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Secondary Infertility: It’s More Common than You Think


#DYK you can be infertile, even if you’ve had a child? Many couples who had an easy time conceiving their first or even second child may find it hard to conceive another one. Secondary infertility is defined as the inability to get pregnant and carry a child to term following the birth of one or more biological children who were conceived without assisted reproductive technology, according to RESOLVE, the National Infertility Association. It is diagnosed when women under 35 have been trying to get pregnant for a year without success, or over 35 and have been trying for six months.

Many more people have this fertility problem than you might think. In fact, RESOLVE states that secondary infertility accounts for 30 percent of infertility cases. What are the causes, and what can you do?

Causes of Secondary Infertility

One of the most common reasons for secondary infertility is the woman’s age. It’s much easier to get pregnant when you’re in your 20s or early 30s than it is in your late 30s or early 40s. A woman’s fertility starts declining slowly in her 20s and then the decline accelerates around age 35. This is mostly caused by decreasing quality and quantity of her eggs, which makes it harder to get pregnant and increases the chance of miscarriage.

A man’s fertility doesn’t decline at the same rate as a woman’s, but he still may have changes due to age, disease or lifestyle factors which affect his sperm production. Medications and some health conditions like diabetes may harm the quality and quantity of his sperm, which can contribute to secondary infertility.

Lifestyle factors can affect both men’s and women’s fertility. Cigarette smoking has been proven to significantly harm fertility in both men and women. Smoking also makes the chances of having a miscarriage higher. Weight gain also has negative effects on a woman’s ability to get pregnant. Obesity can affect your hormone levels and is associated with PCOS, polycystic ovary syndrome, although it’s not clear if the weight gain causes PCOS or PCOS causes weight gain. In men, weight gain can cause them to have increased estrogen and can harm sperm production.

Treatment of Secondary Infertility

It can be heartbreaking to want another child and not be able to get pregnant. Sometimes friends and family are not too sympathetic because you already have a child. What can you do if you’re struggling with secondary infertility? It’s important to consult a reproductive endocrinologist and find out what your options are. Your fertility specialist can test both partners of a male-female couple and determine which fertility treatments are most likely to help you have a child. Options range from Clomid to increase egg production and IUI, intrauterine insemination, to IVF with your own eggs or donor eggs.

In some cases testing won’t reveal a clear cause for secondary infertility. If there is not, your fertility specialist can recommend a course of action. IVF is often the most successful treatment option.

It may help, and it certainly can’t hurt, to make healthier lifestyle choices. Stop smoking (both of you!), lose some weight if you’re overweight, eat a healthy diet, and stay away from drugs and too much alcohol.

And be kind to yourself and the child or children you have. It’s normal to grieve the loss of the child you haven’t had. Try to reassure your existing child that you are a complete family and that any sadness you feel is not their fault. You can decide if you want to pursue fertility treatment and if you are able to afford the time and money commitment involved. You have options to help you add to your family. But it’s important to remember that families come in all sizes, and you have to choose what’s best for you.