What is secondary infertility?

We speak of secondary infertility when pregnancy is not achieved or miscarriage occurs after having had a previous pregnancy. The difference from primary infertility is that the second pregnancy has never been achieved. It is estimated that it can occur in 60 percent of infertile cases.

Secondary infertility is a couple or ladies who have been pregnant before – whether that pregnancy resulted in a live birth or it end up in a miscarriage and they are struggling to conceive again. It is almost as common as primary infertility, which is that you have never been pregnant before – which is, actually, approximately accounts to one in ten to two in ten. However, that might increase a little bit percentage-wise as ladies get a little bit older.
There is some good news about secondary infertility, and some obviously bad news about secondary infertility. The bad news is that ladies are not getting pregnant so, there must be a reason why they are not getting pregnant. The relatively good news, that we know that these ladies have been pregnant before, so we know that some of their eggs have been fertilized before. We know that some of those embryos have implanted in the uterus before but we have to start investigating the reasons. There’s lots of overlap between the investigations of primary infertility and the secondary infertility because although we are defining them when it comes to the ladies, it might still be coming back from a male factor. So, the investigation will include investigating starting by: investigating the sperm – like a semen analysis, investigating the ladies for the uterus and the tubes – to check if there’s any secondary cause for blocking the tube like an infection, for example, checking ovarian reserve, checking other hormonal profile – like thyroid issues and so on, to see if any of the causes can be reversible, specifically that we know that these days have not did not have fertility problems before and if they are lucky to have a reversible cause – like a thyroid issue, then by correcting thyroid profile or thyroid hormones – this might help them in conceiving naturally.

Infertility in women there are two types of infertility or sub- With fertility for women there are two types of fertility, or sub fertility as we like to call it. One is primary where a woman has never conceived, has never been pregnant and the other one is secondary meaning you may have had a pregnancy that may have led to a miscarriage or a successful live birth and after having one child you are trying to conceive and unable to do so again. So there are two different types, classified into two subsections. When we talk about primary infertility, when do we classify it as infertility or when do we think that a couple should come and get some help.

Secondary infertility is definitely less common than primary infertility but it could happen because since their child or the last pregnancy, there has been a change in the health of either of the partners and all the reasons which can contribute to primary subfertility can also contribute to secondary subfertility.

Secondary infertility refers to a situation where a couple have previously conceived a pregnancy, perhaps even had a baby and then they find it difficult to conceive a second or third pregnancy. This is different from primary infertility where they’ve never previously been pregnant together.

Secondary infertility means that the woman has been able to conceive before, regardless of the outcome of the pregnancy. So, for example, if a woman has a baby and after that, she isn’t able to achieve pregnancy, this is secondary infertility. Also if the woman had a miscarriage, which is a confirmed miscarriage – a woman who had a previous termination of pregnancy, or a woman who had an ectopic pregnancy; these are the women who had achieved pregnancy once or twice then struggle to get pregnant after that.

So this in general gives me some reassurance that she has ovulated before, she has open or patent fallopian tubes and her partner has a good sperm count. The same applies with the gentlemen, if he has fathered a child before; that gives me some reassurance that he has been able to achieve that, and then after that secondary infertility happens.

In terms of the outcome of secondary infertility, it’s different here. Because if you know that a woman had an ectopic pregnancy and one tube has been removed, subsequently, that could be the cause of delay because she has one tube less. Also, if she had a significant infection after childbirth or after miscarriage, that can contribute to a delay in achieving pregnancy. Sometimes we cannot find the cause and we call it unexplained delay. The couple will need some reassurance, some test and hopefully, we’ll be able to help them to achieve pregnancy