the womb grows in the wrong place.
• Reduced or impaired sperm count.
• Uterine problems, such as scarring of the uterus. 
• Polycystic ovary syndrome, which impairs the ovaries.
• Obesity or too much weight gain.
• Certain lifestyle choices, like too much alcohol and smoking. 
• Medications.
• A low testosterone level
• Diabetes
• Tumors
• Urinary tract infections

There are so many causes that can affect fertility, and secondary infertility may well have an unexplained causation. Approximately 20% of cases are unexplained. 

What to do if you Suspect Secondary Infertility?

As soon as you begin to suspect that you have a secondary fertility issue, then you need to get in touch with a health care provider. Early intervention is the best to resolve the issue. So, schedule a secondary infertility examination with either a urologist, a woman’s health provider, or a reproductive endocrinologist. The sooner you book the appointment, the sooner you will get your results. Once your secondary infertility issue has been highlighted then, you can begin the right treatment. 

As part of your examination, your doctor will go through all your medical notes to discover whether or not something has changed since the last time you were pregnant. You will be questioned about your periods and how regular, heavy, etc., they are. It is important to know if you are ovulating and producing eggs still. Men will need to disclose if they have a history of conditions such as cancer, thyroid disease, or any other age-related issues. All of these can affect sperm production and its quality.

It may be necessary to do other tests, so you will have this discussion with your doctor. In some cases, an X-ray of the uterus is necessary. This is called a hysterosalpingogram and is used to determine if there are any abnormalities or scarring. The semen will likely be analyzed too. 

What Treatments are Available for Secondary Infertility?

Most of the treatments for secondary infertility are the same as primary infertility. Here is a list of some of the treatments available:

• Medication – this is sought to help women ovulate if they have an ovulatory disorder, for example. Drugs include letrozole and clomiphene. 
• Supplements – things like anti-aging pills or anti-oxidants are great at increasing fertility in men. Anti-oxidants reduce free radicals in the body – free radicals are unstable molecules that lead to illnesses like cancer. By reducing things like free radicals, sperm quality is increased.  
• Surgery – often, surgery is conducted to fix uterine problems. The surgeons will conduct structural issues like removing polyps, fibroids, and scar tissue. Surgery can also be used to fix things like testicular varicocele.
• IUI, intrauterine insemination – this is where sperm is surgically placed into the uterus.
• IVF, in vitro fertilization – this is where you are given daily injections designed to stimulator your ovaries; there is a procedure to retrieve your eggs; in a lab, your eggs will go through a fertilization procedure to produce embryos, then the embryos will be grown, and eventually transferred tot he uterus.